Flashcards in 20. Diarrhoea Deck (27)
What is the definition of diarrhoea?
Increase in amount of stool passed daily to > 300g- usually accompanied by increased frequency + loosening of the stools
What can cause diarrhoea?
Inflammation: IBD, Diverticular disease
Increased bowel motility: Hyperthyroidism, anxiety, IBS
Malabsorption: Coeliac, pancreatic insufficiency
Obstruction only allowing fluid through
Medications: laxatives, colchicine, digoxin, metformin, thiazide diuretics + some Abx
What are the most likely causes of diarrhoea in a young adult?
Going from most to least likely
What are the most likely causes of diarrhoea and elderly patients?
Overflow diarrhoea secondary to constipation
What questions would you ask to characterise the stool?
Is it jelly like/ got mucus in it?
Are they foul smelling + floating?
Are the faeces unusually pale?
What might mucoid diarrhoea suggest?
What does foul smelling/ floating diarrhoea suggest?
What does pale diarrheoa suggest?
Biliary obstruction (lack of bile salts)
What would you ask about the patient's bowel habit if they are presenting with diarrhoea?
Do you rush to the toilet?
Varbaility in bowel habit
How frequently do you open your bowels?
What does urgency in opening bowel suggest?
What does tenesmus suggest?
space occupying lesion in the rectum- carcinoma
What associated symptoms will you ask about in someone with diarrhoea?
eye, skin, joint symptoms- IBD
What will you ask about in the social history of someone with diarrhoea?
Changes in diet
What are the blood markers for coeliac disease?
What signs of IBD should you look for on examination of a patient with diarrhoea?
Mouth ulcers (Crohn's)
Anal ulcers/ fistulae (Crohn's)
Abdominal mass in RLQ (Crohn's)
What signs of coeliac disease may be found on examination
What signs of malignancy should you look for on examination of a patient with diarrhoea?
What can predispose you to C. difficile?
Why should patients with UC be offered regular colonoscopies?
They have an increased risk of colon cancer
What is the most likely infective organism in an outbreak of vomiting and diarrhoea in an old persons nursing home?
What is the most likely infective organism in an outbreak of bloody diarrhoea at a primary school?
What is the most likely infective organism in a student with watery diarrhoea a few days after a BBQ?
What is the most likely infective organism in a group of people with sudden onset diarrhoea a few hours after a party?
What causes the rapid or slow onset of diarrhoea in infection?
Rapid: bacteria have excreted active toxins
Slow: Bacterial growth in the bowel
What is the most likely infective organism in an elderly patient in hospital receiving antibiotics for pneumonia?
What is the most likely infective organism in a young woman who has just returned from Ghana and has right iliac fossa pain?