Page 95 - Learnwell EVS
P. 95
3. Gastrointestinal disorders
Antimicrobial treatment
Diarrhoea without blood
M o s t a cut e d ia rrh o ea s a re ca us ed b y virus es un res po n s ive t o a n t im icro b ia ls .
A n tim icro b ia ls ca n b e b en eficia l in the even t o f cho lera o r gia rd ia s is .
– Cholera: t h e m o s t im po rt a n t pa rt o f t rea t m en t is reh yd ra tio n . I n t h e a b s en ce
of
res is ta n ce ( perfo rm a n tib io tic- s en s itivity tes tin g) , a n tib io tic trea tm en t
dsohxyocyrtcelinnesPtOhe
d ura tio n o f d ia rrho ea :
C hild ren : 4 m g/ kg a s a s in gle 3
adzoithsroemycin PO
A d ults : 3 0 0 m g a s a s in gle d o s e
or
C hild ren : 2 0 m g/ kg a s a s in gle d o s e
A d ults : 1 g a s a s in gle d o s e
Note: d o xycyclin e is us ua lly co n tra in d ica ted in pregn a n t w o m en a n d child ren
un d er
8 yea rs . H o w ever, fo r trea tin g ch o lera , the a d m in is tra tio n o f a s in gle d o s e
s ho uld n o t
pro vo ke a n y a d vers e effects . C heck n a tio n a l reco m m en d a tio n s .
– Giardiasis: tin id a zo le o r m etro n id a zo le, s ee pa ge 1 4 7 .
Bloody diarrhoea (dysentery)
– Shigellosis is the m o s t freq uen t ca us e o f d ys en tery (a m o eb ic d ys en tery is m uch
les s
co m m o n ). If there is n o la b o ra to ry d ia gn o s is to co n firm the pres en ce o f
a m o eb a e, firs t
lin e trea tm en t is fo r s higello s is (s ee pa ge 8 6 ).
– Amoebiasis: a n tipa ra s itic trea tm en t o n ly if m o tile E. histolytica a m o eb a e a re
fo un d in
s to o ls o r if a co rrect s higello s is trea tm en t ha s b een in effective (s ee pa ge 8 8 ).
Prevention
– B rea s tfeed in g red uces in fa n t m o rb id ity a n d m o rta lity fro m d ia rrho ea a n d the
s everity
o f d ia rrho ea epis o d es .
– W hen the child is w ea n ed prepa ra tio n a n d s to ra ge o f fo o d a re a s s o cia ted w ith
the
ris k o f co n ta m in a tio n b y fa eca l m icro - o rga n is m s : d is co ura ge b o tt le-
feed in g; fo o d
m us t b e co o ked w ell; m ilk o r po rrid ge m us t n ever b e s to red a t ro o m
tem pera ture.
– A cces s to s ufficien t a m o un ts o f clea n w a ter a n d pers o n a l hygien e ( w a s hin g
ha n d s
w ith s o a p a n d w a ter b efo re fo o d prepa ra tio n a n d b efo re ea tin g, a fter
d efeca tio n etc.)
a re effective m etho d s o f red ucin g the s prea d o f d ia rrho ea .
Antimicrobial treatment
Diarrhoea without blood
M o s t a cut e d ia rrh o ea s a re ca us ed b y virus es un res po n s ive t o a n t im icro b ia ls .
A n tim icro b ia ls ca n b e b en eficia l in the even t o f cho lera o r gia rd ia s is .
– Cholera: t h e m o s t im po rt a n t pa rt o f t rea t m en t is reh yd ra tio n . I n t h e a b s en ce
of
res is ta n ce ( perfo rm a n tib io tic- s en s itivity tes tin g) , a n tib io tic trea tm en t
dsohxyocyrtcelinnesPtOhe
d ura tio n o f d ia rrho ea :
C hild ren : 4 m g/ kg a s a s in gle 3
adzoithsroemycin PO
A d ults : 3 0 0 m g a s a s in gle d o s e
or
C hild ren : 2 0 m g/ kg a s a s in gle d o s e
A d ults : 1 g a s a s in gle d o s e
Note: d o xycyclin e is us ua lly co n tra in d ica ted in pregn a n t w o m en a n d child ren
un d er
8 yea rs . H o w ever, fo r trea tin g ch o lera , the a d m in is tra tio n o f a s in gle d o s e
s ho uld n o t
pro vo ke a n y a d vers e effects . C heck n a tio n a l reco m m en d a tio n s .
– Giardiasis: tin id a zo le o r m etro n id a zo le, s ee pa ge 1 4 7 .
Bloody diarrhoea (dysentery)
– Shigellosis is the m o s t freq uen t ca us e o f d ys en tery (a m o eb ic d ys en tery is m uch
les s
co m m o n ). If there is n o la b o ra to ry d ia gn o s is to co n firm the pres en ce o f
a m o eb a e, firs t
lin e trea tm en t is fo r s higello s is (s ee pa ge 8 6 ).
– Amoebiasis: a n tipa ra s itic trea tm en t o n ly if m o tile E. histolytica a m o eb a e a re
fo un d in
s to o ls o r if a co rrect s higello s is trea tm en t ha s b een in effective (s ee pa ge 8 8 ).
Prevention
– B rea s tfeed in g red uces in fa n t m o rb id ity a n d m o rta lity fro m d ia rrho ea a n d the
s everity
o f d ia rrho ea epis o d es .
– W hen the child is w ea n ed prepa ra tio n a n d s to ra ge o f fo o d a re a s s o cia ted w ith
the
ris k o f co n ta m in a tio n b y fa eca l m icro - o rga n is m s : d is co ura ge b o tt le-
feed in g; fo o d
m us t b e co o ked w ell; m ilk o r po rrid ge m us t n ever b e s to red a t ro o m
tem pera ture.
– A cces s to s ufficien t a m o un ts o f clea n w a ter a n d pers o n a l hygien e ( w a s hin g
ha n d s
w ith s o a p a n d w a ter b efo re fo o d prepa ra tio n a n d b efo re ea tin g, a fter
d efeca tio n etc.)
a re effective m etho d s o f red ucin g the s prea d o f d ia rrho ea .
