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Pathology
Two main pathological processes are seen in acute gastroenteritis:
• Secretory diarrhoea: toxins interfere with the secretion or reabsorption of water and electrolytes from the small bowel
• Inflammatory diarrhoea: ileum/colon wall inflammation secondary to bacterial invasion/ toxin
Both features may coexist with the same pathogen.
Aetiology
Secretory
Inflammatory
Viruses
Rotavirus
Norovirus
Coronavirus
Bacteria
E. coli
Vibrio cholera
Bacillus cereus (typically from uncooked rice dishes)
Campylobacter spp.
Salmonella spp.
Protozoa
Giardia intestinalis
Cryptosporidium parvum
Cyclospora cayetanensis
Viruses
Rotavirus
Bacteria
E. coli
Shigella spp.
Campylobacter spp.
Yersinia spp.
Clostridium difficile
Protozoa
Entamoeba histolytica
Balantidium coli
Signs
Dehydration, fever, borborygmi, abdominal tenderness.
Symptoms
Anorexia, nausea and vomiting (especially in 1st 24 hours), abdominal colic, diarrhoea, fever.
Investigations
Bloods: Increased WCC in inflammatory diarrhoea, U&E
Microscopy: Stool cultures and microscopy.
Treatment
Rehydration: Oral rehydration solution, IVI fluids, monitor fluid balance
Prognosis
Frequent cause of infant mortality in developing countries. In adults most recover in 4 days.
Complications of dehydration and bacteraemic spread.
Key Facts
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Key Images
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Key References
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