ACUTE GASTRO-ENTERITIS (AGE), TYPES, EPIDEMIOLOGICAL TRIAD, MODE OF TRANSMISSION, CONTROL MEASURES, ORS THERAPY, ResMol, Assessment of dehydration, IV, MAINTAINANCE THERAPY, foods to eat and to avoid, APPROPRIATE FEEDING, CHEMOTHERAPY, ZINC SUPPLEMENTATION, better MCH care, preventive strategies & ends with questions on this topic.

1. Acute Gastro-
Enteritis
Dr. Sunayana Kumthekar
Asst. Prof.

2. Acute Gastro Enteritis
Def
Recent change in
consistency n character of
stools nd passage for
>3times a day.

3. Clinical types
1.Acute watery diarrhoea
2.Acute bloody diarrhoea
3.Persistent diar.
4.Diarrhoea wth severe
malnutrition

4. Epidemiology
•Agent-
1. Virus- Rotavirus
Very high conc- >1012
particles/gm
2. Bact- Enterotoxigenic, Shigella,
Campylobacter jejuni, salmonella,
EPEC.
3.Protozoan- Cryptosporidium

5. • Host
6months-2yrs
High incidence in 6-11months
Cow fed > Breast fed
• Environment
Bacterial= Warm / rainy season
Viral= Winter

6. •Mode of transmission
Feaco-oral route

7. Control
1.Short term- Appropriate clinical
Mx
2.Long term-
a)Better MCH care
b)Preventive strategies
c)Preventing diarrhoeal epidemics

8. Appropriate clinical Mx
1.ORT
2. IV
3.Maintenance therapy
4.Appropriate feeding
5.Chemotherapy
6.Zn supplementation

9. Oral Rehydration Salt
(ORS)
• WHO recommendation
Trisod citrate in place of Sob
bicarbonate
• More stable
• Less stool output
• As Trisod Citrate Increases intestinal
absorption of sod n water.

10. Reduced osmolarity ORS
• Glucose anhydrous- 13.5
• Tri Sodium citrate - 2.9
• Sodium Chloride- 2.6
• Potassium chloride- 1.5
Total= 20.5gms/lt

11. Reduced osmolarity ORS
• Glucose- 75
• Sodium- 75
• Chloride- 65
• Potassium- 20
• Citrate- 10
Total= 245mmol/lt

12. Decreased Na to 75mmol/lt
•Stool output reduced by 20%
•Vomiting reduced by 30%
•IV need by 33%
•Kolkata, 90-95% pt treated
alone with ORS

13. Assessment of Dehydration
1. Pt appearnce
2. Radial pulse
3. Blood pressure
4. Skin elasticity
5. Tongue
6. Ant. Fontanelle
7. Urine flow
8. %body wt loss
9. Estimated fluid loss

14. •When obvious
dehydration exist, bet 50-
100ml fluid loss,
1st 4hrs = 75ml/kg

15. < 2yrs= teaspoon every 1-2min
Older= cup
Over a period of 4hrs,
<2hrs= 50-100ml (¼-1/2 cup)
2-10yrs= 100-200ml (½- 1 cup)
Older n adults= As much as they
want

16. If child vomits ???
Breast fed child ???
Soln should use within what
duration???
Home made ORS ???

17. 1

18. Food
• Rice water
• Unsalted soup
• Yoghurt drinks
• Green coconut water
• Weak tea
Add SALT 3gm/lt

19. Avoid
•Commercial fruit juices
•Carbonated drinks
•Sweetened tea
•Coffee
•Medicinal tea etc

20. Intravenous Rehydration
1.Ringer lactate soln / Hartmann’s
soln for inj. ---Best
2. Diarhhoea Treatment Solution
(DTS)-
3. NS
Never use- Plain glucose, Dextrose

21. Recommended dose of IV
fluid
100ml/kg
Age
1st give
30ml/kg
Then give
70ml/kg
Infant
(<12months)
1hr 5hr
older 30min 2 1/2hr

22. ZN supplementation
<6months = 1/2tab= 10mg
>6months = 1 tab = 20mg
OD for 14days

23. Better MCH Care
1.Maternal Nutrition
2.Child Nutrition
a.Promotion of breastfeeding
b.Appropriate complementary
feeding
c. Supplementary feeding
d.Vit A supplementation

24. Preventive Strategies
1.Sanitation
2.Health Education
3.Immunization
-Rotavirus Vaccine
2.5ml orally
4. Fly control

25. Questions
• Def
• Types
• Grades of dehydration
• Treatment of dehydration a/c to grade
• Content of ORS
• Resmol
• Zn tab doses
• Prevetion