Gastrointestinal Disorder

Case Study 1

Jordan is presented to the hospital with diarrhea and vomiting.  The four-year-old boy’s diarrhea does not have any mucus or stool.  The volume of his urination is also small and dark yellow in color. The fact that he has not eaten anything since supper means that the child’s appetite is down. There are several gastrointestinal disorders that the child could be suffering from.  The first thought that comes to mind with the initial symptoms presented in the child is food poisoning.  Symptoms of food poisoning occur one or two days after the consumption of contaminated food.  Symptoms include vomiting, diarrhea, abdominal pains, general body weakness, and fever.   The second potential illness that Jordan could be suffering from is Celiac disease.  Celiac disease is a gastrointestinal disorder that arises due to extreme sensitivity to gluten.  Symptoms of celiac diseases include abdominal pain, bloating, diarrhea, constipation, vomiting and weight loss.  The two illnesses are ruled out in Jordan’s case because of several factors.  Jordan does not have any abdominal pain, palpations or masses.

 Jordan is likely suffering from viral gastroenteritis which is the inflammation of the stomach and intestines. Since Jordan is not experiencing any abdominal pains, he is most likely suffering from a rotavirus infection. Jordan is demonstrating the basic symptoms of rotavirus which include vomiting, watery diarrhea ad loss of appetite (Burns, & Blosser, 2013). Viral gastroenteritis causes severe diarrhea in children and adults and can result in dehydration and death.  The child also has dark yellow urine, a sign of dehydration.  The symptoms are mild because the parents brought the child to the hospital within the shortest time possible.  In severe cases, the child would have demonstrated stiff joints, sweating, fever, and significant loss of weight. The condition of the child would have worsened with increased diarrhea and vomiting as it causes dehydration (Parashar, Nelson, Kang, 2013).

The first curse of treatment and management of viral gastroenteritis is the provision of plenty of fluids so as to prevent dehydration.  The dark yellow urine is the first sign of dehydration. In severe cases of dehydration hospitalization and the provision of intravenous fluids may be the option towards recovery.  However, in the case of Jordan, he is not severely dehydrated, and thus the provision of oral rehydration solutions (ORS) would work.  The ORS would be the suitable solution for the child since it contains a balanced mixture of water and salts that assist the body replenish lost essential fluids and electrolytes.  As a four-year-old, the child needs between 125-250 ml of the ORS solution every hour (Center for Disease Control and Prevention, 2003). In the case of vomiting persists with the provision of other foods and drinks, the parent can cease giving the foods and drinks and persists in giving the ORS solution.  Jordan’s parents should encourage the child to take extra fluids such as sports drinks if the child can hold it.  The child should also take ample rest to allow for recovery.  Viral gastroenteritis clears within a day or two without the need for further treatment.  However, patients and families must be educated on the importance of basic hygiene standards.  For instance, regular hand washing after visiting the bathroom and before eating or handling any foods is critical.  Fruits and vegetables must be cleaned thoroughly before being eaten.  Moreover, use of clean, uncontaminated water is essential.  A rotavirus vaccine is also recommended, but the first vaccine is given at the age of two months (Bass 2016).

Reference

Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., &Blosser, C. G. (2013). Pediatric primary care (5th ed.). Philadelphia, PA: Elsevier.

Centers for Disease Control and Prevention. (2003). Managing acute gastroenteritis among children: Oral rehydration, maintenance, and nutritional therapy. Morbidity and Mortality Weekly Report, 52(RR-16), 1–20. Retrieved from http://www.cdc.gov/mmwr/PDF/RR/RR5216.pdf

Parashar, U.D., Nelson, E.A., Kang, G. ( 2013). Diagnosis, management, and prevention of rotavirus gastroenteritis in children. BMJ. doi: 10.1136/bmj.f7204

Bass D.M. (2016). Rotaviruses, caliciviruses, and astroviruses. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; chap 265.

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