2. Diarrhea and Constipation Flashcards
What types of stool are the goal?
3 or 4
What are some main medications that cause constipation?
opioids
iron supplements
CCBs
antidepressants
What are some lifestyle causes for constipation?
dehydration
inactivity
pregnancy
diet
What are some disease states that cause constipation?
Colon cancer
IBS
What are some “mush” agents?
PEG emollients non-digestible sugars magnesium Na, Mg, K phosphates fiber
What are some “push” agents?
- Agonists: Senna Cascara bisacodyl - Antagonists: methylnaltrexone alvimopan
What are some “flush” agents?
PEG soap suds Na, Mg, K phosphates molasses non-digestible sugars mineral oil
What is the clinical definition of acute diarrhea?
abrupt onset of 3 or more loose stools per day and lasts no longer than 14 days
What is the clinical definition of chronic/persistent diarrhea?
an episode of diarrhea that lasts longer than 14 days
What is osmotic diarrhea?
water is drawn from the body into the bowel lumen
What is secretory diarrhea?
water is released into the bowel lumen
What is exudative diarrhea?
the presence of blood/pus in stool from inflammation
What is the most common cause of diarrhea?
infection
Most cases of diarrhea require treatment or are self-limiting?
self-limiting
What is the main treatment for all types of diarrhea?
supportive (fluids)
What are some medications for diarrhea?
bismuth subsalicylate
loperamide
atropine/diphenoxylate
What is the treatment for Salmonella induced diarrhea?
not routinely recommended
Ciprofloxacin
What is the treatment for Shigella induced diarrhea?
Bactrim or Ciprofloxacin
What is the treatment for Campylobacter induced diarrhea?
Azithromycin
What is the treatment for E.coli (non O157) induced diarrhea?
Ciprofloxacin
What is the treatment for E.coli (O157) induced diarrhea?
no antimicrobial treatment
supportive care only
What is the treatment for Vibrio paraharmoliticus induced diarrhea?
Doxycycline
What is the treatment for Vibrio cholera induced diarrhea?
Doxycycline or single dose Fluoroquinolones
What is the treatment for Yersinia enterocolitica induced diarrhea?
no antimicrobial treatment
What is the treatment for Giardia lamblia induced diarrhea?
metronidazole
What is the treatment for Cryptosporidium induced diarrhea?
no routine antimicrobial treatment
Severe: Paromomycin
What is the treatment for Cyclospora induced diarrhea?
Bactrim
What is the treatment for Microsporidium induced diarrhea?
Albendazole
What is the treatment for Entamoeba histolytica induced diarrhea?
Metronidazole plus paromomycin
