Makalah B.inggris Gasteoenteritis

8/12/2019 Makalah B.inggris Gasteoenteritis

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%. Spesific urpose

&. Gastroenteritis 'verview

(. Gastroenteritis )auses

*. Gastroenteritis Symptoms

+. Gastroenteritis Diagnosis

. Gastroenteritis Treatment

6. Gastroenteritis Self-Care and Home Remedies

-. Gastroenteritis edical Treatment

/. Gastroenteritis edications

0. Gastroenteritis revention

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BAB II

EXPLANATION

2.1 Gastroenterts O!er!e"

Diarrhea or gastroenteritis 1G23 is an increase in fre!uency and decrease in stool

consistency expenditures than individuals with normal bowel condition 1Dipiro et.al., (443.

Acute gastroenteritis or diarrhea is the fre!uency and dilution %A% where fre!uency

is more than * times per day and the number is more than (44$(4 grams 1Syaiful 5oer,

&0063.

Gastroenteritis is a condition that causes irritation and inflammation of the stomach

and intestines 1the gastrointestinal tract3.

The most common symptoms of gastroenteritis are

• diarrhea,

• nausea, and

• crampy abdominal pain,

• vomiting.

any people also refer to gastroenteritis as 7stomach flu.7 This can sometimes be confusing

because influen"a 1flu3 symptoms include.

• headache,

• muscle aches and pains, and

• respiratory symptoms, but influen"a does not involve the gastrointestinal tract.

The term stomach flu presumes a viral infection, even though there may be other

causes of infection. 8iral infections are the most common cause of gastroenteritis9 but

bacteria, parasites, and food$borne illnesses 1such as from shellfish that has been

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contaminated by sewage or from eating raw or undercooked shellfish from contaminated

water3 can also be the offending agents. any people who experience vomiting

and diarrhea that develops from these types of infections or irritations think they have

7food poisoning,7 when they actually may have a food$borne illness.

Travelers to foreign countries may experience 7traveler:s diarrhea7 from contaminated

food and unclean water. The severity of infectious gastroenteritis depends on the immune

system:s ability to resist the infection. 2lectrolytes 1these include essential elements of

sodium and potassium3 may be lost as the affected individual vomits and experiences

diarrhea.

ost people recover easily from a short episode of vomiting and diarrhea by drinkingfluids and gradually progressing to a normal diet. %ut for others, such as infants and the

elderly, the loss of bodily fluid with gastroenteritis can causedehydration, which is a life$

threatening illness unless the condition is treated and fluids are restored.

The most recent data from the )D), show that deaths from gastroenteritis have

increased dramatically. ;n (44-, &-,444 people died from gastroenteritis, overwhelmingly,

these people were older and the most common infections were Clostridium

difficile and norovirus.

2.2 Gastroenterts Causes

Gastroenteritis has many causes. 8iruses and bacteria are the most common. 8iruses

and bacteria are very contagious and can spread through the consumption contaminated food

or water. ;n up to 4< of diarrheal outbreaks, no specific agent is found. The infection can

spread from person to person because of improper handwashing following a bowel movement

or handling a soiled diaper. Gastroenteritis caused by viruses may last one to two days.

=owever, some bacterial cases can continue for a longer period of time.

#ruses $ Norovirus% Rota!rus% Adeno!ruses% Par!o!ruses% and Astro!ruses&

• Noro!rus $ >ifty to seventy percent of cases of gastroenteritis in adults are caused by

noroviruses 1genus Norovirus, familyCaliciviridae ). This virus is highly contagious

and spreads rapidly. 5orovirus is the most common cause of gastroenteritis in the

?nited States.

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5oroviruses can be transmitted by

o consuming contaminated food and li!uids,

o touching ob@ects contaminated with norovirus and then placing the hands or

fingers in the mouth,

o direct contact with an infected individual 1for example, exposure to

norovirus when caring for or sharing foods, drinks, eating utensils with an

affected individual, and

o exposure to infected individuals and ob@ects in daycare centers and nursing

homes.

5orovirus is often in the news when cruise ship passengers contract the virus causing

gastroenteritis.

• Rota!rus $ According to the )D), 7otaviruswas also the leading cause of severe

diarrhea in ?.S. infants and young children before rotavirus vaccine was introduced

for (446. rior to that, almost all children in the ?nited States were infected with

rotavirus before their th birthday. 2ach year in the ?nited States in the pre$vaccine

period, rotavirus was responsible for more than +44,444 doctor visits9 more than

(44,444 emergency room visits9 ,444 to -4,444 hospitali"ations9 and (4 to 64

deaths in children younger than years of age.7

• Adeno!ruses $ This virus most commonly causes respiratory illness9 however, other

illnesses may be caused by adenoviruses such as gastroenteritis, bladder infections,

and rashillnesses.

