Makindo Medical Notes"One small step for man, one large step for Makindo" |
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Cause | Clinical Presentation | Diagnostic Tests | Management Options |
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Viral Gastroenteritis
(e.g., Rotavirus, Norovirus) |
- Watery diarrhoea, often large volume.
- Vomiting, fever, and abdominal cramps. - Dehydration signs (dry mouth, lethargy, sunken eyes). - Typically lasts 3-7 days. |
- Clinical Diagnosis: Based on history and physical examination.
- Stool Test (PCR): Sometimes used to identify the virus, but not routinely necessary. |
- Oral Rehydration Therapy (ORT): Use oral rehydration solutions (ORS) to prevent dehydration.
- Hydration: Encourage breastfeeding or formula feeding for infants. - Antipyretics: For fever (e.g., paracetamol). - Avoid Antidiarrhoeal Medications in children. |
Bacterial Gastroenteritis
(e.g., Salmonella, Shigella, E. coli) |
- Bloody diarrhoea (dysentery) in some cases.
- Abdominal pain and cramping. - Fever, vomiting, and dehydration. - More prolonged symptoms (over 7 days). |
- Stool Culture and Sensitivity: To identify bacterial pathogens.
- Stool PCR: For faster identification of bacterial species. - Blood Tests: In severe cases, including complete blood count (CBC), electrolytes. |
- Hydration (ORT or IV fluids): For dehydration management.
- Antibiotics: Only for specific bacteria like Shigella or in cases of severe disease (e.g., ciprofloxacin, azithromycin). - Avoid Antidiarrhoeal Agents. |
Parasitic Infections
(e.g., Giardia, Cryptosporidium) |
- Prolonged watery diarrhoea, often lasting more than 1 week.
- Abdominal pain, bloating, and weight loss. - Mild fever and fatigue. - In children, chronic infection can cause growth delay. |
- Stool Ova and Parasites Test: To identify the presence of parasites or cysts.
- Stool Antigen Testing: For Giardia detection. - PCR or Molecular Testing: For specific parasitic identification. |
- Antiparasitic Medications: Metronidazole or tinidazole for Giardia.
- Hydration (ORT or IV fluids): For dehydration. - Nutritional Support: If prolonged illness has led to weight loss or malnutrition. |
Food Allergy or Intolerance
(e.g., Lactose Intolerance, Cow's Milk Protein Allergy) |
- Watery diarrhoea after consuming the offending food.
- Abdominal pain, bloating, and flatulence. - No fever. - Symptoms resolve once the food is eliminated. |
- Elimination Diet: Remove suspected food from the diet and observe for improvement.
- Hydrogen Breath Test: For lactose intolerance. - Skin Prick or IgE Testing: For cow's milk protein allergy. |
- Dietary Modification: Remove the offending food (e.g., lactose-free products for lactose intolerance, hypoallergenic formula for milk allergy).
- Enzyme Supplements: Lactase enzyme supplements may help in lactose intolerance. - Nutritional Counseling: To ensure adequate intake of essential nutrients. |
Antibiotic-Associated Diarrhea
(e.g., Clostridium difficile infection) |
- Watery diarrhoea, often with abdominal cramping.
- History of recent antibiotic use. - Fever in some cases. - Severe cases may present with bloody stools. |
- Stool Culture: For Clostridium difficile toxin detection.
- Stool PCR: For faster diagnosis of C. difficile infection. - Complete Blood Count (CBC): To assess for leukocytosis in severe cases. |
- Discontinue Offending Antibiotic if possible.
- Oral Metronidazole or Vancomycin for C. difficile infection. - Probiotics: May help restore gut flora balance. - Hydration and Supportive Care. |
Malabsorption Syndromes
(e.g., Celiac Disease, Cystic Fibrosis) |
- Chronic diarrhoea, often foul-smelling and bulky stools.
- Failure to thrive or poor weight gain. - Abdominal distention, bloating, and fatigue. - May present with other systemic symptoms (e.g., anaemia, rash). |
- Tissue Transglutaminase Antibodies (tTG-IgA): For celiac disease diagnosis.
- Sweat Test: For cystic fibrosis diagnosis. - Stool Fat Test: For fat malabsorption. |
- Gluten-Free Diet: For celiac disease.
- Pancreatic Enzyme Replacement Therapy (PERT): For cystic fibrosis. - Nutritional Support: To address vitamin deficiencies and ensure growth. |