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Acute
Gastroenteritis
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here for Chinese Version.
Symptoms:
Diarrhoea,
abdominal cramps, poor appetite, nausea, vomiting
Common
causes:
- Viral or
Bacterial Infection (e.g. Samonella)
- Food poisoning
from toxin secreted by bacteria in contaminated food
Please
note:
Gastrointestinal
upset may be caused by other conditions like emotional stress or
food intolerance etc. It may be a side effect of drugs, or a warning
signal of illness at other parts of the body. Children suffering
from febrile illnesses often complain of some degree of gastrointestinal
upset. If in doubt, consult your doctor.
Route
of Infection:
Usually via
ingestion of contaminated food or drink.
Management:
- The condition
is usually self-limiting if managed properly.
- Mismanagement
may lead to dehydration as a result of fluid and electrolyte loss.
Signs
of Dehydration:
- Early signs
are thirst, dry lips and dry tongue.
- If left untreated,
urine darkens and volume decreases, eyeballs become sunken and
skin loses elasticity.
- Severe dehydration
may lead to coma and death, especially in small children.
1. Prevention
of dehydration
- Extra fluids
should be given.
- In the early
stage, boiled water or other suitable drinks (such as mineral
water, boiled water with glucose, clear soups, rice water, diluted
fruit juices, flat lemonade, breast milk etc.) may be sufficient
to replace fluid lost.
- A normal
adult needs approximately 2 to 3 litres of fluid per day, a child
(10 to 40 kg body weight) needs about 1 to 2 litres per day, and
an infant (2 to 10 kg body weight) needs 1/3 to 1 litre per day.
(Allowance should be increased in hot weather).
- Your doctor
may recommend a replacement fluid called ORS (Oral Rehydration
Solution) to be taken in addition to other fluids mentioned above
to replace the extra body fluid lost in diarrhoea and vomiting.
2. Special
Diet
- A patient
with diarrhoea still needs food. The right kind of food will enhance
recovery.
- For breast-fed
infants, breast feeding should continue (if possible, with increased
frequency).
- For bottle-fed
infants, the milk formula should be dilute to one quarter of its
original strength by adding 4 times the usual amount of water
to the child's normal feed. Dilution should be gradually returned
to normal on recovery.
- Older children
and adults should have a bland diet with non-greasy, easily digested
food. (such as crackers, biscuits, dry bread, jam on toast, well
mashed vegetables, clear soups, baked fish etc). Avoid salads,
fruits, eggs, and dairy products, use soya milk instead.
3. Medications
Medications
should only be used under medical supervision to temporarily ease
the symptoms until the illness cures itself in a few days. If used
incorrectly, anti-diarrhoea drugs can cause harm by retaining body
excreta and toxins (especially in infants and young children).
If in doubt,
consult your doctor, especially if:
- The affected
is elderly or an infant under one year
- Dehydration
is possible
- The affected
is febrile or has severe colic
- Fluid replacement
is prevented by repeated vomiting
- Diarrhoea
is frequent and severe (e.g. several times within an hour), or
persisting (illness lasting longer than 3 days)
- There is
blood in the stool
- The affected
has just returned from overseas, or belongs to a group of persons
affected together
Method
of Prevention:
- Avoid contaminated
food or drinks
- Proper storage
of food, separate cooked food from raw food
- Proper cleaning
of cooking or eating utensils, feeding bottles should be properly
sterilized
- Avoid left
over meals, left over milk in infant bottle must be discarded
- Proper personal
hygiene
- Eliminate
flies and cockroaches
- Proper disposal
of excreta (especially of the sick)
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