ما هى اعراض وعلاج النزلة المعوية عند الاطفال

Pediatrics
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ما هى اعراض وعلاج النزلة المعوية عند الاطفال

مشاركةبواسطة دكتور كمال سيد » الجمعة يونيو 13, 2014 12:33 pm

اعراض النزلة المعوية عند الاطفال ,علاج النزلة المعوية .




النزلات المعوية الحادة هي أكثر الأمراض شيوعا في الأطفال على مستوى العالم .

أكثر من خمسة ملايين طفل يموتون سنويا من مضاعفات النزلات المعوية .

أعراض النزلات المعوية :

إسهال مصحوب بارتفاع في درجة الحرارة و قيء ، ويمكن أن يحدث الإسهال بدونهما .

هناك ثلاث درجات لخطورة النزلات المعوية :

1- النزلات المعوية البسيطة .
2- النزلات المعوية المتوسطة.
3- النزلات المعوية الخطيرة .


أسباب و أنواع النزلات المعوية في الأطفال :

1- النزلات المعوية البكتيرية :

واعراضها ..ارتفاع في درجة الحررارة أكثر من ( 38.5 c ) مصحوب بإسهال شديد أو إسهال دموي
و يتم تشخيصها بالآتي :
- مزرعة براز لمعرفة نوع البكتيريا المسببة .
- زيادة عدد كرات الدم البيضاء .
- زيادة معدل CRP .

2- النزلات المعوية الفيروسية :

و أعراضها : ارتفاع طفيف في درجة الحرارة أقل من ( 38.5 c ) مصحوبة بإسهال مائي متوسط .
و عادة تحدث مع :
- التهاب بالجهاز التنفسي .
- في فصل الشتاء .
- إصابة أكثر من فرد في الأسرة .
و السبب الرئيسي لها فيروس الروتا ( Rota virus ) .

3- النزلات المعوية الطفيلية :

و أعراضها : - تختلف من طفيل لآخر و أكثرها شيوعاً :
- طفيل الجيارديا ( Giardia )... ( إسهال مائي بسيط ذو رائحة كريهة و غير مصحوب بحرارة ، لمدة تصل إلى عشرة أيام ) .
- طفيل الأمبيا ( Amoebiasis )... ( إسهال دموي بدون حرارة ).


مضاعفات النزلات المعوية :

1- الجفاف .
2- الفشل الكلوي الحاد .
3- قصور الدورة الدموية .
4- التشنجات .
5- الغيبوبة .
6- النزيف الدموي .
7- الانسداد المعوي .
8- سوء التغذية .
9- نقص المناعة .

علاج النزلات المعوية :

1- تعويض السوائل المفقودة: إما عن طريق الفم ( محلول الجفاف ) ، و إما عن طريق إعطاء السوائل عن طريق الأوردة .

2- علاج المسبب البكتيري بالمضادات الحيوية .

3- علاج مضاعفاتها .

الوقاية من النزلات المعوية :

1- الرضاعة الطبيعية .
2- استخدام الأسلوب الأمثل في تغذية الطفل .
3- تجنب الأمراض المعدية سواء البكتيرية أو الفيروسية .
4- إعطاء الطفل تطعيم الروتا و المضادات لفيروس الروتا .
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Re: ما هى اعراض وعلاج النزلة المعوية عند الاطفال

مشاركةبواسطة دكتور كمال سيد » الجمعة يونيو 13, 2014 1:27 pm

Gastroenteritis
(Stomach Flu)


Overview

Gastroenteritis is a condition that causes irritation and inflammation of the stomach and intestines (the gastrointestinal tract).

The most common symptoms of gastroenteritis are

diarrhea,
nausea, and
crampy abdominal pain,
vomiting.
Many people also refer to gastroenteritis as "stomach flu." This can sometimes be confusing because influenza (flu) symptoms include

headache,
muscle aches and pains, and
respiratory symptoms, but influenza does not involve the gastrointestinal tract.
The term stomach flu presumes a viral infection, even though there may be other causes of infection.

