Diarrhoea and Constipation Flashcards
What is diarrhoea?
Increased liquidity of stool
Increased loose or liquid stool frequency (>3 times a day)
Acute- <= 14 days
Persistent- >= 14 days
Chronic- > 30 days
2 categories of diarrhoea?
Inflammatory
Non- inflammatory
What is inflammatory diarrhoea?
(cause, symptoms)
Presence of an inflammatory process (infection, IBD, injury)
Mucoid and bloody stool, tenesmus, fever, crampy abdominal pain
Small, frequent bowel movements
Gi tract histology abnormal
What is non- inflammatory diarrhoea?
(cause, symptoms)
Watery, large volume, frequent stools (>10 or 20 times a day)
Volume depletion possible as high volume and increased frequency
No tenesmus, blood in stool or fever
Gi tract histology preserved
What is osmotic diarrhoea?
Non- inflammatory
Presence or poorly or unabsorbed solute
Stool volume small
Stops or improves with fasting
Maldigestion or malabsorption
What is secretory diarrhoea?
Non- inflammatory
Altered transport of ions across the mucosa
Increased secretion and decreased absorption
Not improves with fasting
What are the infectious causes of diarrhoea?
Bacteria- E.coli, Salmonella, Vibrio Cholera
Viruses- Rotavirus, Norovirus
Parasites- Cryptosporium
What are the non-infectious causes of diarrhoea?
Cardiovascular drugs- digoxin, propanolol
GI drugs- antacids, H2 antagonists
Endocrine drugs- thyroxine, oral hypoglycaemics
Antibacterials- amoxicillin, erythroymicin
Treatment of diarrhoea?
Antimotility drugs
Diphenoxylate
Codeine
Racecadotril
What is constipation?
Heterogeneous disorder
What are the symptoms of constipation?
Fewer than 3 bowel movements in a week
Straining
Lumpy or hard stools
Sensation of anorectal obstruction
Sensation of incomplete defaecation
Causes of primary constipation?
Normal- transit constipation
Slow- transit constipation
Pelvic floor dysfunction
IBS with constipation
Causes of secondary constipation?
Medications
Metabolic disorders
Endocrine disorders
Psychiatric
Treatment of constipation?
Laxatives- osmotic, stimulant, bulk-forming, faecal softeners
Linaclotide
Lubriprostone
