Diarrhoea Flashcards
What are the two different kinds of diarrhoea?
Acute (typically caused by infection) and Chronic (many causes with one or a mix or underlying mechanisms: inflammatory, osmotic, secretory and fatty)
What is inflammatory diarrhoea and what are some common causes?
-Inflammation of bowel mucosa, leading to exudate.
Causes: IBD, diverticulitis, SIBO (inflammation of enterocytes)
What is osmotic diarrhoea and what are some common causes?
-Osmotically active compounds draw fluid out
Causes: carb malabsorption (lactase intolerance/ IBS), Coeliac disease, SIBO (malabsorption of bacterial by products)
What is secretory diarrhoea and what are some common causes?
-Excessive fluid secretion (eg overstimulation of CFTR channel)
Causes: terminal ileal resection (bile acid isnt reabsorbed, affects colon, water and elecrtolyte secretion), IBD, diverticulitis, neuroendocrine tumours, SIBO (malabsorbed bile acids and food product)
What is fatty diarrhoea, and what are some common causes?
-Fat malabsorption, increased fat in stool
Causes: Bile acid malabsorption, pancreatic exocine insufficiency, SIBO ( deconjugtion of bile acids), coeliac, short bowel syndrome
What is SIBO?
Small intestinal bacterial ovegrowth, increased colonic bacteria in SI due to impaired gut motility (scleroderma, diabetes autonomic neuropathy), strictures, immune deficiency disorders.
What is melaena?
Bleeding of upper intestinal tract (black stool)
What is cholestyramine?
A drug used to aid bile acid malabsorption (remember bile is taken up in ileum via enterohepatic circulation). Binds bile acids
cholating agent
What is short bowel syndrome?
People who have had a large amount of small bowel removed do not absorb all food products well. As a result, there is colonic adaptation.
(presence of colon and ileocaecal valve do better)
To treat, anti motility drugs (such as loperamide, helps with gastric dumping also), cholestyramine and dietary changes