Viral infections are the most common cause of gastroenteritis; but bacteria, parasites, and food-borne illnesses (such as from shellfish that has been contaminated by sewage or from eating raw or undercooked shellfish from contaminated water) can also be the offending agents. Many people who experience vomiting and diarrhea that develops from these types of infections or irritations think they have "food poisoning," when they actually may have a food-borne illness.

Travelers to foreign countries may experience "traveler's diarrhea" from contaminated food and unclean water.

The severity of infectious gastroenteritis depends on the immune system's ability to resist the infection. Electrolytes (these include essential elements of sodium and potassium) may be lost as the affected individual vomits and experiences diarrhea.

Most people recover easily from a short episode of vomiting and diarrhea by drinking fluids and gradually progressing to a normal diet. But for others, such as infants and the elderly, the loss of bodily fluid with gastroenteritis can cause dehydration, which is a life-threatening illness unless the condition is treated and fluids are restored.

The most recent data from the CDC, show that deaths from gastroenteritis have increased dramatically. In 2007, 17,000 people died from gastroenteritis, overwhelmingly, these people were older and the most common infections were Clostridium difficile and norovirus.


Gastroenteritis Causes

Gastroenteritis has many causes. Viruses and bacteria are the most common.

Viruses and bacteria are very contagious and can spread through the consumption contaminated food or water. In up to 50% of diarrheal outbreaks, no specific agent is found. The infection can spread from person to person because of improper handwashing following a bowel movement or handling a soiled diaper.

Gastroenteritis caused by viruses may last one to two days. However, some bacterial cases can continue for a longer period of time.

Medically Reviewed by a Doctor on 2/15/2013
Medical Author:
Benjamin Wedro, MD, FACEP, FAAEM
Medical Editor:
Melissa Conrad Stöppler, MD, Chief Medical Editor

http://www.emedicinehealth.com/gastroen ... cle_em.htm


(Viruses (Norovirus, Rotavirus, Adenoviruses, Parvoviruses, and Astroviruses

Norovirus -
Fifty to seventy percent of cases of gastroenteritis in adults are caused by noroviruses (genus Norovirus, family Caliciviridae).
This virus is highly contagious and spreads rapidly.
Norovirus is the most common cause of gastroenteritis in the United States.

Rotavirus -
According to the CDC, "Rotavirus was also the leading cause of severe diarrhea in U.S. infants and young children before rotavirus vaccine was introduced for 2006. Prior to that, almost all children in the United States were infected with rotavirus before their 5th birthday.

Other viruses that cause gastrointestinal symptoms include:

Adenoviruses -
This virus most commonly causes respiratory illness; however, other illnesses may be caused by adenoviruses such as gastroenteritis, bladder infections, and rash illnesses.

Parvoviruses -
The human bocavirus (HBoV), which can cause gastroenteritis belongs to the family Parvoviridae.

Astroviruses -
Astrovirus infection is the third most frequent cause of gastroenteritis in infants.



(Bacteria (Clostridium difficile, Salmonella, Shigella, and Campylobacter, E coli

Bacteria may cause gastroenteritis directly by infecting the lining of the stomach and intestine. Some bacteria such as Staphylococcus aureus produce a toxin that is the cause of the symptoms. Staph is a common type of food poisoning.

Escherichia coli infection can cause significant complications. E. coli</i> O157:H7 (one type of the bacteria) can cause complications in approximately 10% of affected individuals (for example, kidney failure in children [hemolytic-uremic syndrome or HUS), bloody diarrhea, and thrombotic thrombocytopenic purpura (TTP) in the elderly.

Salmonella, Shigella and Campylobacter

Salmonella, Shigella and Campylobacter are also common causes of illness.

Salmonella is contracted by ingesting the bacteria in contaminated food or water, and by handling poultry or reptiles such as turtles that carry the germs.

Campylobacter occurs by the consumption of raw or undercooked poultry meat and cross-contamination with other foods. Infants may acquire the infection by contact with poultry packages in shopping carts. Campylobacter is also associated with unpasteurized milk or contaminated water. The infection can be spread to humans by contact with infected stool of an ill pet (for example, cats or dogs). It is generally not passed from human to human.

