PATHOPHYSIOLOGY OF ACUTE

GASTROENTERITIS (AGE)

Acute gastroenteritis is usually caused by bacteria and protozoan. In the Philippines,

one of the most common causes of acute gastroenteritis is E. histolytica. The pathologic
process starts with ingestion of fecally contaminated food and water. The organism affects the
body through direct invasion and by endotoxin being released by the organism. Through these
two processes the bowel mucosal lining is stimulated and destroyed the eventually lead to
attempted defecation or tenesmus as the body tries to get rid of the foreign organism in the
stomach.
The client with acute gastroenteritis may also report excessive gas formation that may
leads to
abdominal distention and passing of flatus due to digestive and absorptive malfunction in the
system. Feeling of fullness and the increase motility of the gastrointestinal tract may progress to
nausea and vomiting and increasing frequency of defecation. Abdominal pain and feeling of
fullness maybe relieved only when thepatient is able to pass a flatus.
As the destruction of the bowel continues the mucosal lining erodes due to toxin, direct
invasion of the organism and the action of the hydrochloric acid of the stomach. As the
protective coating of the stomach erodes the digestive capabilities of the acid helps in
destroying the stomach lining. Pain or tenderness of the abdomen is then felt by the patient.
When the burrows or ulceration reaches the blood vessels in the stomach bleeding will be
induced. Dysentery may be characterized by melena or hematochezia depending on the site
and quantity of bleeding that may ensue. Signs of bleeding may be observed also through
hematemesis.
As the bowel is stimulated by the organism and its toxin, the intestinal tract secretes
water and
electrolytes in the intestinal lumen. The body secretes and therefore lost Chloride and
bicarbonate ions in the bowel as the body try to get rid of the organism by increasing peristalsis
and number of defecation. Sodium and water reabsorption in the bowel is inhibited with the lost
of the two electrolytes.
Mild diarrhea is characterized by 2-3 stool, borborygmi (hyperactive bowel sound),fluid
and electrolyte imbalance and hypernatremia. When the condition continue to progress, protein
in the body is excreted to the lumen that further decreases the reabsorption and the body
become overwhelmed that leads to intense diarrhea with more than 10 watery stool. Serious
fluid volume deficit may lead to hypovolemic shock and eventually death.