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Gastroenteritis
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UNIVERSIDAD TECNICA DE MACHALA
ACADEMIC UNIT OF CHEMICAL
SCIENCES AND HEALTH
MEDICINE SCHOOL
ENGLISH
GASTROENTERITIS
STUDENTS
William Cruz
Kevin Herrera
TEACHER:
Mgs. Barreto Huilcapi Lina Maribel
CLASS:
EIGHTH SEMESTER ‘’A’’
Machala, El Oro
2018
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Gastroenteritis
Definition
Gastroenteritis is inflammation of the stomach and intestines. The most frequent
causes are:
Virus.
Food or water contaminated with bacteria or parasites.
Reaction to a new food. Young children may have signs and symptoms for
this reason. Babies who breastfeed may react to a change in the mother's diet.
Side effect of medications.
Etiology
Gastroenteritis can be caused by three types of microorganisms: viruses, parasites and
bacteria. These organisms, present in the feces of an infected person, can contaminate
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food and drinks, as well as other objects (cutlery, dishes and other utensils), and are
transmitted when a person comes in contact with them. They can also be transmitted
from one person to another by direct contact. The risk groups most vulnerable to this
disease are children, the elderly and people with a weak immune system.
The most common viruses that cause gastroenteritis are:
Rotavirus: Rotavirus is the main cause of acute gastroenteritis in children, although it
can also infect adults.
Norovirus: It affects people of all ages, but its spread is very common among school-
age children.
Enteric adenovirus: Adenoviruses are the cause of a large proportion of cases of
gastroenteritis in young children and represent the second most common viral agent
causing diarrhea after rotavirus.
Astrovirus: They are recognized as another of the most common viral agents of
gastroenteritis in children worldwide. Initially they were associated with outbreaks of
diarrhea in children in maternity units.
Signs and symptoms
The main symptom of GEA is diarrhea with the appearance of stools of lesser
consistency and / or greater number, which may contain mucus and / or blood. Other
symptoms that may appear are: nausea, vomiting, colicky abdominal pain and fever.
In general it is a self-limiting process that usually resolves in a period of about 3 to 5
days (no more than 2 weeks), although sometimes it can be prolonged in time as a
consequence of the development of a lactose intolerance or a sensitization to the
proteins of cow's milk. The most important complication of the GEA is the
dehydration, being more frequent in infants due to its larger body surface area, higher
proportion of fluid (mainly extracellular), higher metabolic rate and its inability to
request water. According to the sodium levels, we can classify the
Dehydration in:
- Isonatremic (Na: 130-150 mEq / L): the most frequent in our environment (> 80%).
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- Hypernatraemic (Na> 150 mEq / L): neurological symptoms with lower
hypovolaemia due to intracellular dehydration.
- Hyponatremic (Na <130 mEq / l): greater risk of shock.
To assess the degree of dehydration, the most useful data would be the determination
of the percentage of weight loss. But as in most cases we do not know the previous
weight of the child, there are several scales that are based on clinical and physical
examination to classify the degree of dehydration according to the percentage of the
deficit.
Diagnosis
To diagnose the possible presence and typology of viruses that may be causing
gastroenteritis, a stool test is performed, although this is not usually the case.
Although this pathology is not fatal by itself, the dehydration it produces, if not
enough liquid is ingested, can cause death; this is why normally the specialist will
look for signs of dehydration, such as:
Dry mouth.
Dark yellow urine.
Hollow eyes.
Arterial hypotension.
Sunken spots on the head (in the case of babies).
Confusion.
Vertigo.
The normal thing is that the gastroenteritis disappears in a few days without the need
to follow any treatment. However, it is very important to see the specialist if
symptoms of dehydration occur.
Treatment
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The bases for the treatment of the GEA have recently been reviewed by the European
Society of Gastroenterology, Hepatology and Pediatric Nutrition (ESPGHAN) in
2008:
- Use of oral rehydration solutions to correct dehydration.
- Use of a hypotonic solution (60 mmol / l of sodium and 74-111 mmol / l of
glucose).
- Rapid oral rehydration: 3-4 hours.
- Precocious feedback, restarting a diet suitable for age, without restrictions, as soon
as dehydration is corrected.
- Maintenance of breastfeeding.
- In case of formula feeding, dilution or the use of special formulas (without lactose,
hydrolysates) is not recommended.
- Supplementation with oral rehydration solution for losses sustained due to diarrhea.
- Not performing laboratory tests or applying unnecessary medications.
Oral rehydration solutions (ORS) are the treatment of choice to replace water and
electrolyte losses caused by diarrhea in children with mild or moderate dehydration.
This is thanks to the fact that they have proven to be a safe, fast, inexpensive, non-
aggressive method that allows for the collaboration of family members.
Prevention
Specialists recommend taking precautions with products made with sauces that
contain egg. This food can have salmonella, that reproduces quickly if it spends a lot
of time from the moment of the elaboration until its consumption. This is what often
happens in banquets or celebrations in which many people participate. The food is
prepared with time and can occur cases of bulky poisoning. This same phenomenon
occurs with fish and shellfish that are eaten raw.
You must also take special care with the ice cream that is sold in mobile kiosks and
prepared by hand, since sometimes there is no guarantee that they are in good
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condition. Many of them are made with milk and this food also spoils more easily in
summer.
Much of the summer gastroenteritis, the period of excellence of the disease, is due to
the ingestion of untreated water. When traveling to places where water is drunk from
wells or sources, it is recommended that the water used to drink or clean foods that
are not to be cooked be boiled or sterilized with bleach (one drop of bleach per liter of
water)".
Bibliography
King CK, Glass R, Bresee JS, Duggan C. Managing acute gastroenteritis
among children: oral rehydration, maintenance, and nutritional therapy.
MMWR Recomm Rep 2003; 52: 1-16.
Gavin N, Merrick N, Davidson B. Efficacy of glucose-based oral rehydration
therapy. Pediatrics 1996; 98; 45-51.
Freedman SB, Adler M, Seshadri R, Powell EC. Oral ondansetron for
gastroenteritis in a pediatric emergency. N Engl J Med 2006; 354: 1698-705.