Acute Diarrhoea Overview
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Questions and Answers

What is a primary consequence of increased intestinal motility in cases of diarrhea?

  • Enhanced nutrient absorption
  • Decreased fluid intake
  • Reduced time for absorption (correct)
  • Increased intestinal bacteria

    • Which of the following symptoms is NOT considered a red flag for diarrhea?

  • Blood in stool
  • Weight loss
  • Mild cramping (correct)
  • Nocturnal symptoms

    • What is the typical duration of viral diarrhea?

  • 3-5 days
  • 1-2 days
  • 4-6 days
  • 2-3 days (correct)

    • Which lifestyle change is recommended for managing diarrhea?

    <p>Small, light meals</p> Signup and view all the answers

    Which condition requires immediate referral in patients experiencing diarrhea?

    <p>Recent travel to a tropical climate</p> Signup and view all the answers

    What treatment is commonly recommended for acute diarrhea?

    <p>Oral Rehydration Salts (ORS)</p> Signup and view all the answers

    Which of the following indicates the need for monitoring dehydration symptoms?

    <p>Prolonged vomiting</p> Signup and view all the answers

    Which dietary option is considered easy to digest during episodes of diarrhea?

    <p>BRAT diet</p> Signup and view all the answers

    What is the primary action of stimulant laxatives like senna and bisacodyl?

    <p>They stimulate peristalsis by acting on colonic nerves.</p> Signup and view all the answers

    In managing constipation, which laxative type is preferred for its stool-softening properties?

    <p>Bulk-forming laxatives</p> Signup and view all the answers

    Which of the following symptoms would require a referral for further evaluation?

    <p>Change in bowel habit in an individual over 40 years</p> Signup and view all the answers

    What is the mechanism by which MICROLAX® provides relief from constipation?

    <p>It releases bound water to soften hard feces.</p> Signup and view all the answers

    Which treatment option for hemorrhoids is aimed specifically at reducing inflammation?

    <p>Topical hydrocortisone</p> Signup and view all the answers

    What is a common physical manifestation of moderate dehydration?

    <p>Increased heart rate</p> Signup and view all the answers

    Which group carries a higher risk for dehydration?

    <p>Infants who were low birthweight</p> Signup and view all the answers

    In managing dehydration, what fluid availability is most recommended?

    <p>Oral rehydration solutions (ORS)</p> Signup and view all the answers

    Which of the following symptoms is associated with severe dehydration?

    <p>Confusion leading to coma</p> Signup and view all the answers

    What is the first action advised for a child showing signs of dehydration?

    <p>Encourage frequent sips of ORS</p> Signup and view all the answers

    Which of the following is NOT a symptom of mild dehydration?

    <p>Dry tongue</p> Signup and view all the answers

    What dietary advice should be given to a child recovering from diarrhea?

    <p>Encourage usual fluid intake without fruit juices</p> Signup and view all the answers

    What is the main purpose of scheduled toileting for children with constipation?

    <p>To encourage bowel movements at pre-planned intervals.</p> Signup and view all the answers

    Which electrolyte disturbance is typically associated with dehydration management?

    <p>Hypokalemia</p> Signup and view all the answers

    Which type of laxative acts by retaining fluid within the stool and increasing faecal mass?

    <p>Bulk-forming laxatives</p> Signup and view all the answers

    Which of the following foods is NOT recommended for increasing dietary fiber in children?

    <p>Processed snacks</p> Signup and view all the answers

    What might be a consequence of providing a hyperosmolar soft drink to a dehydrated child?

    <p>Inadequate hydration status</p> Signup and view all the answers

    What is the most severe symptom of profound dehydration?

    <p>Oliguria or anuria</p> Signup and view all the answers

    What should parents NOT do when managing constipation in children under specialist advice?

    <p>Switch formula feed</p> Signup and view all the answers

    Which method is effectively used to encourage good toilet habits in children experiencing constipation?

    <p>Implementing reward systems like star charts</p> Signup and view all the answers

    What is a common effect of bulk-forming laxatives if not accompanied by increased fluid intake?

    <p>Potential intestinal obstruction</p> Signup and view all the answers

    What should parents monitor in a bowel habit diary for a child suffering from constipation?

    <p>The frequency and consistency of stool</p> Signup and view all the answers

    Which of the following is a characteristic of osmotic laxatives?

    <p>They increase fluid in the large bowel.</p> Signup and view all the answers

    Which intervention is generally inappropriate for children under six months experiencing constipation?

    <p>Scheduled toileting routines</p> Signup and view all the answers

    What is a significant consideration when advising on dietary changes for constipation in children?

