Diarrhea (Self Care) Flashcards
Acute Diarrhea is classified as
fewer than 14 days of symptoms
Persistent Diarrhea is classified as
14 days to 4 weeks
Chronic DIarrhea is classified as
More than 4 weeks
How is Acute Diarrhea generally treated?
WIth management of fluid and electrolyte replacement, dietary interventions, and nonprescription drug treatment.
What may be causes for Acute Diarrhea?
Poisoning, medications, intolerance of certain foods, or various non-GI acute or chronic illness
What virus constitutes the most common cause of diarrheal illness in adults and children, with highest incidence in children <5 years of age?
Noroviruses (occurs year-round)
What virus causes gastroenteritis in patients all ages; Most common cause of SEVERE diarrhea in infants and young children?
Rotavirus
How is Norovirus spread
-Most often transmitted by contaminated water or food
-Also from person to person through contact w/ contaminated environmental surfaces
-
How is Rotavirus spread and some adverse effects from it?
-fecal-oral route
-Can cause severe dehydration and electrolyte disturbances, may result in death
Where is the suspected site of infection if PTs diarrhea is watery
Small intestine
(caused by toxin-producing pathogens)
Where is the suspected site of infection if PTs diarrhea is bloody (dysentery-like)
Large intestine
Are any nonprescription therapies available to manage diarrhea caused by protozoa (ex. Entamoeba histolytica)
No, self-management is inappropriate in this case
How does someone get Traveler’s diarrhea?
Acquired mainly through ingestion of contaminated water and/or food
Bacterial and Viral pathogens have an incubation of ______
6-72 hours
Result in quicker onset of diarrhea
Protozoal pathogens have an incubation period of _____
1-2 weeks
Onset of diarrhea rarely seen in first few days
List the 4 classifications of diarrhea
-Osmotic
-Secretory
-Inflammatory
-Motor
What are the classifications/mechanisms of acute diarrhea?
Osmotic
Secretory
What are the classifications/mechanisms of chronic diarrhea?
Motor
Inflammatory
Undigested food particles in stool suggest disease of the _____ _______
Small Intestine
Black, tary stools may indicate ______
Upper GI Bleeding
What does red stool suggest
-Lower bowel or hemrrhoidal bleeding
-Recent ingestion of red foods (beets) or drug products
Many small-volume stools suggests ________
Colonic disorder
Yellowish stools indicate ______
Presence of bilirubin and potentially serious pathology of the liver
Whitish tint to stool suggests _____
Fat malabsorption disease
What age range of children are most likely to suffer from complications that require hospitalization
Children 2 years old and younger
How many bowel movements within 24 hours can potentially lead to loss of fluids and result in circulatory collapse and renal failure in 2 month old infants
8-10 bowel movements
What is the initial self-management with mild to moderate uncomplicated diarrhea? (FIRST-LINE TREATMENT)
Focus on fluid and electrolyte replacement with oral rehydration solutions (ORS)
Is self-care during pregnancy appropriate?
No
2 phases that oral treatment can be carried out
Rehydration therapy
Maintenance therapy
True or False:
ORSs are proven to provide benefit to adults with mild diarrhea who can maintain an adequate fluid intake ?
False: while they are highly recommended, there is little evidence of support when given to otherwise healthy adults who can maintain an adequate fluid intake
Why are premixed products preferred for use in children
They are safe and convenient
Which ORS therapy type potentially reduces stool volume by 20%-30% in children with cholera
Cereal-based ORS therapy
What medication is recommended to provide protection against travelers’ diarrhea
Bismuth subsalicylate (BSS)
What ages in children can use nonprescription loperamide
6 years and older
Name a non prescription antidiarrheal opioid agonist that provides symptomatic relief of acute, nonspecific diarrhea
Loperamide
What are drug interactions reported with loperamide
P-gP inhibitors (quinidine)
Agent FDA approve for management of ACUTE diarrhea
Bismuth subsalicylate (BSS)
What age range for children is the use of BSS safe
children 12 years and older
What is the function of BSS
exerts antidiarrheal effects that reduce fluid and electrolyte losses, frequency of unformed stools, nausea, vomiting
Why should the use of BSS in children be cautioned
Possible Reye syndrome
What patient population is BSS contraindicated with
Pts with AIDs
What drug interactions exist with BSS
-Radiopaque/Radiographic studies
-Aspirin
-Warfarin (toxicity)
-Valproic acid
-Methotrexate
What are the self-care treatment recommendations for children <5 years old
-ORS therapy
-Antidiarrheal agents are NOT recommended
What are the self-care treatment recommendations for geriatric patients (>65 years)
-Self-treatment w/ antidiarrheal medications is STRONGLY cautioned against
- Patients should be referred if diarrhea is severe
What are the self-care treatment recommendations for pregnancy
-Self-treatment w/ non prescription antidiarrheals is INAPPROPRIATE
-Referral
What is the function of Probiotics
-Release antimicrobial
substances in the intestines
-Produce acids (ex. lactic acid)
and short-chain fatty acids that
lower intestinal pH and
suppress growth of pathogenic
bacteria
-Enhance mucosal barrier
integrity and immune
responses
What population can benefit from the use of probiotics
immunocompetent adults and children
When are probiotics used/effective
preventing/treating mild acute, uncomplicated diarrhea, in previously healthy infants and children
Are probiotics ideal for management of moderate to severe diarrhea
No, not enough evidence to support this
How do major adverse effects of probiotics present in older patients
-Systemic Infections
(critically ill, immunocompromised patients, patients with bowel diseases)
