Diarrhoea - Causes,Treatment, and Prevention | Doctors Gang

Diarrhoea -an overview 
Diarrhoea: type,causes, prevention and treatment in Bangladesh

  • What is diarrhoea? 
  • What the types of diarrhoea? 
  • What are the causes of acute watery
  • What are the infectious causes of diarrhoea? 
  • What is chronic diarrhoea?
  • causes of chronic diarrhoea

What is Diarrhoea? 


Defination of Diarrhoea: according to WHO,Passage of loose stool more than three times a day is called diarrhoea.

Types of diarrhoea:


A) Types of Diarrhoea According to duration:
  1. Acute diarrhoea: Diarrhoea persisting less than 14 days.
  2. Persistent diarrhoea: Diarrhoea persisting from 14 days to 6 weeks.
  3. Chronic diarrhoea: Diarrhoea persisting more than 6 weeks.
B) According to nature:
  1. High volume diarrhoea: (>200 gm stool/day or > IL per day) Secretory diarrhoea: Due to intestinal inflammation e.K. viral or bacterial infections,ulcerative colitis or Crohn's disease .  Osmotic diarrhoea: Due to malabsorption, drugs or motility disorders,
  2. Low volume diarrhoea: (<200 gm stool/day).

Acute Watery Diarrhea 

What are the Causes of acute watery diarrhoea?

Cause of acute watery Diarrhea are below:

Infectious causes:

  • Gastroenteritis
  • C. difficile infection
  • Acute diverticulitis
  • Sepsis
  • Pelvic inflammatory disease
  • Meningococcaemia
  • Malaria
  • Pneumonia (specially atypical disease)

Non-infectious causes:

1. Gastrointestinal:
  • Inflammatory bowel disease
  • Bowel malignancy
  • Overflow from constipation
  • Enteral tube feeding

2. Metabolie:
  • Diabetic ketoacidosis
  • Thyrotoxicosis
  • Uraemia
  • Neuroendocrine tumour releasing VIP or 5-HT
3. Drugs and toxins:
  • NSAIDs
  • Cytotoxic agents
  • Antibiotics
  • Ciguatera fish poisoning
  • Dinoflagellates
  • Plant toxins
  • Heavy metals
  • Ciguatera fish poisoning
  • Scombrotoxic fish poisoning

Chronic diarrhoea


Chronic diarrhoea: Diarrhoea persisting more than 4 weeks is called chronic diarrhoca.

Causes of chronic diarrhoea:

  • Irritable bowel syndrome (IBS)
  • Inflammatory bowel disease (IBD)
  • Giardiasis
  • Chronic pancreatitis
  • Thyrotoxicosis.
  • Intestinal tuberculosis.
  • Addison's disease.
  • Colonic carcinoma
  • Pancreatic cancer
  • Lymphoma
  • Coeliac disease
  • Tropical sprue
  • VIPoma
  • Colonic ischaemia
  • Drug induced: NSAIDs, Aminosalicylates, Selective serotonin re-uptake inhibitor (SSRI)

clinical case of chronic diarrhoea 

A young man has come to you with complaints of persistent diarrhoea for the last 6 month.How will you proceed to diagnosis of the case of chronic diarrhoea?

Or 

A 40 years old male presented with chronic diarrhoea with remarkable weight loss for last 3
months. How will you investigate the patients?

My Diagnosis of these case of chronic diarrhoea:
Clinical features of chronic diarrhoea is present such-

Colonic causes:

  • Blood and mucus in stool
  • Cramping lower abdominal pain

Malabsorption:
  • Steatorrhoea.
  • Undigested food in the stool
  • Weight loss and nutritional disturbances

Small bowel causes:
  • Large-volume, watery stool
  • Abdomoinal bloating
  • Cramping mid abdominal pain

Investigations of chronic diarrhoea:

Colonic causes:
  • Colonoscopy with biopsies.
  • Faecal calpotectin

Malabsorption:
  • Ultrasound, CT and MRCP.
  • Small bowel biopsy
  • Barium follow-through.
  • Faecal elastase
Small bowel causes:
  • Barium follow-through
  • Stool volume.
  • Gut hormone profile.
What is normal stool frequency?
Normal stool frequency is 3 times a day to 3 times a week.
of Tinidazole 2 gm.

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