    <p>Ensuring a balanced diet with sufficient fiber</p> Signup and view all the answers

    What is the recommended waiting period before allowing a child to return to school after an episode of gastroenteritis?

    <p>48 hours after the last symptom</p> Signup and view all the answers

    Which of the following is NOT a recommended practice for food hygiene to prevent gastroenteritis?

    <p>Washing hands with cold water only</p> Signup and view all the answers

    Which statement about the rotavirus vaccination is true?

    <p>The vaccine is administered at 2 and 4 months of age.</p> Signup and view all the answers

    What should parents or carers do if a child's diarrhoea lasts longer than 2 weeks?

    <p>Seek advice from a healthcare professional.</p> Signup and view all the answers

    To prevent transmission of gastroenteritis, which of the following practices should be avoided?

    <p>Allowing the child to share towels and flannels.</p> Signup and view all the answers

    What symptom indicates a child may be developing dehydration due to gastroenteritis?

    <p>Lethargy and less responsiveness.</p> Signup and view all the answers

    Which of the following is recommended for infants who are experiencing gastroenteritis?

    <p>Continue breast-feeding or bottle-feeding as desired.</p> Signup and view all the answers

    Which scenario requires immediate medical help for a child with gastroenteritis?

    <p>Child becomes unwell or appears lethargic.</p> Signup and view all the answers

    How can rotavirus spread through recreational activities?

    <p>Through contaminated swimming pool water.</p> Signup and view all the answers

    Which is a common characteristic of constipation?

    <p>Infrequent stools and excessive straining.</p> Signup and view all the answers

    Study Notes

    Increased Intestinal Motility

    • Leads to less time for nutrient absorption
    • A common feature of diarrhoea

    Specific Questions to Consider

    • Frequency of bowel movements
    • Nature of stools
    • Duration and severity of symptoms
    • Onset of symptoms
    • Timing of diarrhoea
    • Recent diet changes
    • Signs of dehydration

    Red Flag Symptoms

    • Dehydration
    • Blood in stool
    • Persistent vomiting
    • Abdominal tenderness
    • Weight loss
    • Nocturnal symptoms
    • Fever
    • Treatment failure

    Acute Diarrhoea

    • Primarily viral or bacterial
    • Rapid onset
    • May involve nausea and vomiting
    • Cramping, flatulence, and abdominal tenderness
    • Usually resolves within 2-3 days (viral) or 3-5 days (bacterial)
    • Monitor for dehydration symptoms

    Treatment Options for Acute Diarrhoea

    • Oral Rehydration Salts (ORS) and increased fluid intake
    • Loperamide
    • Tasectan
    • Lifestyle changes: small, light meals and adequate fluids

    BRAT Diet

    • Banana, rice, applesauce, toast: easily digestible foods
    • Used during diarrhoea recovery

    Diarrhoea Referral Required

    • Long-term change in bowel habit in patients over 50
    • Blood-stained stools
    • Diarrhoea following travel to tropical climates (Giardiasis)
    • Dehydration (children, elderly)
    • Blood or mucus in stool
    • Severe abdominal pain
    • Fever
    • Steatorrhoea
    • Treatment failure for more than 3-4 days
    • Lassitude, anorexia, nausea, lightheadedness, postural hypotension

    Signs of Dehydration

    • Mild: apathy, tiredness, reduced skin elasticity, postural hypotension, muscle cramps, tachycardia, pinched face
    • Moderate: dry tongue or sunken eyes, oliguria, profound apathy, weakness, confusion, tachycardia, peripheral vasoconstriction, systolic blood pressure < 90 mmHg
    • Severe: shock, oliguria or anuria

    Dehydration Risk

    • Increased risk in: infants under 1 year, especially under 6 months
    • Low birthweight infants
    • Infants weaned from breastfeeding during illness
    • Children with 6+ diarrhoeal stools in 24 hours
    • Children with 3+ vomiting episodes in 24 hours

    Dehydration Management

    • Prevention or correction of dehydration and associated electrolyte disturbances
    • Maintenance or resumption of adequate nutritional intake

    Oral Rehydration Solutions (ORS)

    • Glucose stimulates sodium transport in the small intestine
    • ORS Hydration and Dioralyte are widely available
    • Popular soft drinks are hyperosmolar and can worsen diarrhoea

    Rehydration in Children

    • Administer ORS frequently in small amounts
    • Avoid solid food until dehydration is corrected
    • Seek urgent medical advice if the child cannot drink or vomits persistently