• Par!o!ruses ' The human bocavirus 1=%o83, which can cause gastroenteritis

belongs to the family arvoviridae.

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• Astro!ruses $ Astrovirus infection is the third most fre!uent cause of gastroenteritis

in infants.

Bactera $Clostridium difficile% Salmonella, Shigella, and E coli &

%acteria may cause gastroenteritis directly by infecting the lining of the stomach and

intestine. Some bacteria such as Staphylococcus aureus produce a toxin that is the cause of

the symptoms. Staph is a common type of food poisoning.

• 2scherichia coli infection can cause significant complications. 2. coliBCi '&-E=-

1one type of the bacteria3 can cause complications in approximately &4< of affected

individuals 1for example, kidney failure in children 1hemolytic$uremic syndrome or

=?S3, bloody diarrhea, and thrombotic thrombocytopenic purpura 1TT3 in the

elderly

• Salmonella, Shigella and )ampylobacter.

Salmonella, Shigella and )ampylobacter are also common causes of illness.

• )lostridium difficile 1) difficile3 bacteria may overgrow in the large intestine after a

person has been on antibiotics for an infection. The most common antibiotics that

pose a potential risk

Parastes and Proto(oans $Garda% Cr)ptospordu*&

These tiny organisms are less fre!uently responsible for intestinal irritation. A person

may become infected by one of these by drinking contaminated water. Swimming pool sare

common places to come in contact with these parasites. )ommon parasites include

• Giardia is the most fre!uent cause of waterborne diarrhea, causing giardiasis. 'ften,

people become infected after swallowing water that has been contaminated by animal

feces 1poop3. This may occur by drinking infected water from river or lakes but

giardia may also be found in swimming pools, wells and cisterns.

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• Cryptosporidium 1)rypto3 is a parasite that lives in the intestine of affected

individuals or animals. The infected individual or animal sheds

the Cryptosporidium parasite in the stool. )rypto may also be found in food, water,

soil, or contaminated surfaces 1swallowing contaminated water, beverages, uncooked

food, unwashed fruits and vegetables, touching contaminated surfaces such as

bathroom fixtures, toys, diaper pails, changing tables, changing diapers, caring for an

infected individual or handling an infected cow or calf3. Those at risk for serious

disease are individuals with weakened immune systems.

2.3 Gastroenterts +)*pto*s

%y definition, gastroenteritis affects both the stomach and the intestines, resulting in

vomiting and diarrhea.

)ommon gastroenteritis symptoms

• Fow grade fever to &44 > 1*-.- )3

• 5ausea with or without vomiting

• ild$to$moderate diarrhea

• )rampy painful abdominal bloating 1The cramps may come in cycles, increasing in

severity until a loose bowel movement occurs and the pain resolves somewhat.3

ore serious symptoms of gastroenteritis

• %lood in vomit or stool 1blood in vomit or stool is never normal and the affected

individual should call or a visit a health care professional.3

• 8omiting more than +/ hours

• >ever higher than &4& > 1+4 )3

•

Swollen abdomen or abdominal pain

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• Dehydration $ weakness, lightheadedness, decreased urination, dry skin, dry mouth

and lack of sweat and tears are characteristic signs and symptoms.

2.4 Gastroenterts Da,noss

Gastroenteritis is often self$limiting, and the care is supportive designed to control

symptoms and prevent dehydration. Tests may not be needed. ;f the symptoms persist for a

prolonged period of time, the health care professional may consider blood and stool tests to

determine the cause of the vomiting and diarrhea.

Patent -stor) and P)sca/ E0a*naton

Taking a thorough history and physical examination is very helpful in accessing the

diagnosis.

uestions asked by the health care professional may includeE

&. =ave any other family members or friends had similar exposure or symptomsH

(. #hat is the duration, fre!uency, and description of the patient:s bowel movements,

and is vomiting presentH

*. )an the patient tolerate any fluids by mouthH

These !uestions help determine the potential risk of dehydration and may also include

asking !uestions about the amount and fre!uency of urination, weight loss, lightheadedness,

andfainting 1syncope3.

'ther information in the medical history that may be helpful in the diagnosis of

gastroenteritis includeE

• Tra!e/ stor) Travel may suggest E. coli bacterial infection or a parasite infection

ac!uired from something the patient ate or drank. 5orovirus infections tend to occur

when many people are confined to a close space 1for example, cruise ship3.

