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Introduction

Origin,causes and treatments of gastroenteritis using a case study Lower gastrointestinal infections Case history 'Bertrand, a 35 year old Frenchman with nausea,abdominal pain and diarrhoea' Gastroenteritis is a non-specific term used to describe a condition that causes irritation and inflammation of the stomach and intestines in which there is a combination of nausea, vomiting, diarrhoea and abdominal pain.3The gastrointestinal tract contain natural defences which include, gastric acid, bile salts, normal bowel flora, immune responces,motility and protection against toxins by the action of the liver. These influence the nature of local flora and of pathogens that may invade 5. It used to be known as winter vomiting disease1.Micro organisms responsible for gastrointestinal infections vary from one geographic area to another and it depends on the level of sanitation, economic development and hygiene standards. In developing countries it is a major cause of death in children and it is estimated that 4 million children under 5 die from this every year. Usually do to bacteria or parasite contaminating crops and water. In the UK it is estimated that 1 in 5 people will get gastroenteritis and it is usually due to food poisoning. Most cases clear up itself within a week. Severe infections are uncommon in the UK and epidemiology studies have generally noted that rotavirus induced infections peak in the winter and in the summer, bacteria infections are more common. ...read more.

Middle

� Loss of appetite (older children) � Fever, headache and rigors seen in shigellosis and salmonellosis where intestinal mucosa is involved � Tummy ache � Lethargy � Drowsiness If the child is dehydrated you may notice a dry mouth, sunken eyes with no tears and/or a sunken fontanelle (the gap in a baby's skull). Babies may also pass little or no urine. 2 Diagnosis The diagnosis of gastroenteritis is usually made on the basis of clinical symptoms and signs.Physical Examination and culture of a stool sample may be necessary to determine the cause.4 Investigations Examinations performed; � Check temperature, blood pressure, and heart and and respiratory rates. � Assess for abdominal tenderness. � Assess for features of dehydration. Investigate potential causes or contributing factors by asking about: � Recent contact with someone with acute diarrhoea and/or vomiting. � Exposure to a known source of enteric infection (possibly contaminated water or food). � Recent travel abroad (may suggest E. coli or parasite infection from something eaten or drunk). � Recent antibiotics hospital admission within the last 8 weeks - suspect infection with Clostridium difficile Use of proton pump inhibitors (reduction in stomach acid reduces resistance to infective organisms). Exposure to poisons or irritants (swimming in contaminated water or drinking from suspicious fresh water eg mountain streams or wells -Giardia).8 Diet changes and food preparation habits and storage - undercooked, salads improperly stored and prepared food eg potato Perform stool microbial investigations if b****y and/or mucoid diarrhoea, and if immunocompromised. ...read more.

Conclusion

diarrhoea (happened early in the morning and getting worse) Differentiate between food poisoning and travellers diarrhoea. Since he visited Bordeaux a month ago it is highly unlikely that he will show the symptoms now since most micro organisms incubation period is between hrs to days. Next find out about the diarrhoea is it an infectious cause or a non-infectious cause. Find out if he`s sensitive to gluten or if he has crohns disease or irritable bowel syndrome.Are they on any mediaction eg.antibiotics as this is a common side effect. Find out the urgency of the case so is there dysentry, can they keep liquid down,is the pain unbearable. Refer to the hospital immediately. Looking at all of his symptoms and the fact that he went out for lunch on friday we can assume that the cause is infectious and he probably has acute watery diarrhoea casued by acute gastroenteritis. What will the pharmacist advice? hands should be washed thoroughly before handling food and after using the toilet towels and flannels should not be shared he should drink (should be supplemented with fruit juices and soups)lots of fluids avoid dairy products, fatty and spicy food;small light foods should be eaten instead Avoid work until he is at least 48 hours free from diarrhoea and vomiting if symptoms persist after 72 hours consult your GP. Treatment Ask if they are allergic to anything and what medication they are on before giving anything. ...read more.

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