infection of the GI tract caused by bacterial, viral, or parasitic pathogens.

fecal-oral route or contaminated food or water

 Mostly

Presented with diarrhea & vomiting majority resolve within the Ist week . small proportion persist for more than 2w

Enviromental contamination

increased exposure to enteropathogens

young age

immune deficiency

malnutrition

Lack of exclusive breast feeding

Salmonella, shigella & E.coli: most common pathogens causing food-borne.

Cholera : contamination of food & water. clostridium difficile : AB-association D. ( psudomembranous colitis )

rapid onset N.&V. within 6 hour, fever & abd. Cramps within 8-72h Blood in the stools

clinical evaluation: - assess degree of dehydration. - provide rapid resuscitation & rehyd - obtain appropriate Hx ( intake of contaminated food, child-care attendence,recent travel & use of AB) Stool examination :microscopic &Cx

Stool microscopy for: Mucus blood Leukocyte ( bacterial invasion of colon) For parasites

Stool culture : - esp. in bloody D. in immunsuppressed & outbreak of HUS

oral rehydration therapy (ORT): - dehydation more in children than adults - bec. greater basal fluid &elect. requirment per Kg - ORT is the preferred mode of rehydration - C/I in shock & unable to tolerate oral fluid.

- continued enteral feeding aids in recovery. - breast-feeding or nondiluted formula - foods with rice,potatoes, yogurt & fruit - avoid fatty food or high in sugar - withdrawal of milk & replace it w/ lactose free are unnecessary.

zinc supplement: - reduce duration and severity of D.

Probiotics: - nonpathogenic bacteria e.g: lactobacillus - successful in developing countries. Antibiotic: - in select cases reduce duration & severity

promotion of exclusive breast-feeding improved complementary feeding practice . rotavirus immunization improved water & sanitary facility ( hand washing) improved case management of diarrhea.