1. ACUTE DIARRHEA WORLD WIDE 1 BILLION EPISODE/YEAR AGE & SEX EQUAL 3-5 MILLION DEATHS/YEAR SPREAD PERSON TO PERSON-CONTAMINATED FOOD & WATER

2. Diarrhea Definition ?

3. Diarrhea Definition Frequency Consistency

4. Acute Diarrhea < 2Weeks Chronic Diarrhea > 2weeks

5. Etiology ؟

6. - Viral - Bacterial - Parasitic - Food poisoning - Extra-Intestinal - Munchausen Syndrom

7. VIRAL GASTROENTERITIS - - Rota virus - Entero adenovirus- Astrovirus-calcivirus - -Infants > Older children - -Begin with vomiting in 80% then diarrhea - -Vellus damage - -Diarrhea is not bloody - -Dx Stool for ELISA Disaccharidase def.

8. Bacterial Gastroenteritis -E coli EPEC-ETEC-EIEC-EHEC -Salmonella Egg-Milk-Poultry -Shegella -Campylobacter jejuni Chicken -Yersinia enterocoliticua -Clostridium dificile Antibiotic related

9. Parasitic Gastroenteritis -Entamoeba Histolytica Bloody -Giardia Lamblia Not bloody -Cryptosporidium Immunocompromised patients

10. Complications -Dehydration Mild-Moderate-Sever -Electrolyte imbalance - Acidosis -Shock -Prerenal insufficiency -Disaccaridase def -Hemolytic Uremic Syndrom (HUS) Na

11. Investigations Serum Electrolyte,Urea & Creatinine Stool analysis, c/s,Elisa for rota virus Blood Gases Others

12. Treatment -Non (Breast fed) -Fluid & elecrolyte replacement ORS vs IVF -Lactose free formula -NO ANTIDIARRHEAL AGENTS

13. PATHOGENESIS Secretory cAMP & cGMP Osmotic Lactose Transit time Inflamation & T4 Absorption / Digestion

14. ORS Oral rehydration solution 2.5% glucose 75-90 mEq/l Na 45-80 mEq/l cl 30 mEq/l Bicarbonate