Causes, Effects and Prevention of Acute Gastroenteritis Among Pediatrics Patients

By: Margielyn C. Andallo BS Nursing IV-A We know that children loves to eat. There are instances that if they see some foods; one thing that they will most likely do is eat it without even knowing where it came from and whether it is clean or not and it is because they are yet a child. Parents need to supervise their children particularly the food that they eat and be concern of the sources of water that they drink. Based on what I observed in the hospitals that we have affiliated specifically Pediatric wards there are many cases of acute gastroenteritis in children. Moreover, as I remembered that recently my nephew has been hospitalized because of acute gastroenteritis. Curiosity comes in my mind and I am eager to know why it is very common to most of these children, where do they get it, is it from the food or drinks? In addition, what might happen to them when they acquire this preventable disease, as far as I know patients with acute gastroenteritis suffers symptoms like diarrhea, abdominal pain, fever and sometimes they may even exhibit vomiting. It is a public awareness that acute gastroenteritis causes diarrhea and vomiting, yet many people are not cognizant that there are multiple consequences behind those symptoms, which could possibly have a great impact on the general health condition of their children if not treated during the early phase. In connection to this, the reader may find it interesting to know the several causes and effects of acute gastroenteritis among our pediatric patients. For this reason, parents should consistently able to learn and apply the how knowledge to prevent acute gastroenteritis and how to provide their child the appropriate foods they need. According to health care tips gastroenteritis is a general term referring to inflammation or infection of the gastrointestinal tract, primarily the stomach and intestines. It can be caused by infection with bacteria, viruses, or other parasites, or less commonly reactions to new foods or medications. Gastroenteritis is also called the stomach flu as mentioned above it causes diarrhea which act as a protective mechanism of the stomach in getting rid of the causative agent out of the system, an abdominal pain which helps signal a

person that something is wrong internally of the gastrointestinal tract which is likely secondary from the inflammation and also vomiting which is relative to the increase of intraabdominal pressure pushing the content in the stomach toward the esophageal sphincter. It is a very common and highly infectious illness which can be easily spread and is a potentially a serious problem in babies and young child population. They experienced most episodes of diarrhea and vomiting caused by viruses like the Rotavirus. Transmission of this virus is from person-to-person if one comes in contact with infected stool. Rotavirus can also be found on toys and other surfaces in childcare centers. Though often considered a benign disease, acute gastroenteritis remains a major cause of morbidity and mortality in children around the world, many children younger than 5 years, or roughly few of all child deaths. Because the disease severity depends on the degree of fluid loss, accurately assessing dehydration status remains a crucial responsibility in preventing mortality. Luckily, most cases of dehydration in children can be accurately diagnosed by means of a careful clinical examination and should be treated even with simple and cost-effective measures. A study made by Gillian Bently state that acute gastroenteritis is common in the Philippines particularly in the urban areas and the reason of this is that some Filipinos are not aware regarding the proper handling and preparation of food. Another reason stated is poor nutritional status and no supplementation of fluids and vitamins makes infants more susceptible to gastroenteritis and these is the most important factor yet. Nutritional adequacy may be partly determined by the feeding method employed, but it also interacts synergistically with diarrheal episodes. Diarrheal diseases results from the rapid uncontrollable transit time of food. This in turn leads to reduced absorption and utilization of nutrients with alteration of the intestinal epithelial cells. If these physiologies persist, it may then result to infants or children apparent decrease of their weight or a weight loss. Here in the Philippines breastfeeding has been promoted in each household, it is said that through breastfeeding the babies are protected and could lessen the chance to acquire common diseases. Yet even if it is mandatory there are still several mothers who do not comply with these simple rule then they resort using formula feeding. Based on the study the infants or children using the milk formula are more susceptible to suffer from gastroenteritis due to their source of water. Among women who are living in urban areas honestly states that sanitation and nutrition are most likely inadequate giving the high tendency of preparing the milk formula improperly and worst of all in an unhygienic measure. Water quality and its availability plays an important part in determining risks for diarrheal diseases, which is why water quality is particularly important when infants are being fed with commercial formula instead of breast milk, and it may determine the higher morbidity rates in infants, especially among women of low socioeconomic status in developing countries including Philippines. Boiling water prior to preparing formulas