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• E0posure to posons or oter rrtantsSwimming in contaminated water or

drinking from suspicious fresh water such as mountain streams or wells may indicate

infection with Giardia $ an organism found in water.

• Det can,e% ood preparaton a3ts% and stora,e #hen the disease occurs

following exposure to undercooked or improperly stored or prepared food 1for

example foods at picnics and %%s that should be refrigerated to avoid

contamination3, food poisoning must be considered. ;n general, symptoms caused by

bacteria or their toxins will become apparent after the following amount of timeE

o Staphylococcus aureus in ( to 6 hours

o Clostridium / to &4 hours

o Salmonella in &( to -( hours

• 4edcatons ;f the patient has used antibiotics recently, they may have antibiotic$

associated irritation of the gastrointestinal tract, caused byclostridium

difficile infection.

hysical examination will explore the reasons for symptoms that may not be related to

infection. ;f there are specific tender areas in the abdomen, the health care practitioner may

wanttodetermineif the patient, has appendicitis, gallbladder disease, pancreatitis, diverticulitis,

or other conditions that maybe the cause of the patient:s symptoms.

'ther noninfectious gastrointestinal diseases such as )rohn:s disease, ulcerative

colitis, or microscopic colitis also must be considered. The health care practitioner will feel

the abdomen for masses. A rectal examination may be considered, in which the physician

inspects the anus for any abnormalities and then inserts a finger in the rectum to feel for any

masses. Stool obtained during this test may be tested for the presence of blood.

The health care practitioner may perform other laboratory tests, including complete

blood count 1)%)3, electrolytes, and kidney function tests. Stool samples may be collected

and tested for blood or different types of infection.

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2.5 Gastroenterts Treat*ent

Treatment of gastroenteritis include self$care and home remedies that are aimed at

keeping the patient well hydrated to avoid dehydration. edical treatment may be necessary

if the patient becomes dehydrated and needs hospitali"ation to rehydrate via an ;8 solution.

Some medications may be prescribed to treat some infections 1for example, ). diff 3, to stop

vomiting, and antidiarrheal medication to treat diarrhea 1either over$the$counter or

prescription3, depending upon the condition of the patient and cause of gastroenteritis.

2.5 Gastroenterts +e/'Care and -o*e Re*edes

The treatment of gastroenteritis is aimed at hydration and home remedies that address

keeping fluid in the body are key to recovery.Since most causes of gastroenteritis are due to

viruses, replacing the fluid lost because of vomiting and diarrhea allows the body to

recuperate and fight the infection.

Dehydration can also intensify the symptoms of nausea and vomiting. The critical

step is replacing fluids when the affected individual is nauseous and doesn:t want to drink

1hydrate3. This is especially difficult with infants and children. Small fre!uent offerings of

clear fluids, sometimes only a mouthful at a time, may be enough to replenish the body:s fluid

stores and prevent an admission to the hospital for intravenous 1;83 fluid administration.;n general, clear fluids 1anything you can see through3, may be tolerated in small

amounts. Think of it as adding @ust an ounce or less to the saliva that the patient is already

swallowing. =owever, giving too much fluid at one time may cause increased nausea due to a

distended stomach, which causes additional irritation.

)lear fluids do not include carbonated beverages but colas or ginger ale with the fi""

gone are often well tolerated. )oke syrup may also be helpful in settling the stomach.

Iello and popsicles may be 7solid food7 alternatives to clear fluids in children who aren:tinterested in clear fluids.

De)draton n c/dren

'ral rehydration therapy using balanced electrolyte solutions such as edialyte or

GatoradeCowerade may be all that is needed to replenish the fluid supply in an infant or

child. lain water is not recommended because it can dilute the electrolytes in the body and

cause complications such as sei"ures due to low sodium.

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The key to oral rehydration is small fre!uent feedings. ;f offered free access to a

bottle, infants especially may drink !uickly to !uench their thirst and then vomit. ;nstead it

may be best to limit the amount of fluid given at one time. There are a variety of regimens

that are used and they follow a basic formatE

• 'ffer &C* of an ounce 1 to &4 cc3 of fluid at one time. #ait to &4 minutes then

repeat.

• ;f this amount is tolerated without vomiting, increase the amount of fluid to (C* of an

ounce 1&4 to (4 cc3. #ait and repeat.

• ;f tolerated, increase the fluid offered to & ounce 1*4 cc3 at a time.

• ;f vomiting occurs, go back to the &C* of an ounce 1 to &4 cc3 and restart.

• 'nce the child is tolerating significant fluids by mouth, a more solid diet can be

offered.

The important thing to remember is that the goal is to provide fluid to the child and

not necessarily calories. ;n the short term, hydration is more important than nutrition.

