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Gastrointestinal
Acute Gastroenteritis
دست اور الٹی
Vomiting, loose stools and abdominal cramps from viral or bacterial causes. Assess hydration, correct with IV fluids if needed, and give antibiotics only for the listed indications.
- ICD-10
- —
- Source
- OPD handbook pp.65–70
- Status
- Draft
Not yet reviewed by a clinician. Check doses and brands against current national guidelines before use.
Symptoms
- Vomiting
- Loose stools
- Abdominal cramps
Diagnosis
- Take vitals of all patients
- Keep an eye on hydration status: tongue, capillary refill time (CRT), eyes, skin turgor
- Causes: viral gastro, bacterial gastro
Treatment
Step 1 of 5
1. Emergency / acute management
- Correction with IV fluid, i.e. Ringer's lactate
- IV antibiotics: Inj Flagyl, Inj Cipro
- IV antiemetic: Inj Gravinate
- IV antipyretic: Inj Provas
- IV antispasmodic: Inj No-Spa
Prescription
Ringer's lactate (Hartmann's solution)IV crystalloid
Dose1 litre IV stat (500 mL in a 5-year-old, 15 kg child)
Brands Generic / hospital supply
Caution: Monitor for fluid overload, especially in dengue critical-phase recovery
CiprofloxacinFluoroquinolone antibiotic
DoseIV
Brand Inj Cipro
Also sold as Novidat, Mercep, Cipro, Ciproxin, Ciprin
DimenhydrinateAntiemetic
Dose1 ampoule in IV fluid
Brand Inj Gravinat
Also sold as Gravinate, Gravinat
DrotaverineAntispasmodic
Dose1 ampoule in IV fluid
Brand Inj No-Spa
Also sold as No-Spa, Nospa, No-Spa Forte
Step 2 of 5
2. Indications of antibiotics
- Fever
- Abdominal cramps
- Bloody stools
Step 3 of 5
3. Discharge medicines if bacterial
Prescription
CiprofloxacinFluoroquinolone antibiotic
Dose1+1
Brand Tab Novidat 500 mg
Also sold as Novidat, Mercep, Cipro, Ciproxin, Ciprin
DrotaverineAntispasmodic
Dose1+1
Brand Tab No-Spa Forte 80 mg
Also sold as No-Spa, Nospa, No-Spa Forte
DimenhydrinateAntiemetic
Dose1+1+1, if vomiting (SOS)
Brand Tab Gravinat
Also sold as Gravinate, Gravinat
DoseOne glass/cup after each motion (per the Urdu note)
Brands WHO low-osmolarity ORS sachet
Free ORS is stocked at government facilities and distributed by Lady Health Workers. Many private ORS brands exist; check the sachet states the WHO low-osmolarity formula.
Caution: Mix with the exact volume of clean water stated on the sachet; Discard made-up solution after 24 hours
Paracetamol (Acetaminophen)Analgesic / antipyretic
DoseSOS if fever
Brand Panadol
Also sold as Panadol, Calpol, Febrol, Pedrol, Calpol 6 Plus (250 mg/5 mL)
Caution: Do not exceed 4 g/day in adults or 60 mg/kg/day in children; Avoid in severe liver disease
Step 4 of 5
4. Discharge medicines if viral
- Eat yoghurt (dahi); khichdi, water and fruit juices
- Return if fever or blood in the stools
Prescription
DoseOne glass after each motion
Brands WHO low-osmolarity ORS sachet
Free ORS is stocked at government facilities and distributed by Lady Health Workers. Many private ORS brands exist; check the sachet states the WHO low-osmolarity formula.
Caution: Mix with the exact volume of clean water stated on the sachet; Discard made-up solution after 24 hours
Step 5 of 5
5. Paediatric viral gastroenteritis (child 5 y, 15 kg, mild dehydration)
- Inj R/L 500 mL IV stat
- ORS after each motion
- Add yoghurt to khichdi and eat
- If fever or blood in the stools, return to the doctor
Prescription
Zinc sulfateMicronutrient
Dose2 tsf (written '2+2+2' and 'OD'; confirm)
Brand Syp Zincat
Recorded as written
Zinc dispersible tablets are part of the national diarrhoea management protocol.
Sample prescription from the book (patient details removed)
- Male, 18 y, loose stools with abdominal cramps and vomiting, 8 episodes in 1 day, fever (T 102 °F, pulse 120): Plan: IV line; Inj R/L 1 L IV stat; Inj No-Spa 1 ampoule in IV fluid; Inj Gravinat 1 ampoule in IV fluid; Inj Provas 1 g IV stat; Inj Flagyl 400 mg IV stat. Discharge: Tab Flagyl 400 mg 1+1+1; Tab Novidat (cipro) 500 mg 1+1; Tab No-Spa Forte 80 mg 1+1; Tab Gravinat 1+1+1 if vomiting; Tab Panadol 500 mg 2 tabs if fever; ORS after each motion.
- Adult, 25 y, loose watery stools 1 day, no fever, no cramps, no blood: IV line; Inj R/L 1 L IV stat; Tab Hidrasec 100 mg 1+1; ORS after each motion; Tab Gravinat 1+1+1 if vomiting; eat yoghurt; khichdi, water and fruit juice.