Differential Diagnosis for Gastroenteritis

 by Xin Wei

Pneumonia:

Inflammatory illness in the lungs

Symptoms : 

nausea, vomiting, loss of appetite, joint pains, unusually rapid breathing, chest pains, muscle aches, high fever with  shaking chills , cough producing yellow sputum.

 

Cough is usually not present in GE.

 

Appendicitis

What it is:

Painful swelling and inflammation of the appendix

 

Symptoms:

The abdominal pain usually

• occurs suddenly, often causing a person to wake up at night
• occurs before other symptoms
• begins near the belly button and then moves lower and to the right
• is new and unlike any pain felt before
• gets worse in a matter of hours
• gets worse when moving around, taking deep breaths, coughing, or sneezing

Other symptoms of appendicitis may include

• loss of appetite
• nausea
• vomiting
• constipation or diarrhea
• inability to pass gas
• a low-grade fever that follows other symptoms
• abdominal swelling
• the feeling that passing stool will relieve discomfort

 

Investigation

·  Rebound tenderness.

applying hand pressure to a patient’s abdomen and then letting go.

Pain felt upon the release of the pressure indicates rebound tenderness.

·  Rovsing’s sign.

Applyi hand pressure to the lower left side of the abdomen.

Pain felt on the lower right side of the abdomen upon the release of pressure on the left side

 

Pain in GE is generalised and tenderness is not well localised.

Absence of these signs rules out Appendicitis.

 

Bowel Obstruction

What it is:

mechanical or functional obstruction of the intestines, preventing the normal transit of theproducts of digestion

 

Symptoms:

abdominal pain, vomiting, constipation

 

GE is not associated with constipation.

Therefore, bowel obstruction is ruled out.

 

Ulcerative Colitis

What it is

Causes inflammation and sores, called ulcers, in the lining of the rectum and colon.

Ulcers form where inflammation has killed the cells that usually line the colon,

then bleed and produce pus.

Inflammation in the colon also causes the colon to empty frequently, causing diarrhea.

 

Symptoms:

Abdominal pain

Bloody diarrhoea

 anaemia

 fatigue

weight loss

loss of appetite

rectal bleeding

loss of body fluids and nutrients

skin lesions

joint pain

growth failure (specifically in children)

 

 

Usually not associated with vomiting.

Therefore ruled out.

If diarrhoea persists, colonoscopy is done.