Diarrhoea Flashcards
What is diarrhoea
frequent loose water stool
Symptoms of diarrhoea
- abdominal cramps
- nausea
- flatulence
-dehydration
Referral for Diarrhoea: Duration
- babies under 3 months: immediately
- under 1 year, diabetic, elderly: >1 day
- under 3 years: > 2 days
- Refer all if over 3 weeks
Referral for Diarrhoea: Signs of Dehydration
- dry skin
- sunken eyes
- dry tongue
- drowsiness
- dark urine/less
- depressed fontanelle in babies
Referral for Diarrhoea: Alarm symptoms
- blood or mucus in stool
- unexplained weight loss
- long standing change in bowel habit >50 years
- suspected faecal impaction in elderly (poorly formed stools)
Referral for Diarrhoea: other symptoms
- severe vomiting / high grade fever
- recent travel abroad
What medications can cause diarrhoea
- magnesium antacids
- NSAIDs
- Iron
- Laxatives
- Antibiotics
- Digoxin
- Proton Pump inhibitors
- Diuretics
- SSRIs
OTC treatment First Line
Diarolyte (Oral rehydration therapy)(all ages)
How does Diarolyte work
replaces lost fluids and electrolytes
How to take Diarolyte
Adult: 1 to 2 sachets after each loose motion
How to reconstitute Diarolyte
- Dissolve sachet in 200ml of water
- for babies must use boiled and cooled water
- make immediately before use
OTC treatment: Second Line
Loperamide (12+)
- Imodium
How does Loperamide work
Anti-motility drug binds to opioid receptors in gut to slow peristalsis
How to take Loperamide
Adult: 2 capsules after each loose motion
(max 8 a day)
(not recommended in pregnancy or breastfeeding)
Less recommended alternatives to main OTC products
Kaolin and Morphine (J Collis Browne mixture) (12+)
- Prone to abuse
Bismuth Salicylate (16 plus)
- pepto-bismol
(avoid in aspirin hypersensitivity)
(causes black stools and tongue)