Lecture 8: Management of Diarrhoea and Constipation Flashcards
What is diarrhoea?
An increase in the liquidity of the stool and or increased loose or liquid stool frequency ( more than 3 times a day)
What is the classifiction of diarrhoea?
- acute ( <14 days)
- persistent (>14 days)
- chronic (>30 days)
What are the two types of diarrhoea?
- Inflammatory
- Non inflammatory
What is inflammatory diarrhoea?
Presence of an inflammatory process, can be due to a viral, bacterial or parasitic infection, radation injury or IBD. It is mucoid and bloody stool, tenesmus, fever, crampy abdominal pain, small frequent bowel movements. Histology of the GI tract is abnormal
What is non inflammatory diarrhoea?
Watery, large volume, frequent stool (>10 to 20 a day)
No tenesmus, blood in the stool, fever or faecal leucocytes
Histology og GI tract is preserved
What are the two types of non inflammatory diarrhoea?
- Osmotic diarrhoea
- Secretory diarrhoea
What is osmotic diarrhaea?
Presence of unabsorbed or poorly absorbed solute ( eg Mg2+, mannitol)
Stool volume is small
Stops or improves with fasting
Due to maldigestion or malabsorption
What is secretory diarrhoea?
Altered transport of ions across the mucosa. Increased secretion and decreased absorption of fluids
Doesnt improve with fasting
What is the most common cause of acute diarrhoea?
Infections
What bacteria cause acute diarrhoea?
- E. coli
- Campylobacter
- Salmonella
- C. diff
- Listeria
- Vibrio cholerae
What viruses cause diarrhoea?
- Rotavirus
- Norovirus
- Adenovirus
- Astrovirus
What parasites/ protozoa cause diarrhoea?
- Entamoaeba histolitica
- Giarfia lambia
- Cryptosporidium
What is the most common cause of non infectious diarrhoea?
Medication
What cardiovascular drugs cause diarrhoea?
- Digoxin
- Quinidine
- Propanalol
- ACE inhibitors
What GI drugs cause diarrhoea?
- Antacids (magnesium salts)
- Laxatives
- H2 antagonists