Shigella bacteria generally spreads from an infected person to another person. Shigella are present in diarrheal stools of infected individuals while they are ill, and for up to one to two weeks after contracting the infection. Shigella infection also may be contracted by eating contaminated food, drinking contaminated water, or swimming or playing in contaminated water (for example, wading pools, shallow play fountains). Shigella can also spread among men who have sex with men.

Clostridium difficile

Clostridium difficile (C difficile) bacteria may overgrow in the large intestine after a person has been on antibiotics for an infection. The most common antibiotics that pose a potential risk for C difficile include:
clindamycin (for example, Cleocin),
fluoroquinolones (for example, levofloxacin [Levaquin], ciprofloxacin [Cipro, Cirpo XR, Proquin XR]),
penicillins, and
cephalosporins.
Other risk factors for C difficile infection are hospitalization, individuals 65 years of age or older, and existing chronic medical conditions.

The CDC lists C. Difficile</i> as one of the most common causes of death due to gastroenteritis and suggest that new strains of the bacteria have become more aggressive and dangerious.

http://www.emedicinehealth.com/gastroen ... ge3_em.htm
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Re: ما هى اعراض وعلاج النزلة المعوية عند الاطفال

مشاركةبواسطة دكتور كمال سيد » الجمعة يونيو 13, 2014 1:36 pm

gastroenteritis contd

(Parasites and Protozoans (Giardia, Cryptosporidium

These tiny organisms are less frequently responsible for intestinal irritation. A person may become infected by one of these by drinking contaminated water. Swimming pools are common places to come in contact with these parasites. Common parasites include

Giardia is the most frequent cause of waterborne diarrhea, causing giardiasis. Often, people become infected after swallowing water that has been contaminated by animal feces (poop). This may occur by drinking infected water from river or lakes but giardia may also be found in swimming pools, wells and cisterns.
Cryptosporidium (Crypto) is a parasite that lives in the intestine of affected individuals or animals. The infected individual or animal sheds the Cryptosporidium parasite in the stool. Crypto may also be found in food, water, soil, or contaminated surfaces (swallowing contaminated water, beverages, uncooked food, unwashed fruits and vegetables, touching contaminated surfaces such as bathroom fixtures, toys, diaper pails, changing tables, changing diapers, caring for an infected individual or handling an infected cow or calf). Those at risk for serious disease are individuals with weakened immune systems.

Other Common Causes of Gastroenteritis

Gastroenteritis that is not contagious to others can be caused by chemical toxins, most often found in seafood, food allergies, heavy metals, antibiotics, and other medications.


Gastroenteritis Symptoms

By definition, gastroenteritis affects both the stomach and the intestines, resulting in vomiting and diarrhea.

Common gastroenteritis symptoms

(Low grade fever to 100 F (37.7 C
Nausea with or without vomiting
Mild-to-moderate diarrhea
Crampy painful abdominal bloating (The cramps may come in cycles, increasing in severity until a loose bowel movement occurs and the pain resolves somewhat.)

More serious symptoms of gastroenteritis

Blood in vomit or stool (blood in vomit or stool is never normal and the affected individual should call or a visit a health care professional.)
Vomiting more than 48 hours
(Fever higher than 101 F (40 C
Swollen abdomen or abdominal pain
Dehydration - weakness, lightheadedness, decreased urination, dry skin, dry mouth and lack of sweat and tears are characteristic signs and symptoms.


When to Seek Medical Care

Most often gastroenteritis is self-limiting, but it can cause significant problems with dehydration. Should that be a concern, contacting a primary care professional is reasonable.

Vomiting blood or having bloody or black bowel movements are not normal, and emergency care should be sought. Some medications such as iron or bismuth subsalicylate (Pepto-Bismol) can turn stool black in color.

Fever, increasing severity of abdominal pain, and persistent symptoms should not be ignored and seeking medical care should be considered.


