I.

INTRODUCTION

Although often considered a benign disease, acute gastroenteritis remains a

major cause of morbidity and mortality in children around the world, accounting for 1.8
million deaths annually in children younger than 5 years, or roughly 17% of all child
deaths. Because the severity of the disease can widely vary depending on the volume
of fluid loss, accurately assessing and treating dehydration in children presenting with
acute gastroenteritis remains a critical skill for every emergency physician. Luckily, most
cases of dehydration in children can be accurately diagnosed by a careful clinical
examination and treated with simple, cost-effective measures. Infections of the GI tract
are among the most common childhood illnesses. There are at least 1 billion episodes
of gastroenteritis in children around the world every year.
Anyone can get gastroenteritis. It is most common in children under age 5, in day cares,
among travelers, among the immune suppressed, and in places lacking clean food or
water.
Gastroenteritis is an infection of the bowel (intestines) that causes diarrhea and
sometimes vomiting. It is common in infants and children. It is more serious in infants
and young children than it is in adults. Diarrhea and vomiting can cause the loss of
important fluids and minerals the body needs (dehydration). Infants and children lose
fluids and minerals quicker than adults. Since water makes utmost of an infant's or
child's weight this can lead to serious illness and require hospitalization.

A. Background of the Study

Gastroenteritis (also known as stomach flu, although unrelated to influenza) is

inflammation of the gastrointestinal tract, involving both the stomach and the small
intestine and resulting in acute diarrhea. The inflammation is caused most often by
infection with certain viruses, less often by bacteria or their toxins, parasites, or adverse
reaction to something in the diet or medication. Worldwide, inadequate treatment of
gastroenteritis kills 5 to 8 million people per year, and is a leading cause of death
among infants and children under 5. At least 20% of cases, and the majority of severe
cases in children, are due to rotavirus. Other significant viral agents include adenovirus
and astrovirus.
Different species of bacteria can cause gastroenteritis, including Salmonella,
Shigella, Staphylococcus, Campylobacter jejuni, Clostridium, Escherichia coli, Yersinia,
and others. Some sources of the infection are improperly prepared food, reheated meat
dishes, seafood, dairy, and bakery products. Each organism causes slightly different
symptoms but all result in diarrhea.
Gastroenteritis is a catchall term for infection or irritation of the digestive tract,
particularly the stomach and intestine. It is frequently referred to as the stomach or
intestinal flu, although the influenza virus is not associated with this illness. Major
symptoms include nausea and vomiting, diarrhea, and abdominal cramps. These
symptoms are sometimes also accompanied by fever and overall weakness.
Gastroenteritis typically lasts about three days. Adults usually recover without problem,
but children, the elderly, and anyone with an underlying disease are more vulnerable to
complications such as dehydration.

B. Rationale for choosing the case

• To study and describe the nature of the disease
• To enhance our knowledge and increase our awareness in the
development or manifestation of the disease.
• To implement interventions that would help the client overcome the effects
of the disease.

C. Significance of the Study

• Nursing Students
Through this study, the students will be able to broaden their knowledge
regarding Acute Gastroenteritis. They will have a clear and better understanding
about the nature of the disease and the essence of having awareness about the
manifestation of it as well as to gain knowledge about its signs and symptoms
and treatment.
 • Client
This study may help the client’s S.O. to fully understand the disease and
its treatment.

D. Scope and Limitation

This study covers and focuses on the following:
• A brief discussion of the nature of the disease and the anatomy and
physiology of the system involve.
• Tracing the pathophysiology of Acute Gastroenteritis.
• Introducing the patient, identifying the cause of the disease by determining
the client’s history of past illness.
• Understanding the actions, contraindications, special precautions and
nursing interventions of the prescribed medicines of the patient.
• Formulating an appropriate nursing interventions and plan for the patient.
• Health teaching regarding the disease.

II. CLINICAL SUMMARY

A. Eclectic Model
1. Bio-demographic Data:
a. Name : Baby GC
b. Age : 2 months old
c. Sex : Female
d. Civil Status : Single

2. Source of Information
A. Primary Sources:
• Mr. and Mrs. GC
• Nurses on Duty
B. Secondary Sources:
 • Patient’s records and chart
3. Chief Complaint:
• 2 consecutive days of defecating loose-watery stool

4. History of the Present Illness:

According to her parents, after 2 months of feeding her with
lactose-intolerant milk, Baby GC began to defecate loose-watery stool. They
decided to change her milk but as wasn’t expected, Baby GC continued to
defecate the same.

