Difference between revisions of "Viral gastroenteritis"

 
Line 10: Line 10:
 
*Crampy/diffuse [[abdominal pain]]
 
*Crampy/diffuse [[abdominal pain]]
 
*Features that suggest non-viral etiology:
 
*Features that suggest non-viral etiology:
**Bloody diarrhea ([[Salmonella]], [[shigella]])
+
**[[rectal bleeding|Bloody diarrhea]] ([[Salmonella]], [[shigella]])
**RLQ pain ([[Yersina]], [[Entamoeba]])
+
**[[RLQ pain]] ([[Yersinia]], [[Entamoeba]])
**Recent antibiotics + copious, foul diarrhea ([[C. Diff]])
+
**Recent [[antibiotics]] + copious, foul diarrhea ([[C. Diff]])
**Consumption of previously cooked/reheated foods (especially meats, mayonaise, etc.)
+
**Consumption of previously cooked/reheated foods (especially meats, mayonnaise, etc.)
 
**Explosive, "rice-water" diarrhea ([[cholera]])
 
**Explosive, "rice-water" diarrhea ([[cholera]])
 
**bloating, really nasty flatus/stools ([[giardia]])
 
**bloating, really nasty flatus/stools ([[giardia]])
Line 20: Line 20:
 
{{Abdominal Pain DDX Diffuse}}
 
{{Abdominal Pain DDX Diffuse}}
 
{{Nausea and vomiting DDX}}
 
{{Nausea and vomiting DDX}}
 +
 
==Evaluation==
 
==Evaluation==
 
*Assess hydration status
 
*Assess hydration status
Line 26: Line 27:
 
**>10 stools in previous 24hr
 
**>10 stools in previous 24hr
 
**[[Traveler's diarrhea|Travel to high-risk country]]
 
**[[Traveler's diarrhea|Travel to high-risk country]]
**Fever
+
**[[Fever]]
**Bloody stool
+
**[[rectal bleeding|Bloody stool]]
 
**Persistent diarrhea
 
**Persistent diarrhea
 +
 
==Management==
 
==Management==
 
#Rehydration (PO preferred)
 
#Rehydration (PO preferred)
 
#*30mL(1oz)/kg/hr
 
#*30mL(1oz)/kg/hr
 
#*[[Reduced-osmolarity oral rehydration solution]]  
 
#*[[Reduced-osmolarity oral rehydration solution]]  
#Antiemetic
+
#[[Antiemetics]]
 
#*[[Ondansetron]] 0.15mg/kg/dose IV/PO
 
#*[[Ondansetron]] 0.15mg/kg/dose IV/PO
 
#*May worsen diarrhea
 
#*May worsen diarrhea

Latest revision as of 16:49, 30 September 2019

See Acute gastroenteritis (peds) for pediatric patients

Background

  • Most common cause of acute gastroenteritis (AGE)
  • Viral gastroenteritis usually lasts <7d
  • Do NOT diagnosis isolated vomiting as AGE!

Clinical Features

Differential Diagnosis

Diffuse Abdominal pain

Nausea and vomiting

Critical

Emergent

Nonemergent

Evaluation

Management

  1. Rehydration (PO preferred)
  2. Antiemetics

Disposition

  • Most can be discharged

Admit

  • Unable to tolerate PO
  • Hemodynamic instability
  • Significant comorbidities

See Also

External Links

References