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## Parasitic Diseases (Giardiasis, Strongylodiasis, Coccidiosis) Parasites live/multiply within the intestines, causing damage to the intestinal mucosa. Symptoms vary with the parasitic agent and can include loss of weight, diarrhea, and steatorrhea. Antiparasitic drugs as indicated for the specifi...

## Parasitic Diseases (Giardiasis, Strongylodiasis, Coccidiosis) Parasites live/multiply within the intestines, causing damage to the intestinal mucosa. Symptoms vary with the parasitic agent and can include loss of weight, diarrhea, and steatorrhea. Antiparasitic drugs as indicated for the specific parasite. ## Crohn's Disease Crohn's disease manifests with inflammation of the GI system. Inflammation is transmural (often leading to intestinal stenosis and fistulas), focal and discontinuous with aphthous ulcerations progressing to linear and irregular shaped ulcerations. Granulomas may be present. Common sites of inflammation are the terminal ileum and cecum. Condition is usually chronic, but an acute flare-up may mimic appendicitis. Children may have delayed development and stunted growth. There is a genetic component to the disease. Symptoms include: - Perirectal abscess/fistula in advanced disease - Diarrhea usually present with colonic disease. May have nocturnal bowel movements, watery stools, and rectal hemorrhage - Anemia may develop with chronic bleeding - Abdominal pain most common in lower right quadrant, usually indicating transmural inflammation; may include: - Post-prandial pain and cramping - Nausea and vomiting (usually related to strictures of the small intestine) - Weight loss - Fever and night sweats Treatment includes: - Corticosteroids and antibiotics for acute exacerbations - Immunomodulatory agents - (cyclosporine, methotrexate) - Antidiarrheals - Aminosalicylate ## Body Fluid Balance Body fluid is primarily intracellular fluid (ICF) or extracellular space (ECF). By 3 years of age, the fluid balance has stabilized and remains throughout adulthood: - ECF: 20-30% (intrastitial fluid, plasma, transcellular fluid). - ICF: 40-50% (fluid within the cells). The fluid compartments are separated by semipermeable membranes that allow fluid and solutes (electrolytes and other substances) to move by osmosis. Fluid also moves through diffusion, filtration, and active transport. In fluid volume deficit, fluid is out of balance, and ECF is depleted; an overload occurs with increased concentration of sodium and retention of fluid. Signs of fluid deficit include: - Thirsty, restless to lethargic - Increasing pulse rate, tachycardia - Fontanels depressed (infants) - Decreased urinary output - Normal BP progressing hypotension ## Appendicitis Appendicitis is inflammation of the appendix. Inflammation is transmural (often leading to intestinal stenosis and fistulas), focal and discontinuous with aphthous ulcerations progressing to linear and irregular shaped ulcerations. Granulomas may be present. Common sites of inflammation are the terminal ileum and cecum. Condition is usually chronic, but an acute flare-up may mimic appendicitis. Children may have delayed development and stunted growth. There is a genetic component to the disease. Symptoms include: - Acute abdominal pain usually in the right lower quadrant. - Anorexia - Nausea and vomiting - Fever - Diarrhea