5. Current Health Status:

a. Body Movement
Baby GC flexes her upper and lower extremities well.
b. Affect and Mood
Baby GC is fairly active while she’s awake and usually cries when
she’s irritable.

6. Activities of Daily Living

a. Nutrition
Baby GC receives incomplete nutritional diet for her age because she
is not directly breastfed by her mother because her nipple is inverted.
b. Elimination
Baby GC urinates usually about 330 ml per day and defecates twice a
day.
c. Hygiene, Grooming and Body Odor
Baby GC usually cleaned by her mother every morning and dressed
her neatly and has no foul odor.
d. Rest and Sleep
Baby GC is fairly and quietly sleeping for long period of time.
 7. Past Biophysical Health
a. Allergies
No allergies noted.
b. Immunization
BCG has already given to Baby GC.
d. Growth and Development
Baby GC has decreased weight from 3.9 kg to 3.2 kg.
e. Foreign Travel
No noted foreign travel so far.
f. Family Health History
Baby GC’s father has a history of hypertension and gets used to smoking,
while her mother has no history of any disease.

8. Spiritual
a. Religious Belief and Practice
Baby GC’s family is a Roman Catholic and practice to go to church every
Sunday and they believe in “herbularios” or “hilots”.

B. Physical Assessment
1. General Observation (Day 1-Nov. 27, 2008)
a. General Appearance and Behavior
• Pallor
• Weak Cry
• Fairly Weak
b. Vital Signs
4pm
• T- 36.7°C 8pm
• P- 136 bpm • T- 36.8°C

• R- 38 breaths/min. • P- 128 bpm

• R- 40 breaths/min
c. Height and Weight
Height: (Normal Value: 50 cm or 20”) Result: 38.1 cm
Weight: (Normal Value: 2.7- 3.8 kg) Result: 3.9 kg

Complete Physical Examination

SKIN
• Cyanotic
• Poor skin turgor
• No lesions
HEAD
• Symmetrical
• Sunken fontanels
FACE
• Symmetrical
EYES
• Symmetrical
• Sunken eyeball
• Lower Conjunctiva is pale.
• Absence of tears when crying.
EARS
• Symmetrically aligned to the outer cantus of the eye
• No discharge
NOSE
• Symmetrical
• No discharge
MOUTH
• Pale and dry lips
• Uvula in midline
CHEST
 • Shape: symmetrical
• Respiration: spontaneous
• Heart: (-) murmur
ABDOMEN
• Tender
• With gargling bowel sounds
EXTREMITIES
• Grossly normal
• Cyanotic
• Capillary refill (5-6 sec.)
ANUS
• Patent

General Observation (Day 2-Nov. 28, 2008)

a. General Appearance and Behavior
• Pallor
• Weak Cry
• Fairly Weak
b. Vital Signs
4pm 8pm
• T- 38.1°C • T- 37.4°C
• P- 142 bpm • P- 124 bpm
• R- 56 breaths/min • R- 34 breaths/min.
c. Height and Weight
Height: (Normal Value: 50 cm or 20”) Result: 38.1 cm
Weight: (Normal Value: 2.7- 3.8 kg) Result: 3.5 kg

Complete Physical Examination

SKIN
• Slight cyanotic
 • Poor skin turgor
• No lesions
HEAD
• Symmetrical
• Sunken fontanels
FACE
• Symmetrical
EYES
• Symmetrical
• Sunken eyeball
• Lower Conjunctiva is pale.
• Absence of tears when crying
EARS
• Symmetrically aligned to the outer cantus of the eye
• No discharge
NOSE
• Symmetrical
• No discharge
MOUTH
• Pale and dry lips
• Uvula in midline
CHEST
• Shape: symmetrical
• Respiration: spontaneous
• Heart: (-) murmur
ABDOMEN
• Tender
• With gargling bowel sounds
EXTREMITIES
 • Grossly normal
• Cyanotic
• Capillary refill (3-4 sec.)
ANUS
• patent
General Observation (Day 3-Nov. 29, 2008)
a. General Appearance and Behavior
• Good cry
• Fairly active
• Irritable
b. Vital Signs
4pm 8pm
• T- 37°C • T- 36.9°C
• P- 126 bpm • P- 122 bpm
• R- 38 breaths/min. • R- 36 breaths/min
c. Height and Weight
Height: (Normal Value: 50 cm or 20”) Result: 38.1 cm
Weight: (Normal Value: 2.7- 3.8 kg) Result: 3.2 kg