    Gastroenteritis Infection Control

    • Thorough hand washing after using the toilet and before eating
    • Disinfectant cleaning of toilets after diarrhoea and vomiting episodes
    • Frequent hand washing, especially after nappy changes or potty cleaning
    • Do not share towels, flannels, cutlery, or eating utensils
    • Exclude children from school or nursery for 48 hours after last diarrhoea/vomiting episode
    • Avoid swimming pools for 2 weeks after last episode

    Preventing Gastroenteritis

    • Practicing good food hygiene:
      • Regular hand washing, surface, and utensil cleaning with hot, soapy water
      • Separate storage of raw and cooked food
      • Proper refrigeration of food
      • Thoroughly cooking food
      • Avoiding expired food

    Rotavirus Vaccine

    • Available for children born on or after 1 October 2016
    • Administered at 2 and 4 months of age
    • Not effective for children over 8 months old

    Follow-Up for Diarrhoea in Children

    • Children should seek healthcare advice if symptoms persist beyond:
      • Diarrhoea: 5-7 days (usually), 2 weeks (maximum)
      • Vomiting: 1-2 days (usually), 3 days (maximum)
    • Monitor for dehydration and shock signs (unwell, deteriorating, irritable, lethargic, less responsive)

    Constipation

    • Defecation that is unsatisfactory, reduced normal bowel habit
    • Infrequent stools
    • Excessive straining

    Treating Constipation in Children

    • Age-appropriate behavioural interventions:
      • Scheduled toileting: encourage bowel movements at planned intervals (after meals, bedtime)
      • Bowel habit diary: track stool frequency and consistency
      • Encouragement and reward systems: star charts, praise for positive toileting behaviours

    Treating Constipation in Children

    • Balanced diet with sufficient fibre: fruit, vegetables, high-fibre bread, baked beans, wholegrain breakfast cereals
    • Avoid unprocessed bran (bloating, flatulence, reduced micronutrient absorption)
    • Avoid fibre supplements
    • Maintain normal physical activity based on developmental stage (warm baths, massage, bicycle motion for babies)

    Bulk-Forming Laxatives

    • Retain fluid in stool, increasing faecal mass, stimulating peristalsis
    • Stool-softening properties
    • Examples: ispaghula husk (Fybogel®), sterculia (Normacol®)
    • Increase fluid intake while taking (prevent intestinal obstruction)

    Osmotic Laxatives

    • Increase fluid in the large bowel, drawing water from the body
    • Fluid accumulation in lower bowel stimulates peristalsis
    • Stool-softening properties
    • Example: Lactulose (works in 48 hours, safe for infants, pregnancy, breastfeeding)

    Stimulant Laxatives

    • Stimulate colonic or colonic and rectal nerves, causing peristalsis
    • Examples: bisacodyl (Dulcolax®), senna (Senokot®), glycerol suppositories

    Enema

    • MICROLAX® is a fast-acting micro-enema
    • Provides quick relief within 5-15 minutes
    • Works locally in the rectum without irritating the intestine
    • Softens hard faeces by releasing bound water
    • Limiting absorption of active ingredients from the rectum
    • Dosage: children over 3 and adults - one as needed

    Haemorrhoids

    • Referral required:
      • Over 40 years old with persistent change in bowel habits
      • Unexplained bleeding
      • Severe pain during defecation
      • Blood mixed in stool
      • Fever
      • Treatment failure for >7 days

    Haemorrhoid Treatment

    • Diet and lifestyle advice to minimize constipation and straining
    • Laxatives as needed (bulk-forming preferred, lactulose alternative)
    • Avoid stimulant laxatives without stool softening activity (e.g. senna)
    • Symptomatic relief: analgesia (paracetamol), topical products

    Topical Haemorrhoid Preparations

    • Soothing: mild astringents, emollients, or lubricants
    • Treating perianal inflammation and pain: corticosteroids and/or local anaesthetics

    OTC Haemorrhoid Treatment Options

    • Anaesthetics (lidocaine, benzocaine): short-term relief from itching and pain
    • Astringents (zinc, bismuth): protective coating over haemorrhoids, antiseptic properties
    • Anti-inflammatory (hydrocortisone): reduces swelling

    Haemorrhoid Referral

    • Sclerotherapy, rubber band ligation, haemorrhoidectomy

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    Description

    This quiz focuses on the causes, symptoms, and treatments related to acute diarrhoea. It covers topics such as increased intestinal motility, dietary recommendations like the BRAT diet, and the importance of monitoring for dehydration. Assess your understanding of the urgent symptoms and treatment options available.

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