W4 L1 - Lower GI therapeutics (SUMMARY) Flashcards
(38 cards)
What is the definition of diarrhoea?
Change in bowel habit with substantially more frequent and looser stools than usual.
World Health Organization 2017 defines it as the passage of three or more loose or liquid stools per day.
How is diarrhoea categorized?
- Acute: < 14 days
- Persistent: > 14 days but < 28 days
- Chronic: > 28 days
What are common causes of acute diarrhoea?
- Infection (bacterial, viral)
- Ingestion of toxins
- Other causes (drugs, parasites, anxiety)
What are the symptoms of acute diarrhoea?
- Loose or liquid stools
- Increased frequency (3 or more times per day)
- Abdominal cramping
- Flatulence
- Mild abdominal tenderness
When should adults be referred for diarrhoea?
- Symptoms > 72 hours
- Severe vomiting and fever
- Recent travel to tropical/subtropical climate
- Blood or mucus in stools
- Severe pain/rectal pain
What is Oral Rehydration Therapy (ORT)?
A solution containing sodium, potassium, citrate/bicarbonate, and glucose to prevent dehydration.
What pharmacological treatment can be used for acute diarrhoea?
- Loperamide
- Morphine (low dose)
- Diphenoxylate
- Adsorbents (e.g., bismuth subsalicylate)
What is the mechanism of action of Loperamide?
Agonist of µ (mu) opioid receptor, reducing propulsive peristalsis and increasing intestinal transit time.
What are the contraindications for Loperamide?
- Active ulcerative colitis
- Antibiotic associated colitis
- Bloody/suspected inflammatory diarrhoea
Define constipation.
Defaecation that is unsatisfactory due to infrequent stools or difficult stool passage, typically < three bowel movements per week.
What are common causes of constipation?
- Functional (idiopathic)
- Secondary (induced by condition or medicine)
- Non-medical factors (diet, lifestyle)
- Medical conditions
What are the symptoms of constipation?
- Abdominal discomfort
- Abdominal cramping
- Bloating
- Difficulty passing stool
- Bright red specks of blood due to straining
What are the four main types of laxatives?
- Bulk-forming
- Stimulant
- Osmotic
- Faecal-softening
What is the mechanism of action of bulk-forming laxatives?
Increase faecal mass through water binding to stimulate peristalsis.
What defines Irritable Bowel Syndrome (IBS)?
Chronic condition with abdominal pain, bloating, and change in bowel habit lasting at least 6 months.
What are the key symptoms of IBS?
- Abdominal pain or discomfort
- Altered bowel habits (constipation or diarrhoea)
- Bloating
What are the non-pharmacological treatments for constipation?
- Increase fluid intake
- Dietary changes
- Lifestyle measures (exercise)
What are the red flags for constipation in adults?
- Unexplained weight loss
- Blood in stools
- Age > 40 with marked change in habit
What is the pathophysiology of constipation?
Increased water resorption in the large intestine leads to harder stools that are more difficult to pass.
What is the purpose of using antibiotics in diarrhoea treatment?
To identify and treat the causative organism after stool sample analysis.
What is the first-line treatment for acute diarrhoea?
Oral Rehydration Therapy/Solution (ORT/ORS) to prevent dehydration.
Fill in the blank: Diarrhoea can be caused by _______.
[infection, ingestion of toxins, drugs, anxiety]
True or False: Diarrhoea is considered a disease.
False; it is a sign of an underlying problem.
What are the roles of dietary changes in managing IBS?
To alleviate symptoms and improve bowel function.