Complete Physical Examination

SKIN
• Good skin turgor
• No lesions
HEAD
• Symmetrical
• Sunken fontanels
FACE
• Symmetrical
EYES
• Symmetrical
 • Presence of tears when crying
• Lower conjunctiva is pink.
EARS
• Symmetrically aligned to the outer cantus of the eye
• No discharge
NOSE
• Symmetrical
• No discharge
MOUTH
• Pink and moist lips
• Uvula in midline
CHEST
• Shape: symmetrical
• Respiration: spontaneous
• Heart: (-) murmur
ABDOMEN
• soft
• No gargling bowel sounds
EXTREMITIES
• Grossly normal
• Cyanotic
• Capillary refill (2-3 sec.)
ANUS
• patent
 C. Laboratory and Diagnostics Examination
Clinical Chemistry

November 24, 2008

Type of Exam
Clinical Chemistry

TEST NORMAL RESULT INTERPRETATION SIGNIFICANCE

VALUE OF THE
RESULT
Sodium 135- 137meq/L NORMAL
155meq/L
Potassium 3.4- 2.40meq/L BELOW NORMAL Decrease
5.3meq/L potassium
indicates
chronic diarrhea

November 27, 2008

Type of Exam
Clinical Chemistry

TEST NORMAL RESULT INTERPRETATION SIGNIFICANCE

VALUE OF THE
RESULT
Sodium 135-155meq/L 137.5meq/L NORMAL
Potassium 3.4-5.3meq/L 2.40meq/L BELOW NORMAL Decrease
potassium
indicates
chronic diarrhea
November 23, 2008
Type of Exam
Gross Examination
FECALYSIS
Color: Yellow
Consistency: Mushy
Occult Blood: None
MICROSCOPIC
Red blood cells: 0-1
Ova or parasite: None found
OTHERS
Bacteria: Moderate
Fat Globules: Many

November 27, 2008

Type of Exam
Gross Examination
FECALYSIS
Color: Yellow brown
Consistency: Soft
Ova or parasite: None (no intestinal parasite found)
OTHERS
Bacteria: Moderate
Fat Globules: Rare

Significance of the Result:

Presence of fat globules indicates malabsorption syndrome due to undigested
milk.
D. Course in the Ward
 November 25, 2008, Baby GC, a 2 month old child was admitted to Gastro
room in Pediatric Ward of the Laguna Provincial Hospital with the chief complaint
of loose watery stool and impaired bowel movement.

On the third day of her admission, November 27, Ms. Ma. Katrina
Panisan, our Clinical Instructress, endorsed us Baby GC. We received her at
2pm with an IV fluid of D5 0.3NaCl ½ liter at 280cc and 10meqs of KCl via
soluset at 10cc to run at 32-33µgtts/min. which was inserted at the right
metacarpal vein not infusing well. We referred Baby GC to Ma’am Panisan for
edema on her IV site. We’ve performed thorough physical assessment, checked
and monitored her vital signs every four hours, attended her needs as well as
monitored her urine and stool output. She defecated 3x during our shift. Her due
medication was given by the NOD.

On the fourth day of admission, November 28, 2008, we received her with
an IVF of D5 0.3NaCl ½ liter at 355cc and 10 meqs of KCl via soluset at 68cc,
inserted at the right metatarsal infusing well. Still, we monitored her vital signs
every four hours, maintained and regulated her IVF. By this time, she defecated
twice with yellow-greenish mushy stool during our shift.

On the fifth day of admission, November 29, 2008, her abdomen was not
distended and tender at all. She had no IVF when we received her and her bowel
pattern was in normal condition according to her mother. They could go home
anytime according to the doctor.

III. CLINICAL DISCUSSION OF THE DISEASE

A. Anatomy and Physiology
THE DIGESTIVE SYSTEM OF INFANTS
Infants growing digestive system leaves
them vulnerable for all kinds of gastro-intestinal
problems. Infants simply can’t digest foods as
effectively as adults, whose own systems really
can’t handle the garbage that passes for food
nowadays. Interestingly, infants possess unique
enzymes in their mouths which are not evident in
adults. When your baby feeds, these enzymes start
breaking down fats in the breastmilk while it’s still in
their mouth as a kind of head start on the digestive
process. By the time food gets to your child’s
stomach, it’s already broken down a little so it’s
easier to digest.

