Tuesday, January 29, 2013

0 All about stomach flu - Gastroenteritis. Part - 3


In this last part of the article "All about stomach flu - Gastroenteritis" will describe:

6 Mastering
6.1 Rehydration
6.2 Diet
6.3 Antiemetics
6.4 Antibiotics
6.5 antidiarrhoeals
7 Epidemiology


Mastering of stomach flu:

Gastroenteritis of stomach flu usually occurs as an acute self-limited disease that does not require the use of drugs. The preferred treatment for mild to moderate cases of dehydration is oral rehydration therapy (AC). Metoclopramide and / or ondansetron, however, can help some children abutilskopolamin helps abdominal pain.

Rehydration:

The main treatment for stomach flu in both children and adults is rehydration. It is preferable to apply oral rehydration therapy, although you may need intravenous feeding, if there is a reduced level of consciousness, or if dehydration is severe. Products for oral replacement therapy containing complex carbohydrates (ie those that are made from wheat or rice) may be better than those made only from sugars. Drinks, especially high in simple sugars, such as soft drinks and fruit juices are not recommended for children under 5 years of age, as it may increase diarrhea. If no more specific and effective preparations for AC or existing chemicals are unacceptable taste, can be used plain water. Young children can use a nasogastric tube feed fluid if necessary.

Diet:

Recommended infant feeding continues as usual, and formula feeding children who are bottle-fed should continue immediately after rehydration with AC. It is usually not necessary to give formulas without lactose-reduced or lactose. Children should continue their usual diet during episodes of diarrhea, however, should avoid foods high in simple sugars. No longer recommended diet BRAT (bananas, rice, applesauce, toast and tea), as it contains adequate nutrients and is more useful than the normal diet. Some probiotics appear to be useful in reducing both the duration of the disorder and the frequency of bowel movements. They may also be useful in the prevention and treatment of the use of antibiotic diarrhea. Fermented milk products (such as yogurt) are such useful features. Zinc supplementation is effective in the treatment and prevention of disease among children in developing countries.

Antiemetics:

Antiemetic medications (drugs to relieve urinary urgency nausea and vomiting) can help vomiting in children. Ondasetron provides some comfort as it once implementation is associated with reduced need for intravenous fluids, fewer hospital admissions and reduce vomiting. Metoclopramide may also help. However it is possible to use ondasetron is associated with an increased percentage of cases returned to the hospital for children. The intravenous form of ondasetron can be applied orally, but only at the discretion and recommendation of a medical professional. Dimenhidrinatat reduces vomiting but does not provide significant clinical benefit.


Antibiotics:

In gastroenteritis usually do not use antibiotics, although sometimes recommended if stomach flu symptoms are particularly severe or if it is isolated or suspected bacterial cause. If you need to apply antibiotics, macrolides (such as azithromycin) is preferable to a fluoroquinolone, as the proportion of fluoroquinolone resistance is higher. Pseudo-membrane colitis, which is usually caused by the use of antibiotics is addressed through immediate withdrawal of antibiotics, and treatment with metronidazole or vancomycin. The following types of bacteria and protozoa are treatable Shigella Salmonella Tiffy and giardiya. In cases giardiya or entameba histolitika be treated with tinidazole and it is better than treatment with metronidazole. World Health Organization (WHO) recommends the use of antibiotics in young children who have both bloody diarrhea and fever.

Antidiarrhoeals:

Antidiarrheal drug (diarrhea medicine) is a theoretical risk of complications and although clinical experience indicates that it is unlikely that these drugs are not recommended for people with bloody diarrhea or diarrhea complicated by fever. Loperamide, an opioid analogue commonly used for the treatment of diarrhea. Loperamide is not recommended for children, as it can pass through more immature blood-brain barrier and cause toxicity. Bismuth subsalitsilat, insoluble complex of trivalent bismuth and salicylate, can be used in mild to moderate cases, but it is theoretically possible risk of toxicity salitsilatna.

Epidemiology:

It is estimated that cases of gastroenteritis annually worldwide are three to five billion, mostly affected are children and those in developing countries. According to data from 2008 gastroenteritis resulting in about 1.3 million deaths in children under five years of age, with most cases in the poorest countries in the world. More than 450,000 of those deaths in children under 5 years of age due to rotavirus.Holerata accounts for about three to five million cases of disease and leads to death in approximately 100,000 people annually. In developing countries, children under two years of age often develop an annual six or more infections that lead to clinically significant gastroenteritis. It is not as common in adults partly because of the development of acquired immunity.
In 1980 gastroenteritis from any cause has led to 4.6 million deaths in children, and most cases occur in developing countries. Percentages of mortality, however, significantly decreased (to approximately 1.5 million deaths per year) to 2000, largely due to the introduction and widespread use of oral rehydration therapy. In the U.S., infections causing gastroenteritis is the second most common infection after the common cold), leading to between 200 and 375 million cases of acute diarrhea in approximately ten million deaths annually, 150 to 300 of those deaths were in children under five.

Related Articles:
All about stomach flu - Gastroenteritis. Part 1

All about stomach flu - Gastroenteritis. Part 2 

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