Frequency of Gastrointestinal Symptoms among Infants and Children Presenting with Acute Respiratory Infections (ARIs)

Abstract

Acute respiratory infections are responsible for 39% of outpatient consultations in Egypt at PHC facilities; they are also a common reason for hospital admissions (MOHP 2000). Abdominal pain and gastrointestinal (GI) symptoms, such as vomit-ing or diarrhea, are common chief complaints in young children present-ing in emergency departments (ED) (McCollough and Sharieff 2006). So, this clinical study was conducted on infants, children and adoles-cents to measure the frequency of gastrointestinal symptoms including (anorexia, vomiting, dysphagia, abdominal pain, diarrhea, constipation and abdominal distention) among those with ARIs.

This work included 300 patients presented with respiratory

symptoms and diagnosed as ARTIs, 144 males and 156 females with age range between 2 to 204 months, a mean age 60 ± 5.7 months, and 100 patients were presented with GI manifestations with age range between 2 to 186 months, a mean age 71 ± 6 months, at a period of six months from May 2014 to October 2014, on Wednesdays.

All patients have undergone medical history taking, with spe-

cial emphasis on the respiratory symptoms (onset, course, dura-tion, and severity) and signs. Associated gastrointestinal symptoms (nausea, vomiting, abdominal pain, diarrhea, and constipation) with analysis for each symptom (onset, course, duration, frequen-cy, severity, and the relation to the respiratory symptoms).

Patients have undergone careful clinical examination with

special emphasis on vital data (heart rate, respiratory rate, and temperature), weight, abdominal examination (distension, tender-

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Summary and conclusions

ness, and rigidity), and respiratory examination (rhonchi, wheezes and crackles).

Some patients needed to ask for chest x-ray when pneumonia was clinically suspected.

It was found that frequency of ARTIs as follows: URTIs 65% and LRTIs 35% and were differentiated to: acute rhinopharyn-giotonsillitis 8%, acute bacterial tonsillopharyngitis 32%, AOM 7%, acute sinusitis 2%, acute croup 6%, acute bronchitis 7%, acute bronchiolitis 18% and Pneumonia 10%.

The mostly presented respiratory symptoms were cough 53% and sore throat 42%.

GI symptoms are frequently presented in patients with ARTIs, and (nausea without vomiting, vomiting, diarrhea and abdominal pain) are the most frequent presentations. Patients with nausea without vomiting in their complaints were 35 (11.66%), and those with vomiting were 55 (18.33%), diarrhea 37 (12.33%), abdominal pain 17 (5.66%), distension 4 (1.33%) and constipation 2 (0.66%).

GI symptoms presented in AOM were nausea without vomiting

(25.5%), vomiting (21.6%) and diarrhea (7.8%). In acute bacterial ton-sillopharyngitis was nausea without vomiting (10.4%), vomiting (13.5%), abdominal pain (17.7%) and diarrhea (11.5%). In rhi-nopharyngio-tonsillitis was nausea without vomiting (21%), vomiting (12.5%) and diarrhea (12.5%). In acute sinusitis was nausea without vomiting (33.3%) and vomiting (16.7%). In acute croup was nausea without vomiting (27.8%), vomiting (22.2%) and diarrhea (16.7%). In acute bronchitis were vomiting (33.3%) and diarrhea (14.2%). In acute