Gastroenteritis Diagnosis

Gastroenteritis is often self-limiting, and the care is supportive designed to control symptoms and prevent dehydration. Tests may not be needed.

If the symptoms persist for a prolonged period of time, the health care professional may consider blood and stool tests to determine the cause of the vomiting and diarrhea.

Patient History and Physical Examination

Taking a thorough history and physical examination is very helpful in accessing the diagnosis.

Questions asked by the health care professional may include:

Have any other family members or friends had similar exposure or symptoms?
What is the duration, frequency, and description of the patient's bowel movements, and is vomiting present?
Can the patient tolerate any fluids by mouth?
These questions help determine the potential risk of dehydration and may also include asking questions about the amount and frequency of urination, weight loss, lightheadedness, and fainting (syncope).

Other information in the medical history that may be helpful in the diagnosis of gastroenteritis include:

Travel history: Travel may suggest E. coli bacterial infection or a parasite infection acquired from something the patient ate or drank. Norovirus infections tend to occur when many people are confined to a close space (for example, cruise ship).
Exposure to poisons or other irritants: Swimming in contaminated water or drinking from suspicious fresh water such as mountain streams or wells may indicate infection with Giardia - an organism found in water.
Diet change, food preparation habits, and storage: When the disease occurs following exposure to undercooked or improperly stored or prepared food (for example foods at picnics and BBQs that should be refrigerated to avoid contamination), food poisoning must be considered.

In general, symptoms caused by bacteria or their toxins will become apparent after the following amount of time:
Staphylococcus aureus in 2 to 6 hours
Clostridium 8 to 10 hours
Salmonella in 12 to 72 hours

Medications: If the patient has used antibiotics recently, they may have antibiotic-associated irritation of the gastrointestinal tract, caused by clostridium difficile infection.

Physical examination will explore the reasons for symptoms that may not be related to infection. If there are specific tender areas in the abdomen, the health care practitioner may want to determine if the patient has appendicitis, gallbladder disease, pancreatitis, diverticulitis, or other conditions that may be the cause of the patient's symptoms.

Other noninfectious gastrointestinal diseases such as Crohn's disease, ulcerative colitis, or microscopic colitis also must be considered. The health care practitioner will feel the abdomen for masses. A rectal examination may be considered, in which the physician inspects the anus for any abnormalities and then inserts a finger in the rectum to feel for any masses. Stool obtained during this test may be tested for the presence of blood.

The health care practitioner may perform other laboratory tests, including complete blood count (CBC), electrolytes, and kidney function tests. Stool samples may be collected and tested for blood or different types of infection.
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اشترك في: الخميس إبريل 04, 2013 10:28 pm

Re: ما هى اعراض وعلاج النزلة المعوية عند الاطفال

مشاركةبواسطة دكتور كمال سيد » الجمعة يونيو 13, 2014 1:37 pm

gastroenteritis contd

(Parasites and Protozoans (Giardia, Cryptosporidium

These tiny organisms are less frequently responsible for intestinal irritation. A person may become infected by one of these by drinking contaminated water. Swimming pools are common places to come in contact with these parasites. Common parasites include

Giardia is the most frequent cause of waterborne diarrhea, causing giardiasis. Often, people become infected after swallowing water that has been contaminated by animal feces (poop). This may occur by drinking infected water from river or lakes but giardia may also be found in swimming pools, wells and cisterns.
Cryptosporidium (Crypto) is a parasite that lives in the intestine of affected individuals or animals. The infected individual or animal sheds the Cryptosporidium parasite in the stool. Crypto may also be found in food, water, soil, or contaminated surfaces (swallowing contaminated water, beverages, uncooked food, unwashed fruits and vegetables, touching contaminated surfaces such as bathroom fixtures, toys, diaper pails, changing tables, changing diapers, caring for an infected individual or handling an infected cow or calf). Those at risk for serious disease are individuals with weakened immune systems.

Other Common Causes of Gastroenteritis

Gastroenteritis that is not contagious to others can be caused by chemical toxins, most often found in seafood, food allergies, heavy metals, antibiotics, and other medications.


