gastroenteritis%20-%20parasitic
GASTROENTERITIS - PARASITIC
Frequently, patients with gastrointestinal parasitic infections do not have any signs and symptoms that are specific for parasitic infections (eg fever, malaise, fatigue, sweating, wt loss, anorexia, edema, pruritus).
Some patients may be asymptomatic.
Gastrointestinal symptoms, if present, include diarrhea, abdominal pain, dysentery, flatulence, jaundice, rectal prolapse, dyspepsia, malabsorption, vomiting and biliary colic. 

Gastroenteritis%20-%20parasitic Management

Adjunctive Therapy

  • Antiemetic agents (eg Ondansetron) may be used in children >4 years of age to decrease vomiting or help avoid the need for IV fluid, but may increase episodes of diarrhea
  • Zinc supplementation given during an episode of diarrhea may decrease the duration and severity of diarrheal illness, and reduce the incidence of diarrhea in the next 2-3 months
    • For patients up to 6 months, may give 10 mg/day PO x 10-14 days
    • Patients ≥6 months, may give 20 mg/day PO x 10-14 days
  • Probiotics have been shown to reduce the intensity and duration of acute infectious diarrhea in children
    • May be used in rotavirus gastroenteritis
    • Eg Lactobacillus spp, Saccharomyces boulardii, Bifidobacterium spp
  • Racecadotril, an antisecretory agent, may be used as an adjunctive therapy in acute diarrhea
    • Studies showed decreased diarrhea duration and reduced stool output following administration of Racecadotril in children with acute diarrhea
  • Bovine colostrum contains antimicrobial peptides (lactoferrin, lactoperoxidase), immune-regulating and inflammatory cytokines, and growth factors that may help provide passive immunity by enhancing different immune functions (eg phagocytosis, antigen presentation, antimicrobial activity via antigen chelation, inflammation control) in the gastrointestinal tract
    • Studies showed that bovine colostrum improved clinical symptoms (eg reduced stool frequency, reduced occurrence and duration of diarrhea) in children with infectious diarrhea
    • Clinical benefit in the prevention and management of infectious diarrhea is currently being determined in clinical trials
  • Hematinics for anemia may help restore hemoglobin level
  • Surgical intervention may be considered in patients with obstruction, massive GI bleeding, perforated colon, toxic megacolon
  • Human milk, gelatin tannate and other probiotics are being studied to conclude their use in the management of gastroenteritis
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