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home - Colon - Colonic Infection - Travellers Diarrhoea Written by Dr Sebastian Zeki
Knowledge

Recognises the range of important inflammatory conditions of the
intestine other than inflammatory bowel disease
Knows the range of potential aetiologies including infection and
ischaemia
Understands how diverticular disease can give rise to complications mini-CEX, SCE 1
Knows how diseases can affect the peritoneum and how such
conditions can present both in the acute and chronic situation
Knows the range of both acute and chronic intestinal infections and
their various presentations
Knows the means of investigations of infectious diseases and
understands the principles and use of antimicrobial therapy

Skills
Makes a full clinical assessment of patients presenting with infective
and inflammatory conditions
Recognises the potential urgency of the clinical situation. Selects
appropriate investigations and treatments

Behaviours
Manages patients with inflammatory and infective conditions carefully,
competently and sympathetically.

Travellers Diarrhoea

Pathogens causing travelers' diarrhoea: Enterotoxigenic Escherichia coli.Enteroaggregative E. coli .Campylobacter jejuni .Salmonella species .Shigella species . Traveller’s Diarrhoea Risk factors:Travel in underdeveloped countries.Hypochlorhydria due to surgery or medication.Immunocompromised.Young age. Diagnosis Only send stool culture in a patient with fever and colitic symptoms.In patients with predominantly upper GI symptoms (eg, bloating, gas, nausea), stool examination for G. lamblia and cyclospora should be undertaken. Treatment Oral rehydration solution= Antibiotics Guidance on Prevention:Improve food and drink selection —Ice is not safe unless from boiled water.Alcohol does not sterilize water or ice.Carbonated and bottled water is usually safe - hot tea or coffee is safe.Uncooked food is bad eg Fruit salads, lettuce, or chicken salads. Unpeeled fruits are fine.Condiments on the table can frequently become contaminated.Steam table buffets are dodgy. Illness starts 4-14 days after arrival Usually lasts 1- days.Is self- limiting8 to 15 % have it for >1 wk 1% have it for > 1/1220% need bedrest for 1-2 days 1/2 teaspoon of salt, 1/2 teaspoon of baking soda, and 4 tablespoons of sugar to one litre of water Quinolone / azithromycin/ rifaximin for 3 days Bacteria Written by Dr Sebastian Zeki

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