Normal Digestive Tract Phenomena

Gastrointestinal function varies with maturity; what is a physiologic event in a
newborn or infant might be a pathologic symptom at an older age. A fetus can swallow
amniotic fluid as early as 12 wk gestation, but nutritive sucking in neonates 1st develops
at about 34 wk gestation. The coordinated oral and pharyngeal movements necessary
for swallowing solids develop within the 1st few months of life. Before this time, the
tongue thrust is upward and outward to express milk from the nipple, instead of a
backward motion, which propels solids toward the esophageal inlet. By 1 month of age,
infants appear to show preferences for sweet and salty foods. Infants' interest in solids
increases at about 4 months of age.

HUMAN DIGESTION PROCESS

Phases of Gastric Secretion
• Cephalic phase - This phase occurs before food enters the stomach and
involves preparation of the body for eating and digestion. Sight and thought
stimulate the cerebral cortex. Taste and smell stimulus is sent to the
hypothalamus and medulla oblongata. After this it is routed through the vagus
nerve and release of acetylcholine. Gastric secretion at this phase rises to 40%
of maximum rate. Acidity in the stomach is not buffered by food at this point and
thus acts to inhibit parietal (secretes acid) and G cell (secretes gastrin) activity
via D cell secretion of somatostatin.
• Gastric phase - This phase takes 3 to 4 hours. It is stimulated by distention of
the stomach, presence of food in stomach and increase in pH. Distention
activates long and myentric reflexes. This activates the release of acetylcholine
which stimulates the release of more gastric juices. As protein enters the
stomach, it binds to hydrogen ions, which raises the pH of the stomach to around
pH 6. Inhibition of gastrin and HCl secretion is lifted. This triggers G cells to
release gastrin, which in turn stimulates parietal cells to secrete HCl. HCl release
is also triggered by acetylcholine and histamine.
• Intestinal phase - This phase has 2 parts, the excitatory and the inhibitory.
Partially-digested food fills the duodenum. This triggers intestinal gastrin to be
released. Enterogastric reflex inhibits vagal nuclei, activating sympathetic fibers
causing the pyloric sphincter to tighten to prevent more food from entering, and
inhibits local reflexes.

Oral cavity
In humans, digestion begins in the oral cavity where food is chewed. Saliva is
secreted in large amounts (1-1.5 litres/day) by three pairs of exocrine salivary glands
(parotid, submandibular, and sublingual) in the oral cavity, and is mixed with the chewed
food by the tongue. There are two types of saliva. One is a thin, watery secretion, and
its purpose is to wet the food. The other is a thick, mucous secretion, and it acts as a
lubricant and causes food particles to stick together and form a bolus. The saliva serves
to clean the oral cavity and moisten the food, and contains digestive enzymes such as
salivary amylase, which aids in the chemical breakdown of polysaccharides such as
starch into disaccharides such as maltose. It also contains mucin, a glycoprotein which
helps soften the food into a bolus.
Swallowing transports the chewed food into the esophagus, passing through the
oropharynx and hypopharynx. The mechanism for swallowing is coordinated by the
swallowing center in the medulla oblongata and pons. The reflex is initiated by touch
receptors in the pharynx as the bolus of food is pushed to the back of the mouth.

Esophagus
The esophagus is a narrow muscular tube about 25 centimeters long which starts
at pharynx at the back of the mouth, passes through the thorax and thoracic diaphragm,
and ends at the cardiac orifice of the stomach. The wall of the esophagus is made up of
two layers of smooth muscles, which form a continuous layer from the esophagus to the
oten and contract slowly, over long periods of time. The inner layer of muscles is
arranged circularly in a series of descending rings, while the outer layer is arranged
longitudinally. At the top of the esophagus, is a flap of tissue called the epiglottis that
closes during swallowing to prevent food from entering the trachea (windpipe). The
chewed food is pushed down the esophagus to the stomach through peristaltic
contraction of these muscles. It takes only about seven seconds for food to pass
through the esophagus and no digestion takes place.

