Diarrhoea (4.6) Flashcards
What does diarrhea constitute? What causes it?
Change from ones normal bowel habit
- increase in frequency
- soft, watery stools
- associated urgency, nausea, cramps
Causes:
- Infection e.g. virus/bacteria/parasite
- Diseases e.g. diverticulitis, IBD
- Diet, hormonal, drugs, anxiety impaction
What is the time course of diarrhoea? What is the main complication?
Time course:
> Acute: <7days (viral)
> Persistent: >14 days
> Chronic > 1 month
Dehydration = main complication
What is the difference between mild, moderate and severe dehydration?
Mild dehydration (<5% loss of body weight)
- Increased thirst, dry mucuous membranes
- Dark yellow urine, decreased skin turgor, sunken eyes
Moderate dehyration (5-10% loss of body weight)
- Moderate thirst (drinks eagerly ), dry mouth, non-tearing eyes
- Decreased urination
- Dark amber or brown urine
- Decreased skin tugor, sunken fontanelle and eyes
Severe dehydration (>10% loss of body weight)
- Altered behaviour e.g. anxiety, confusion
- Extremely thirsty but may be too lehargic to say
- Drinking poorly or not at all
- Little or no urination
- Decreased skin turgor, sunken fontanelle and eyes
- Circulatory collapse (weak rapid pulse, cool or blue extremities or hypotension), rapid breathing
For diarrhoea;
A) Who is the patient?
B) What are the symptoms
C) How long
D) Actions taken?
E) Medications?
G) Medical conditions?
A)
- Infant, young and elderly
- Pregnant and breastfeeding
- Traveled abroad recently –> risk of giardiasis infection
B)
- Frequency and nature of stools
- Onset of symptoms
- Blood or mmucus in motions
- Abdominal pain
- Other signs/symptoms:
> fever, vomitting, malaise, constipation, weight loss, signs of dehydration
- signs and dehydration
C)
- Children and elderly > 2-3 days
- Persistent change in bowel habit
- Previous history
- Overseas in past 2 months
- Food intake
D)
- Antidiarrheal
- Rehydration
E)
- Recent antibiotics
> pseudomembranous colitis (due to clostridium difiicile overgrowth –> refer)
- medication causing diarrhoea
F)
- Renal, liver or heart disease
What medications cause diarrhoea
Self care for diarrhoea?
- Increase fluids
- Resume normal food intake after rehydration
- Continue breastfeeding and bottle feeding
- Limit cows milk, sugar, alcohol, fatty/spicy food
- Increase starchy foods
- Live cultures (lactobacillus (GG))
- Wash hands well before food preparation and after toiletting
