Diarrhoea Flashcards
What is the general definition of diarrhoea
The passage of three or more loose or liquid stools per day
How long does someone have to have diarrhoea for it to be considered as :
. Acute
. Chronic
. Persistent
Acute diarrhoea < 7 days
Chronic >1 month
Persistent > 14 days
State and explain what can cause diarrhoea (3)
- osmotic laxative which causes malabsorption->
Increase in osmotic load in gut lumen
Soluble compounds cannot be absorbed by small intestine, thus draws fluid into gut lumen e.g. - Infections: e.g. E.coli and drug allergies -> increase in secretion
Increased secretion of fluid and electrolytes into intestine with decreased absorption - Infection by shigella (type of bacteria) -> inflamed intestinal lining
Damage to intestinal mucosal cells affects absorption of fluid/electrolytes, results in fluid/blood loss
What is gastroenteritis and what are the symptoms
Inflammation of the gastrointestinal tract (GI) including stomach and intestine. Symptoms include diarrhoea, vomiting and abdominal pain
How can bacterial diarrhoea typically be contracted?
Through contaminated food and drink or as “ travellers diarrhoea “ often caused by E.coli
What are two common viruses that cause diarrhoea?
. Rotavirus - common amongst young children
. Norovirus
What are some non-infective causes of diarrhoea (6)
. Anxiety
. Alcohol
.food allergies
. Coffee
. Sweets- high sorbitol content
. Medications (e.g. laxatives, antibiotics, chemotherapy, magnesium, metformin)
What are some causes of chronic diarrhoea (8)
. IBS
. Diet
. IBD (inflammatory bowel disease)
. Microscopic colitis ( inflammation of the large intestine, causes watery diarrhoea )
. Coeliac disease- immune system attacks your own tissues when you eat gluten
. Malabsorption e.g. lactose intolerance
. Cancer
. Faecal impaction
What are symptoms of diarrhoea (5)
- passing frequent, soft, watery stools
- irritation of stomach lining can also cause stomach cramps
- nausea
- fever
- loss of appetite
When should a patient with diarrhoea be referred?
. Weight loss- could be sign of bowel cancer
. If travelling causes fever AND diarrhoea
. Signs of dehydration, especially amongst elderly and babies
. Blood in stool
.persistent, more than 2 weeks
Why is care important for babies and the elderly when dealing with diarrhoea?
They are at higher risk of dehydration.
When should a baby under 1 year old with diarrhoea be referred to a healthcare provider?
After 24 hours.
When should children aged 1-3 years with diarrhoea be referred to a healthcare provider?
After 48 hours.
When should an adult with diarrhoea be referred to a healthcare provider?
After 72 hours.
When should an elderly person with diarrhoea be referred to a healthcare provider?
After 48 hours.
What dietary advice should be given to those with diarrhoea?
. Small, light meals with plain foods
.avoid fruit or fizzy drinks
. Avoid dairy
. Continue to breastfeed or bottle feed as normal, do not dilute formula milk
What is the first-line treatment for diarrhoea, especially in children?
Oral rehydration therapy.
What does oral rehydration therapy provide?
Glucose and electrolytes.
What is the age restriction for over-the-counter oral rehydration therapy?
It is restricted to those aged 1 year and older.
What is the first choice agent for diarrhoea after Oral Rehydration Therapy (ORT)?
Loperamide.
How does Loperamide work to treat diarrhoea?
It slows small and large intestine transit by decreasing bowel motility through action on opioid receptors in the gut.
What are the benefits of Loperamide in treating diarrhoea?
It can increase absorption of fluid and electrolytes, reduce duration, and reduce stool frequency.
At what age is Loperamide recommended for diarrhoea treatment?
Over 12 years.
What are some adverse drug reactions (ADRs) associated with Loperamide?
Constipation and megacolon.
What is a common morphine product used in the treatment of diarrhea?
Diocalm®
Why might the use of morphine products for diarrhea treatment be a concern?
Potential for abuse.
Name two types of adsorbents used in traditional diarrhea treatments.
Kaolin and charcoal.
How do adsorbents help in treating diarrhea?
They add bulk to the stool but are not absorbed from the gut.
Why might adsorbents have limited therapeutic use in diarrhea treatment?
They may still allow fluid loss from the bowel.
What is a product that combines kaolin and morphine?
Kaolin and Morphine Mixture.
What is a common bismuth-containing product used for diarrhea?
Bismuth subsalicylate (e.g., Pepto-Bismol).
What symptoms does bismuth subsalicylate treat?
Diarrhea, heartburn, and nausea.
How does bismuth subsalicylate work in the body?
It reduces intestinal motility.
At what age is bismuth subsalicylate recommended?
For individuals over 16 years.
What are potential side effects of bismuth subsalicylate?
Blackened stools and tongue.
What is the function of bulk-forming agents in diarrhea treatment?
Cause water absorption in the colon to form a firmer stool
In addition to diarrhea, for what other condition are bulk-forming agents used?
Constipation.
When might bulk-forming agents be particularly useful?
In conditions with chronic diarrhea.