Stomach
The stomach is a small, “J”-shaped pouch with walls made of thick, elastic
muscles, which stores and helps break down food. Food enters the stomach through
the cardiac orifice where it is further broken apart and thoroughly mixed with gastric
acid, pepsin and other digestive enzymes to break down proteins. The acid itself does
not break down food molecules, rather it provides an optimum pH for the reaction of the
enzyme pepsin and kills many microorganisms that are ingested with the food. The
parietal cells of the stomach also secrete a glycoprotein called intrinsic factor which
enables the absorption of vitamin B-12. Other small molecules such as alcohol are
absorbed in the stomach, passing through the membrane of the stomach and entering
the circulatory system directly. Food in the stomach is in semi-liquid form.
The transverse section of the alimentary canal reveals four distinct and well developed
layers within the stomach:
• Serous membrane, a thin layer of mesothelial cells that is the outermost wall of
the stomach.
• Muscular coat, a well-developed layer of muscles used to mix ingested food,
composed of three sets running in three different alignments. The outermost
layer runs parallel to the vertical axis of the stomach (from top to bottom), the
middle is concentric to the axis (horizontally circling the stomach cavity) and the
innermost oblique layer, which is responsible for mixing and breaking down
ingested food, runs diagonal to the longitudinal axis. The inner layer is unique to
the stomach, all other parts of the digestive tract have only the first two layers.
• Submucosa, composed of connective tissue that links the inner muscular layer to
the mucosa and contains the nerves, blood and lymph vessels.
• Mucosa is the extensively folded innermost layer filled with connective tissue and
covered in gastric glands that may be simple or branched tubular, and secret
mucus, hydrochloric acid, pepsinogen and renin. The mucus lubricates the food
and also prevents hydrochloric acid from acting on the walls of the stomach.

Small intestine
After being processed in the stomach, food is passed to the small intestine via
the pyloric sphincter. The majority of digestion and absorption occurs here after the
milky chyme enters the duodenum. Here it is further mixed with three different liquids:
• Bile, which emulsifies fats to allow absorption, neutralizes the chyme and is used
to excrete waste products such as bilin and bile acids.
• Pancreatic juice made by the pancreas.
• Intestinal enzymes of the alkaline mucosal membranes. The enzymes include
maltase, lactase and sucrase (all three of which process only sugars), trypsin
and chymotrypsin.
 As the pH level changes in the small intestines and gradually becomes basic,
more enzymes are activated further that chemically break down various nutrients into
smaller molecules to allow absorption into the circulatory or lymphatic systems. Small,
finger-like structures called villi, each of which is covered with even smaller hair-like
structures called microvilli improve the absorption of nutrients by increasing the surface
area of the intestine and enhancing speed at which nutrients are absorbed. Blood
containing the absorbed nutrients is carried away from the small intestine via the
hepatic portal vein and goes to the liver for filtering, removal of toxins, and nutrient
processing.
The small intestine and remainder of the digestive tract undergoes peristalsis to
transport food from the stomach to the rectum and allow food to be mixed with the
digestive juices and absorbed. The circular muscles and longitudinal muscles are
antagonistic muscles, with one contracting as the other relaxes. When the circular
muscles contract, the lumen becomes narrower and longer and the food is squeezed
and pushed forward. When the longitudinal muscles contract, the circular muscles relax
and the gut dilates to become wider and shorter to allow food to enter.

Large intestine
After the food has been passed through the small intestine, the food enters the large
intestine. The large intestine is roughly 1.5 meters long, with three parts: the cecum at the
junction with the small intestine, the colon, and the rectum. The colon itself has four parts: the
ascending colon, the transverse colon, the descending colon, and the sigmoid colon. The
large intestine absorbs water from the bolus and stores feces until it can be egested. Food
products that cannot go through the villi, such as cellulose (dietary fiber), are mixed with other
waste products from the body and become hard and concentrated feces. The feces is stored in
the rectum for a certain period and then the stored feces is egested due to the contraction and
relaxation through the anus. The exit of this waste material is regulated by the anal sphincter.

Fat digestion
The presence of fat in the small intestine produces hormones which stimulate the
release of lipase from the pancreas and bile from the gallbladder. The lipase (activated
by acid) breaks down the fat into monoglycerides and fatty acids. The bile emulsifies the
fatty acids so they may be easily absorbed.
Short- and some medium chain fatty acids are absorbed directly into the blood via
intestine capillaries and travel through the portal vein just as other absorbed nutrients
do. However, long chain fatty acids and some medium chain fatty acids are too large to
be directly released into the tiny intestinal capillaries. Instead they are absorbed into the
fatty walls of the intestine villi and reassembled again into triglycerides. The triglycerides
are coated with cholesterol and protein (protein coat) into a compound called a
chylomicron.
Within the villi, the chylomicron enters a lymphatic capillary called a lacteal, which
merges into larger lymphatic vessels. It is transported via the lymphatic system and the
thoracic duct up to a location near the heart (where the arteries and veins are larger).
The thoracic duct empties the chylomicrons into the bloodstream via the left subclavian
vein. At this point the chylomicrons can transport the triglycerides to where they are
needed.

