Diarrhea Flashcards
With Diarrhea, what electrolytes will be low?
Bicarbonate
Potassium
Acute Diarrhea is less than?
2 weeks
Chronic Diarrhea is more than?
4 weeks
Acute Diarrhea can be classified into what categories?
- Infectious
- Non-infectious
Non-infectious Acute Diarrhea can be classified into what categories?
- Inflammatory
- Non-inflammatory
Inflammatory acute diarrhea
Blood and pus in stool
Non-inflammatory acute diarrhea
Watery
What 2 things are common causes for Non-inflammatory Acute diarrhea?
Meds
Foods
(watery diarrhea)
Most cases of Antibiotic - Associated Diarrhea are NOT attributable to?
C. Difficile
What classificati/on does Antibiotic-Associated Diarrhea fall into
Acute Diarrhea
- Non-infectious
– Non-inflammatory
= Watery diarrhea
Antibiotic - Associated Diarrhea occurs while taking an antibiotic. When does it resolve?
After medication discontinuation
3 most common causes of Chronic Diarrhea?
Lactose Intolerance
IBS
Medications
3 most common causes of Chronic Diarrhea?
Lactose Intolerance
IBS
Medications
Diagnostic for Chronic Diarrhea?
Endoscopic examination and mucosal biopsy
Secretory Diarrhea
HIGH volume watery diarrhea
- persists during fasting
Osmotic Diarrhea
Increased osmotic gap and gas production
- stops during fasting
A majority of the diarrheas in this lecture are?
Osmotic Diarrhea
3 things that characterize IBS?
Altered bowel habits
Abdominal pain
Absence of organic pathology
What causes IBS?
Abnormal GI motility
Enhanced visceral sensation
3 things that characterize IBS?
Altered bowel habits
Abdominal pain
Absence of organic pathology
How do you treat IBS?
Low FODMAP diet
Alarm symptoms will not be present with?
3 main causes of chronic diarrhea
= Lactose Intolerance, IBS, Meds
What are some Alarm symptoms?
Acute onset Nocturnal diarrhea Fever and weight loss Blood in the stool FH of cancer, IBD, Celiac disease
What are some Alarm symptoms?
Acute onset Nocturnal diarrhea Fever and weight loss Blood in stool FH of cancer, IBD, Celiac disease
Secondary Lactase Deficiency can be caused by?
Crohn Disease
Celiac Disease
What test can diagnose Lactase Deficiency?
Hydrogen breath test
What causes Antibiotic - Associated Colitis?
Clostridiodes Difficile
What toxins does C. Difficile produce?
Cytotoxin A and B
What is the stool like for C. Difficile - Antibiotic - Associated Colitis?
Greenish, foul smelling, watery diarrhea 5-15 times a day
Greenish, foul smelling, watery diarrhea 5-15 times a day could indicate?
C. Difficile – Antibiotic - Associated Colitis
What changes in the bowel will be seen with Antibiotic - Associated Colitis?
Pseudomembranous Colitis (yellow adherent plaques) Volcano exudate of fibrin and neutrophils
For C. Difficile, what sanitization is adequate?
Wash hands with soap and water
What are risk factors for C. Difficile - Antibiotic - Associated Colitis?
Age
Hospitalizations
Multiple/prolonged antibiotic use
Ex. of antibiotics that can cause C. Difficile - Antibiotic - Associated Colitis?
Ampicillin
Clindamycin
Cephalosporins
Fluoroquinadones
Complications of C. Difficile - Antibiotic - Associated Colitis?
Toxic Megacolon
Hemodynamic instability
Perforation and death
What 2 things are seen on endoscopy of the bowel with Celiac Disease?
Loss of villi
Atrophy of duodenal folds
What 2 things are seen on endoscopy of the bowel with Celiac Disease?
Loss of villi
Atrophy of duodenal folds
Where are Bile salts absorbed?
Ileum
Bile Salt Malabsorption involves loss of bile salts. What condition can impair their resorption?
Crohn Disease
– Affects Ileum!!
Symptoms of Bile Salt Malabsorption?
Steatorrhea
Decreased absorption of fat-soluble vitamins
Watery - secretory diarrhea
What are possible complications of Bile Salt Malabsorption?
Osteoporosis, Bleeding issues, Hypocalcemia
== Due to decreased absorption of fat-soluble vitamins
Symptoms of Fecal Impaction?
Paradoxical Diarrhea
= Liquid stool leaks around impacted feces (overflow incontinence)
Symptoms of Fecal Impaction?
Paradoxical Diarrhea
= Liquid stool leaks around impacted feces (overflow incontinence)
What is a complication of Chronic Laxative use?
Melanosis Coli
What is Melanosis Coli?
Complication of Chronic laxative use
= BENIGN hyperpigmentation of colon