DIARRHEA

Rina Ayu .S / 201501205

 Definition
A common condition that involves unusually
frequent and liquid bowel movement . The opposite
of constipation. There are many infectious and
noninfectious causes of diarrhea. Persistent diarrhea
is both uncomfortable and dangerous to the health
because it can indicate and underlying infection and
may mean that the body is not able to absorb some
nutrients due to a problem in the bowel
 Types of diarrhea
• Osmotic diarrhea: occurs when there is a loss of
water due to heavy osmotic load, e.g. due to
maldigestion or due to high uptake of sorbitol,
fructose etc.
• Secretory diarrhea: due to increased active secretion
and/or inhibition of absorption; little to no structural
damage; e.g. cholera-toxin activates adenylatcyclase,
higher cAMP-level, decreased Na-absorption &
increased Cl-secretion, high osmotic gradient leads
to water-inflow
• Motility-related diarrhea: occurs due to abnormal
motility of GIT, if food moves to quickly there is not
enough contact-time for water & nutrients to be
absorbed; e.g. after vagotomy or diabetic
neuropathy
• Inflammatory diarrhea: damage of mucosal lining or
brush-border leads to a passive loss of protein-rich
fluids and decreased ability to absorb these fluids;
features of the other three types can be found in this
one; it can be caused by bacterias, viruses, parasites
and autoinflammatory diseases
 Acute diarrhea
• Lasts less than 4 weeks
• Usually caused by infections (>90%) or food poisoning with
bacterial toxins (Salmonella)
• Most of non-febrile diarrheas are caused by viruses (viral
gastroenteritis); most common reason for diarrhea in children
is Rotavirus (~40%)
• Febrile types (invasive pathogenes) are usually caused by
Campylobacter or Salmonella
• Severe types are cholera, typhus and intestinal tuberculosis
• Cause for bloody diarrhea can be e.g. dysentery
 Chronic diarrhea
• Lasts longer than 4 weeks
• Reasons can be: stress, food intolerance (e.g.
lactose intolerance), disorders of
pancreas/liver/gallbladder, chronic intestinal
infections (Morbus Crohn, Colitis ulcerosa),
bowel cancer
 Complications
• Loss of water: dehydration (dizzyness,
unconsciousness)
• Loss of electrolytes: cramps
• In severe cases both can lead to death
 Treatment
• In case of severe diarrhea suckling babies,
children, old people should always go to a
doctor
• Most important is sufficient uptake of water
and electrolytes (salt)
• Antidiarrhoetics are not always
recommendable, cause pathogenes stay in the
intestine
• In case of bacterial infection: antibiotics