29.2 Chronic Diarrhoea Flashcards
diarrhoea worse in viral gastro or colitis?
worse in viral gastro cause large bowel can’t cope with amount of fluid absorption wise
cholera is what kind of diarrhoea?
secretory
rotavirus is what kind of diarrhoea
more osmostic
definition of chronic diarrhoea in children?
usually a least two weeks
Chronic Non specific diarrhoea is?
- usually longer than 2 weeks
- child is thriving
- no stool MCS,
- TTG is normal
what is osmotic diarrhoea?
sugar malabsorption/intolerance
secondary causes of osmotic diarrhoea?
short gut
bacterial overgrowth
allergies
imune deficiency
inuit have common deficiency in what that causes profuse diarrhoea?
congenital sucrose malabsorption
how to test if osmotic vs. secretory?
osmotic will stop if NBM
infective causes of secretory diarrhoea?
e.coli
fat malabsorption
laxative abuse
-rare tumours
inflammatory causes of diarrhoea? infective?
campylobacter
salmonella
yersinia
amoebic dysentery
idiopathic inflammatory bowel diseases?
UC, Crohn's indeterminate eosinophilic enteritis -immune dffiency -blood and pus
erythema nodosum when you press on it?
tender
crohns affects what layer of gut? consequence?
full thickness - stricturing/ cobblestoning
UC affects predomantly what layer of gut?
mucosa
why important to know if can’t handle long or medium chain fatty acids?
if long chain only, can nourish with medium chains (direct absorption)
classic disease involving fat malabsorption?
cystic fibrosis
dx of coeliac disease?
TTG IgA Abx
new european guidelines for coeliac dx?
if first degree relative plus +ve TTG 10x normal, don’t need a bx to prove
where is coeliac serology not reliable?
- very young (<2)
- IgA deficiency
abdo pain with defecation in crohn’s is common?
Nope, abdo pain is,
pain with defection more UC
IBD, give opiates?
never: risk of toxic megacolon
