diarrhoea Flashcards
symptoms associated
- crampy abdominal pain
- fever
- blood stained stool
- steatorrhoea
what are common causes of secretory diarrhoea
- enterotoxins (cholera, e.coli, c.diff)
- hormones
- bile salts
- fatty acids
- laxatives
why does diarrhoea occur
because of damage to the intestinal mucosal cell so that there is a loss of fluid and blood
common causes
- shigella
- UC
- crohns
what diseases do not cause ‘true’ diarrhoea
- IBS
- colorectal cancer
- diverticular disease
- faecal impaction
does acute diarrhoea require investigation
no
how long does travellers diarrhoea last
2-5 days
symptoms of acute diarrhoea
- fever
- abdominal pain
- vomiting
what can occur if diarrhoea is severe
dehydration
who is at risk of dehydration
very young and elderly
what is treatment for acute
fluid and electrolyte replacement
what is given to infants with acute diarrhoea
rehydration solutions e.g. sodium chloride
what do anti-diarrhoeals impair the clearance of
any pathogen from bowel
when are antibiotics occasionally necessary
- infective gastroenteritis
does chronic diarrhoea need investigation
yes
what is first line investigation for chronic diarrhoea if stool culture negative
colonoscopy with ileoscopy
first line investigation for chronic diarrhoea with blood
colonoscopy with biopsies
what causes colonic lesions on colonoscopy
- UC
- crohns
- carcinoma
what is done for malabsorption
- blood test
- jejunal biopsy
what disease cause small bowel lesions
- coeliac
- tropical sprue
- giardia
what diseases cause pancreatic lesions
- chronic pancreatitis
- carcinoma
what investigations are done for water/loose stools
- flexible sigmoidoscopy
- colonoscopy
- biopsy
what diseases cause colonic lesions
- IBD
- pseudomembraneous colitis
when can pseudomembraneous colitis occur
following the use of antibiotics
what is the causative agent of pseudomembraneous colitis
C.diff
what is an under-diagnosed cause of chronic diarrhoea
bile acid malabsorption
when does bile acid diarrhoea occur
when the terminal ileum fails to reabsorb bile acids
what does an increase in bile acid in the colon cause
diarrhoea
how is bile acid malabsorption diagnosed
SeHCAT test
treatment of bile acid malabsorption
bile salt sequestrants e.g. colestyramine
what do bile salt sequestrants do
they bind and inactivate the action of bile acids in the colon
is chronic diarrhoea a symptom of HIV
yes