Gastroenteritis Symptoms

By definition, gastroenteritis affects both the stomach and the intestines, resulting in vomiting and diarrhea.

Common gastroenteritis symptoms

(Low grade fever to 100 F (37.7 C
Nausea with or without vomiting
Mild-to-moderate diarrhea
Crampy painful abdominal bloating (The cramps may come in cycles, increasing in severity until a loose bowel movement occurs and the pain resolves somewhat.)

More serious symptoms of gastroenteritis

Blood in vomit or stool (blood in vomit or stool is never normal and the affected individual should call or a visit a health care professional.)
Vomiting more than 48 hours
(Fever higher than 101 F (40 C
Swollen abdomen or abdominal pain
Dehydration - weakness, lightheadedness, decreased urination, dry skin, dry mouth and lack of sweat and tears are characteristic signs and symptoms.


When to Seek Medical Care

Most often gastroenteritis is self-limiting, but it can cause significant problems with dehydration. Should that be a concern, contacting a primary care professional is reasonable.

Vomiting blood or having bloody or black bowel movements are not normal, and emergency care should be sought. Some medications such as iron or bismuth subsalicylate (Pepto-Bismol) can turn stool black in color.

Fever, increasing severity of abdominal pain, and persistent symptoms should not be ignored and seeking medical care should be considered.


Gastroenteritis Diagnosis

Gastroenteritis is often self-limiting, and the care is supportive designed to control symptoms and prevent dehydration. Tests may not be needed.

If the symptoms persist for a prolonged period of time, the health care professional may consider blood and stool tests to determine the cause of the vomiting and diarrhea.

Patient History and Physical Examination

Taking a thorough history and physical examination is very helpful in accessing the diagnosis.

Questions asked by the health care professional may include:

Have any other family members or friends had similar exposure or symptoms?
What is the duration, frequency, and description of the patient's bowel movements, and is vomiting present?
Can the patient tolerate any fluids by mouth?
These questions help determine the potential risk of dehydration and may also include asking questions about the amount and frequency of urination, weight loss, lightheadedness, and fainting (syncope).

Other information in the medical history that may be helpful in the diagnosis of gastroenteritis include:

Travel history: Travel may suggest E. coli bacterial infection or a parasite infection acquired from something the patient ate or drank. Norovirus infections tend to occur when many people are confined to a close space (for example, cruise ship).
Exposure to poisons or other irritants: Swimming in contaminated water or drinking from suspicious fresh water such as mountain streams or wells may indicate infection with Giardia - an organism found in water.
Diet change, food preparation habits, and storage: When the disease occurs following exposure to undercooked or improperly stored or prepared food (for example foods at picnics and BBQs that should be refrigerated to avoid contamination), food poisoning must be considered.

In general, symptoms caused by bacteria or their toxins will become apparent after the following amount of time:
Staphylococcus aureus in 2 to 6 hours
Clostridium 8 to 10 hours
Salmonella in 12 to 72 hours

Medications: If the patient has used antibiotics recently, they may have antibiotic-associated irritation of the gastrointestinal tract, caused by clostridium difficile infection.

Physical examination will explore the reasons for symptoms that may not be related to infection. If there are specific tender areas in the abdomen, the health care practitioner may want to determine if the patient has appendicitis, gallbladder disease, pancreatitis, diverticulitis, or other conditions that may be the cause of the patient's symptoms.

Other noninfectious gastrointestinal diseases such as Crohn's disease, ulcerative colitis, or microscopic colitis also must be considered. The health care practitioner will feel the abdomen for masses. A rectal examination may be considered, in which the physician inspects the anus for any abnormalities and then inserts a finger in the rectum to feel for any masses. Stool obtained during this test may be tested for the presence of blood.