can significantly help in reducing bacterial and viral levels, rather than drinking water directly irrespective of knowing where its source from and its quality. In addition, most of the mothers stated that they boiled the water that were used for both infant formulas and as a supplement while some of them stated that their water were boiled irrespective of source. Water sanitation is therefore a critical variable determining infants' risks for gastroenteritis. This factor should therefore be given untimely attention to drive more future bountiful efforts to improve infant health and the educational programs in concert with those already initiated in the hospital setting would be of high benefit in reducing infant morbidity in urban places in Philippines. Such programs should be designed to improve maternal understanding of adequate infant nutrition, with particular emphasis on the importance of breastfeeding and clean water. Nevertheless, even though acute gastroenteritis is very common here in the Philippines we can easily prevent it from affecting innocent life by proper explaining to the mothers the safest way in preparing formula fed when they are not able to breastfeed. Considering the source of their water supply and the appropriate method in boiling the water is also an advantageous avenue. Mothers should also expand their knowledge about the proper sanitation on the place also; they need to realize that the nutrition of their children is very important to keep them healthy and productive in the later years of development. Supplementation of foods which are rich in vitamins and minerals is a good source of immunity against opportunistic virus around these children. One of the earliest sign of acute gastroenteritis in children is the abdominal pain followed by diarrhea and sometimes with vomiting. Abdominal pain occurs due to the invasion of the microorganism inside the intestinal tract and infant will cry because of the pain they experience. Acute gastroenteritis is usually self-limiting and it can be based on the severity of the condition but it is usually treated in hospitals. For instance mothers brings their child to the hospital if they exhibit 5 or more times of diarrhea combined with abdominal pain for some reasons that diarrhea can cause dehydration and although it is rarely life threatening prompt treatment is necessary because it can cause shock and for this reason it can lead to death. Recently, I read an article regarding gastroenteritis in children and it stated that blood test for patients are not recommended instead they need to give attention on the hydration and it also emphasized that the oral rehydration therapy is one of the key to regain the normal fluid status of the child. Hydration of the patients suffering from acute gastroenteritis plays an important factor on the health of the child since they are losing too much of water from their body and the urgent replacement of this is one of the treatment to address for dehydration.

In status like severe diarrhea, patient suffers from life-threatening fluids and electrolyte imbalances, causing the malabsorption syndrome and it can also affect other system on their body for example if there is a significant drop of serum potassium level which might affect in the contraction of the muscles even the cardiac muscles and may manifest muscle spasm and arrhythmias. In addition to that, the hearts myocardium tries to perform its compensatory mechanism by pumping more and contracting faster than the usual due to the imbalance in the body. Though it is not often happening because acute gastroenteritis is treatable, a close monitoring is still indispensable. Therefore, it is important to assess hydration in gastroenteritis as the hydration status helps to determine the immediate management for this condition. The infant or child with profuse watery diarrhea and frequent vomiting is most at risk. Patients will also manifest signs of dehydration usually showing sunken eyeballs, with poor skin turgor and decreased in capillary refill within 5-6 seconds. While children with no dehydration or mild dehydration can still be manageable at home, but otherwise if the child has high risk for complications or who cannot be adequately cared for at home should be considered for admission. Children with mild-moderate dehydration who does not tolerate oral fluids should be admitted for observation. Oral rehydration solutions are preferable than other clear fluids for preventing and treating dehydration. The effective treatment of the acute gastroenteritis is focused on hydration likely from diarrhea and vomiting. Therefore, it is encouraged that patient should be forced to take fluid according to their needs in order to replace electrolytes and fluids lost. However, forcing fluids may not be in a form of big shots of water. Instead, parents should give the sufferer small and frequent drinks through a straw. This way nausea and vomiting wont be triggered. Bland and soft foods may be given as well to avoid further irritation of the gastrointestinal lining. Soft diet is beneficial especially in children. The BRAT diet consists of bread, rice, apple, and toast are also among the best food of choice to help in treating the condition. Children should not be given formula milk as it can trigger diarrheic episodes, however if the baby is breastfed, one can continue feeding milk. Furthermore, medications should be taken regularly as prescribed, on exact dosage, time, & frequency, making sure that the purpose of medications is fully disclosed by the health care provider. In severe cases, hospitalization may be required and intravenous fluid therapy may be needed to prevent dehydration. Finally, since this is a highly contagious disease especially the viral one, preventive care and measures should be taken thus preventing transmission from other individuals. Since gastroenteritis is transmitted thru fecal-oral route, good hand hygiene by all of the family members is vital in preventing the spread of the disease form one person to another. This includes careful hand washing, proper nappy disposal, and preparation and storage of food and drinking water. In conclusion, infants and children are more susceptible to have Acute Gastroenteritis (AGE) so we need to stop the occurrence of this disease by means of information dissemination to the parents. The primary prevention of AGE is by having

baseline knowledge towards the disease because with proper teaching and information leads to the full cooperation.

Nurses are made by GOD, gift from Heaven and Born to Care