Infectious Diarrhoea
Gastroenterology (12%) Core Clinical Conditions
1A: Able to diagnose and manage
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Definition Aetiology Pathophysiology Risk factor Sign and Symptoms Investigations Management
Definition
Infectious diarrhoea, also known as infectious gastroenteritis, is a common condition characterised by the inflammation of the gastrointestinal tract resulting in loose or watery stools. It is caused by the invasion and colonisation of pathogenic microorganisms in the gut, leading to an infection that disrupts the normal functioning of the digestive system.
Aetiology
Bacteria, viruses, parasites, and sometimes even certain fungi.
Can be caused by: Escherichia coli (E.coli), Salmonella, Shigella, Campylobacter, and Clostridium difficile.
Viruses: norovirus, rotavirus, and enteric adenovirus.
Parasites: Giardia lamblia, Cryptosporidium, and Entamoeba histolytica
Pathophysiology
Pathogens invade the GI tract, which can occur through various routes such as ingestion of contaminated food or water, direct contact with infected individuals, or exposure to contaminated surfaces.
These microorganisms release toxins or cause direct damage to the lining of the intestine, leading to increased fluid secretion and decreased absorption, resulting in the characteristic symptoms of diarrhoea.
Risk factors
Poor hygiene.
Consumption of contaminated food or water.
Living in a crowded environment.
Immunocompromised (children are more susceptible to severe symptoms).
Sign and symptoms
Frequent loose or watery stools.
Abdominal cramps.
Nausea, vomiting, and occasionally fever.
Dehydration may occur, which can manifest as decreased urine output, dry mouth, lightheadedness, and fatigue.
Diagnosis and investigations
Good medical history and physical examination should be sufficient for diagnosis.
Stool sample.
Management
Ensure patients remain properly hydrated. To achieve this, I advise them to increase their fluid intake.
Monitor the urine electrolytes (UE) to assess their electrolyte balance. If needed, we may initiate treatment with either oral or intravenous (IV) fluids for electrolyte replacement.
In rare cases where antibiotic treatment is necessary, it should only be undertaken under the supervision of a microbiologist or infectious disease specialist. It is crucial to exercise caution and seek expert guidance to ensure appropriate and effective antibiotic use for our patients.
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