>or infants and children, fluid status can be monitored by

• whether they are urinating,

• if they have saliva in their mouths,

• tears in their eyes, and

• sweat in their armpits or groin.

;f the child:s baseline weight is known, dehydration can be measured by comparingweight. edical care should be accessed immediately, if the child is listless, floppy or does

not seem to be acting normal.

De)draton n adu/ts

Although adults and adolescents have a larger electrolyte reserve than children, electrolyte

imbalance and dehydration may still occur as fluid is lost through vomiting and diarrhea.

Severe symptoms and dehydration usually develop as complications of medication use or

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chronic diseases such as diabetes or kidney failure9 however, symptoms may occur in healthy

people.

• )lear fluids are appropriate for the first (+ hours to maintain ade!uate hydration.

• After (+ hours of fluid without vomiting, begin a soft$bland solid diet such as the

%AT diet 1bananas, rice, apples, toast3 and then progress the diet to other foods as

tolerated.

2.6 Gastroenterts 4edca/ Treat*ent

?pon seeking medical attention, if the patient cannot take fluids by mouth because of

vomiting, the health care practitioner may insert an ;8 to replace fluids back into the body

1rehydration3.

;n infants, depending upon the level of dehydration, intravenous fluids may be

delayed in order to attempt oral rehydration therapy. >re!uent feedings, as small as a &C6

ounce 1 cc3 at a time, may be used to restore hydration.

2.7 Gastroenterts 4edcaton

Antibiotics are usually not prescribed until a bacteria or parasite has been identified as

the cause of the infection. Antibiotics may be given for certain bacteria,

specifically )ampylobacter,Shigella, and 8ibrio cholerae, if properly identified through

laboratory tests. 'therwise, using any antibiotic or the wrong antibiotic can worsen some

infections or make them last longer.

Antibiotics are not used to treat virus infection.Some infections, such as salmonella,

are not treated with antibiotics. #ith supportive carecomprising of fluids and rest, the body is

able to fight and resolve the infection without antibiotics.

>or adults, the health care practitioner may prescribe medications to stop the vomiting

1antiemetics3 such as prometha"ine1henergan, Anergan3, prochlorpera"ine1)ompa"ine3,12











or ondansetron 1Jofran3. Sometimes these medications are prescribed as a suppository.

Doctors usually do not recommend antiemetics for infants, but depending upon the situation,

older children may be prescribed an antiemetic 1antinausea3 medication in a lower dosage.

Antidiarrhea medications are not usually recommended if the infection is associated

with a toxin that causes the diarrhea. The most common antidiarrheal agents for people older

than * years of age include over$the$counter 1'T)3 medications such as

diphenoxylateatropine 1Fomotil, Fofene, Fonox3 or loperamidehydrochloride 1;modium3.

2.8 Gastroenterts Pre!enton

#ith most infections, the key is to block the spread of the organism.

• Always wash your hands.

• 2at properly prepared and stored food.

•

%leach soiled laundry.

• 8accinations for 8ibrio cholerae, and rotavirus have been developed. otavirus

vaccination is recommended for infants in the ?.S. 8accines for 8. cholerae may be

administered to individuals traveling to at$risk areas.

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BAB III

END

9.1 Conc/uson

Diarrhea or gastroenteritis disease is an important disease around people who are still

the main cause of morbidity and mortality someone, especially in children. This reflected a

lot of people who suffer from diarrhea or gastroenteritis coming out of hospital. As a result of

many factors, including diarrheal diseases environmental health, higene individual,

nutritional status, socioeconomic factors, determine diarrheal disease, many cases of diarrhea

sufferers who experience severe dehydration and many die if not done the right actions.

9.2 +u,,eston

%ased on the results of this paper mainly kepeda author expects readers and especially

students ST;Kes )eria %uana gastroenteritisl order to add knowledge about the 2nglishlanguage courses.

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RE:ERENCE+

#ebb, A9 Starr, 1(44 Apr3. 7Acute gastroenteritis in children.7. Australian family

physician 9; 1+3E ((-L*&.

an S 1December (4&&3. 7The clinical importance of emerging )ampylobacter

species7. Nature Reviews. Gastroenterology & epatology 7 1&(3E 660L/.

2ckardt AI, %aumgart D) 1Ianuary (4&&3. 78iral gastroenteritis in adults7. Recent !atents on

Anti"infective #rug #iscovery 5 1&3E +L6*.

S"a@ewska, =9 D"iechciar", 1(4&4 Ian3. 7Gastrointestinal infections in the pediatric

population.7. Current opinion in gastroenterology 25 1&3E *6L++.

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Makalah B.inggris Gasteoenteritis

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