The health care practitioner may perform other laboratory tests, including complete blood count (CBC), electrolytes, and kidney function tests. Stool samples may be collected and tested for blood or different types of infection.
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اشترك في: الخميس إبريل 04, 2013 10:28 pm

Re: ما هى اعراض وعلاج النزلة المعوية عند الاطفال

مشاركةبواسطة دكتور كمال سيد » الجمعة يونيو 13, 2014 1:38 pm

gastroenteritis contd

(Parasites and Protozoans (Giardia, Cryptosporidium

These tiny organisms are less frequently responsible for intestinal irritation. A person may become infected by one of these by drinking contaminated water. Swimming pools are common places to come in contact with these parasites. Common parasites include

Giardia is the most frequent cause of waterborne diarrhea, causing giardiasis. Often, people become infected after swallowing water that has been contaminated by animal feces (poop). This may occur by drinking infected water from river or lakes but giardia may also be found in swimming pools, wells and cisterns.
Cryptosporidium (Crypto) is a parasite that lives in the intestine of affected individuals or animals. The infected individual or animal sheds the Cryptosporidium parasite in the stool. Crypto may also be found in food, water, soil, or contaminated surfaces (swallowing contaminated water, beverages, uncooked food, unwashed fruits and vegetables, touching contaminated surfaces such as bathroom fixtures, toys, diaper pails, changing tables, changing diapers, caring for an infected individual or handling an infected cow or calf). Those at risk for serious disease are individuals with weakened immune systems.

Other Common Causes of Gastroenteritis

Gastroenteritis that is not contagious to others can be caused by chemical toxins, most often found in seafood, food allergies, heavy metals, antibiotics, and other medications.


Gastroenteritis Symptoms

By definition, gastroenteritis affects both the stomach and the intestines, resulting in vomiting and diarrhea.

Common gastroenteritis symptoms

(Low grade fever to 100 F (37.7 C
Nausea with or without vomiting
Mild-to-moderate diarrhea
Crampy painful abdominal bloating (The cramps may come in cycles, increasing in severity until a loose bowel movement occurs and the pain resolves somewhat.)

More serious symptoms of gastroenteritis

Blood in vomit or stool (blood in vomit or stool is never normal and the affected individual should call or a visit a health care professional.)
Vomiting more than 48 hours
(Fever higher than 101 F (40 C
Swollen abdomen or abdominal pain
Dehydration - weakness, lightheadedness, decreased urination, dry skin, dry mouth and lack of sweat and tears are characteristic signs and symptoms.


When to Seek Medical Care

Most often gastroenteritis is self-limiting, but it can cause significant problems with dehydration. Should that be a concern, contacting a primary care professional is reasonable.

Vomiting blood or having bloody or black bowel movements are not normal, and emergency care should be sought. Some medications such as iron or bismuth subsalicylate (Pepto-Bismol) can turn stool black in color.

Fever, increasing severity of abdominal pain, and persistent symptoms should not be ignored and seeking medical care should be considered.


Gastroenteritis Diagnosis

Gastroenteritis is often self-limiting, and the care is supportive designed to control symptoms and prevent dehydration. Tests may not be needed.

If the symptoms persist for a prolonged period of time, the health care professional may consider blood and stool tests to determine the cause of the vomiting and diarrhea.

Patient History and Physical Examination

Taking a thorough history and physical examination is very helpful in accessing the diagnosis.

Questions asked by the health care professional may include:

Have any other family members or friends had similar exposure or symptoms?
What is the duration, frequency, and description of the patient's bowel movements, and is vomiting present?
Can the patient tolerate any fluids by mouth?
These questions help determine the potential risk of dehydration and may also include asking questions about the amount and frequency of urination, weight loss, lightheadedness, and fainting (syncope).

Other information in the medical history that may be helpful in the diagnosis of gastroenteritis include:

Travel history: Travel may suggest E. coli bacterial infection or a parasite infection acquired from something the patient ate or drank. Norovirus infections tend to occur when many people are confined to a close space (for example, cruise ship).
Exposure to poisons or other irritants: Swimming in contaminated water or drinking from suspicious fresh water such as mountain streams or wells may indicate infection with Giardia - an organism found in water.
Diet change, food preparation habits, and storage: When the disease occurs following exposure to undercooked or improperly stored or prepared food (for example foods at picnics and BBQs that should be refrigerated to avoid contamination), food poisoning must be considered.