Digestive hormones
There are at least four hormones that aid and regulate the digestive system:
• Gastrin - is in the stomach and stimulates the gastric glands to secrete
pepsinogen(an inactive form of the enzyme pepsin) and hydrochloric acid.
Secretion of gastrin is stimulated by food arriving in stomach. The secretion is
inhibited by low pH .
• Secretin - is in the duodenum and signals the secretion of sodium bicarbonate in
the pancreas and it stimulates the bile secretion in the liver. This hormone
responds to the acidity of the chyme.
• Cholecystokinin (CCK) - is in the duodenum and stimulates the release of
digestive enzymes in the pancreas and stimulates the emptying of bile in the gall
bladder. This hormone is secreted in response to fat in chyme.
• Gastric inhibitory peptide (GIP) - is in the duodenum and decreases the stomach
churning in turn slowing the emptying in the stomach. Another function is to
induce insulin secretion.
Significance of pH in digestion
Digestion is a complex process which is controlled by several factors. pH plays a
crucial role in a normally functioning digestive tract. In the mouth, pharynx, and
esophagus, pH is typically about 6.8, very weakly acidic. Saliva controls pH in this
region of the digestive tract. Salivary amylase is contained in saliva and starts the
breakdown of carbohydrates into monosaccharides. Most digestive enzymes are
sensitive to pH and will not function in a low-pH environment like the stomach. A pH
below 7 indicates an acid, while a pH above 7 indicates a base; the concentration of the
acid or base, however, does also play a role.
pH in the stomach is very acidic and inhibits the breakdown of carbohydrates while
there. The strong acid content of the stomach provides two benefits, both serving to
denature proteins for further digestion in the small intestines, as well as providing non-
specific immunity, retarding or eliminating various pathogens.
In the small intestines, the duodenum provides critical pH balancing to activate digestive
enzymes. The liver secretes bile into the duodenum to neutralise the acidic conditions
from the stomach. Also the pancreatic duct empties into the duodenum, adding
bicarbonate to neutralize the acidic chyme, thus creating a neutral environment. The
mucosal tissue of the small intestines is alkaline, creating a pH of about 8.5, thus
enabling absorption in a mild alkaline in the environment.

B. ECOLOGICAL MODEL

HYPOTHESIS:
 The cause of illness of the body is due to unclean environment and the parents are
lack of knowledge about sanitation and proper preparation of food for the child.

PREDISPOSING FACTORS:
a. Agent- contaminated feeding bottle
b. Host- Baby God-Centered
c. Environmental- Unclean environment, and the presence of bacteria

NURSING MODEL:
Florence Nightingale Environmental Adaptation Model
According to Florence Nightingale, in order for the patient/ client to be in the best
possible condition, we should change or manipulate the environment. Also, she
emphasized the importance of providing the client with pure/ fresh water, practice of
cleanliness and assessing the client’s diet.

ANALYSIS:
Based on the assessment done on the client and interview of the parents, their
environment is not clean enough, although they use distilled water for the milk formula,
the mother was not aware of proper cleaning of the feeding bottle.
The illness of the child may be due to dirty environment and unhygienic practices of the
parents.

INTERPRETATION:
If only the parents would practice cleanliness in their environment and will be aware of
proper cleaning of materials needed for the preparation of the food of the child, the child
will be healthy and illness will be prevented.

C. Pathophysiology and Symptomatology

PATHOPHYSIOLOGY OF ACUTE GASTROENTERITIS

PREDISPOSING FACTORS:

• Contaminated Feeding bottle

• Lactose intolerance
 Presence of bacteria in the Absence of enzyme to digest
feeding bottle lactose (lactase)

Ingestion of bacteria Lactose is not digested nor

absorbed into the blood
stream

Presence Bacteria enter the intestinal

of bacteria tract and excrete exotoxin Lactose passes into the colon
in stool

Damages the intestinal Enteric bacteria try to digest

mucosa causing lactose
Fever inflammation

Fermentation of Most particles of

lactose lactose still
undigested

Production of gas
Abdominal (mixture of H,
distention CO2, methane)
Flatulence

Increase in
osmotic pressure
in the intestine

Intestinal absorption Water is pulled in into the

becomes impaired intestine by the unabsorbed
particles of lactose
Gastrointestinal motility is
increased Diarrhea

Fluids and electrolytes

secreted at fast rates

Sunken
Fontanels
Dehydration Sunken eyeballs
Hypokalemia Dry skin
Cyanotic
Poor skin turgor
Dry lips