Diarrhoea Flashcards by Holly O'Flanagan | Brainscape

Q

What is diarrhoea?

A

‘Abnormal passage of loose or liquid stools more than three times daily and/ or a volume of stool greater than 200g/day’

What is normal for patient- change from baseline

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Q

Acute diarrhoea

A

Less than 4 weeks

Most acute diarrhoea infectious

Self limiting, ?investigate after 1 week

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Q

Chronic diarrhoea

A

More than 4 weeks

Chronic pathology

Always investigate

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Q

Viral causes of diarrhoea

A

Rotavirus

Norovirus

Enteric adenovirus

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Q

Parasitic causes of diarrhoea

A

Cryptosporidium parvum

Chronic

giardia lamblia
entamoeba histolyticia

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Q

Bacterial causes of diarrhoea

A

Salmonella

Shigella

Campylobacter

Staph aureus

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Q

Causes of osmotic diarrhoea

A

Lactose intolerance

Some laxatives

Bile salt diarrhoea

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Q

Bile salt test

A

SeHCAT scan

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Q

Stools in malabsorption

A

Large, greasy, pale stools

Steatorrhoea

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Q

Causes of fatigue

A

Malabsprtion

Deficiency- iron, B12

Lack of sleep

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Q

Causes of chronic diarrhoea: colonic

A

Inflammatory bowel disease

Microscopic colitis

Colorectal cancer

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Q

Causes of chronic diarrhoea: small bowel

A

Coeliac

Crohn’s

Bile salt malabsorption

Lactose intolerance

Small bowel bacterial overgrowth

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Q

Causes of chronic diarrhoea: pancreatic

A

Chronic pancreatitis

Pancreatic cancer

Cystic fibrosis

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Q

Causes of chronic diarrhoea: endocrine

A

Hyperthyroidism

Diabetes

ADdison’s disease

Hormone secreting tumours

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Q

Causes of chronic diarrhoea: other

A

Drugs

Alcohol

Facticious

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Q

Mechanisms of diarrheoa

A

Osmotic- lactose intolerance

Malabsorption- steatorrhoea

Secretory- E.coli

Inflammatory

Neoplastic

Ischaemic

Post irradiation

Q

Not IBS

A

Does not cause diarrhoea at night

Does not cause weight loss

Q

Stool tests

A

Microscopy and culture

Faecal elastase

Faecal calprotectin

Q

Imaging

A

Colonoscopy

Barium enema

Small bowel enema

CT

Video capsule

MRI small bowel

SeHCAT scan

Q

Ulcerative colitis

A

Affect only colon

Continuous inflammation

Any age, peak 20-40

Mucosal inflamamtion

Bloody diarrhoea

`Extraintestinal manifestations

Q

Crohn’s disease

A

Any part of GI tract

Any age, peak 20-40

Transmural inflammation, deep ulcers

Skip lesions

Q

Treatment for IBD

A

5 ASA preparations - UC

Corticosteroids

Azathioprine/ 6-mercaptopurine

Methotrexate

Biologics

Surgery