In general, symptoms caused by bacteria or their toxins will become apparent after the following amount of time:
Staphylococcus aureus in 2 to 6 hours
Clostridium 8 to 10 hours
Salmonella in 12 to 72 hours

Medications: If the patient has used antibiotics recently, they may have antibiotic-associated irritation of the gastrointestinal tract, caused by clostridium difficile infection.

Physical examination will explore the reasons for symptoms that may not be related to infection. If there are specific tender areas in the abdomen, the health care practitioner may want to determine if the patient has appendicitis, gallbladder disease, pancreatitis, diverticulitis, or other conditions that may be the cause of the patient's symptoms.

Other noninfectious gastrointestinal diseases such as Crohn's disease, ulcerative colitis, or microscopic colitis also must be considered. The health care practitioner will feel the abdomen for masses. A rectal examination may be considered, in which the physician inspects the anus for any abnormalities and then inserts a finger in the rectum to feel for any masses. Stool obtained during this test may be tested for the presence of blood.

The health care practitioner may perform other laboratory tests, including complete blood count (CBC), electrolytes, and kidney function tests. Stool samples may be collected and tested for blood or different types of infection.
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مشاركةبواسطة دكتور كمال سيد » الجمعة يونيو 13, 2014 1:40 pm

Gastroenteritis Treatment

Treatment of gastroenteritis include self-care and home remedies that are aimed at keeping the patient well hydrated to avoid dehydration. Medical treatment may be necessary if the patient becomes dehydrated and needs hospitalization to rehydrate via an IV solution.

Some medications may be prescribed to treat some infections (for example, C. diff), to stop vomiting, and antidiarrheal medication to treat diarrhea (either over-the-counter or prescription), depending upon the condition of the patient and cause of gastroenteritis.

Gastroenteritis Self-Care and Home Remedies

The treatment of gastroenteritis is aimed at hydration and home remedies that address keeping fluid in the body are key to recovery.

Since most causes of gastroenteritis are due to viruses, replacing the fluid lost because of vomiting and diarrhea allows the body to recuperate and fight the infection. Dehydration can also intensify the symptoms of nausea and vomiting. The critical step is replacing fluids when the affected individual is nauseous and doesn't want to drink (hydrate). This is especially difficult with infants and children. Small frequent offerings of clear fluids, sometimes only a mouthful at a time, may be enough to replenish the body's fluid stores and prevent an admission to the hospital for intravenous (IV) fluid administration.

In general, clear fluids (anything you can see through), may be tolerated in small amounts. Think of it as adding just an ounce or less to the saliva that the patient is already swallowing. However, giving too much fluid at one time may cause increased nausea due to a distended stomach, which causes additional irritation.

Clear fluids do not include carbonated beverages but colas or ginger ale with the fizz gone are often well tolerated. Coke syrup may also be helpful in settling the stomach.

Jello and popsicles may be "solid food" alternatives to clear fluids in children who aren't interested in clear fluids.

Dehydration in children

Oral rehydration therapy using balanced electrolyte solutions such as Pedialyte or Gatorade/Powerade may be all that is needed to replenish the fluid supply in an infant or child. Plain water is not recommended because it can dilute the electrolytes in the body and cause complications such as seizures due to low sodium.

The key to oral rehydration is small frequent feedings. If offered free access to a bottle, infants especially may drink quickly to quench their thirst and then vomit. Instead it may be best to limit the amount of fluid given at one time. There are a variety of regimens that are used and they follow a basic format:

Offer 1/3 of an ounce (5 to 10 cc) of fluid at one time. Wait 5 to 10 minutes then repeat.
If this amount is tolerated without vomiting, increase the amount of fluid to 2/3 of an ounce (10 to 20 cc). Wait and repeat.
If tolerated, increase the fluid offered to 1 ounce (30 cc) at a time.
If vomiting occurs, go back to the 1/3 of an ounce (5 to 10 cc) and restart.
Once the child is tolerating significant fluids by mouth, a more solid diet can be offered.
The important thing to remember is that the goal is to provide fluid to the child and not necessarily calories. In the short term, hydration is more important than nutrition.

For infants and children, fluid status can be monitored by

whether they are urinating,
if they have saliva in their mouths,
tears in their eyes, and
sweat in their armpits or groin.
If the child's baseline weight is known, dehydration can be measured by comparing weight.

Medical care should be accessed immediately, if the child is listless, floppy or does not seem to be acting normal.

Dehydration in adults

Although adults and adolescents have a larger electrolyte reserve than children, electrolyte imbalance and dehydration may still occur as fluid is lost through vomiting and diarrhea. Severe symptoms and dehydration usually develop as complications of medication use or chronic diseases such as diabetes or kidney failure; however, symptoms may occur in healthy people.

Clear fluids are appropriate for the first 24 hours to maintain adequate hydration.
After 24 hours of fluid without vomiting, begin a soft-bland solid diet such as the BRAT diet (bananas, rice, apples, toast) and then progress the diet to other foods as tolerated.

http://www.emedicinehealth.com/gastroen ... e10_em.htm
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Re: ما هى اعراض وعلاج النزلة المعوية عند الاطفال

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Gastroenteritis Medical Treatment

Upon seeking medical attention, if the patient cannot take fluids by mouth because of vomiting, the health care practitioner may insert an IV to replace fluids back into the body (rehydration).

In infants, depending upon the level of dehydration, intravenous fluids may be delayed in order to attempt oral rehydration therapy. Frequent feedings, as small as a 1/6 ounce (5 cc) at a time, may be used to restore hydration.

Antibiotics are usually not prescribed until a bacteria or parasite has been identified as the cause of the infection. Antibiotics may be given for certain bacteria, specifically Campylobacter, Shigella, and Vibrio cholerae, if properly identified through laboratory tests. Otherwise, using any antibiotic or the wrong antibiotic can worsen some infections or make them last longer.

Antibiotics are not used to treat virus infections.

Some infections, such as salmonella, are not treated with antibiotics. With supportive care comprising of fluids and rest, the body is able to fight and resolve the infection without antibiotics.

For adults, the health care practitioner may prescribe medications to stop the vomiting (antiemetics) such as promethazine (Phenergan, Anergan), prochlorperazine (Compazine), or ondansetron (Zofran). Sometimes these medications are prescribed as a suppository. Doctors usually do not recommend antiemetics for infants, but depending upon the situation, older children may be prescribed an antiemetic (antinausea) medication in a lower dosage.

Antidiarrhea medications are not usually recommended if the infection is associated with a toxin that causes the diarrhea. The most common antidiarrheal agents for people older than 3 years of age include over-the-counter (OTC) medications such as diphenoxylate atropine (Lomotil, Lofene, Lonox) or loperamide hydrochloride (Imodium).
http://www.emedicinehealth.com/gastroen ... e12_em.htm

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Diarrhea is one of the leading causes of infant sickness and death. Worldwide, diarrhea accounts for 3-5 million deaths yearly for all age groups. In general, most adults and children recover after they are appropriately rehydrated.


Gastroenteritis Follow-up


After an infection or irritation of the digestive tract, the person may not be able to eat a regular diet. Some people may be unable to tolerate dairy products for several weeks after the disease has run its course. The diet should be advanced slowly from bland non-dairy soups and grain products to a solid meal.
If symptoms continue or worsen, call a health care professional.
Food handlers should not return to work until their symptoms have resolved. Salmonella infections are a special case; those who work in the medical profession or who are food handlers need to have negative stool cultures for Salmonella before being allowed to return to work.

Gastroenteritis Prevention

With most infections, the key is to block the spread of the organism.

Always wash your hands.
Eat properly prepared and stored food.
Bleach soiled laundry.
Vaccinations for Vibrio cholerae, and rotavirus have been developed. Rotavirus vaccination is recommended for infants in the U.S. Vaccines for V. cholerae may be administered to individuals traveling to at-risk areas.
http://www.emedicinehealth.com/gastroen ... e15_em.htm
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