Diarrhoea, Constipation, Coeliac disease, IBS Flashcards
How is diarrhoea categorized?
acute (<14 days), persistent (>14 days <28) & chronic (>28 days)
Acute diarrhoea is not infectious. True or false?
false, usually infectious
Acute diarrhoea is usually self-limiting in 3 days. True or false?
True
What are the 4 mechanisms that cause diarrhoea?
- increased osmotic load in gut lumen
- increase in secretion of fluid and electrolytes into intestine and reduced absorption
- inflammation of intestinal lining caused by inflammation of intestinal mucosal cells will result in fluid and blood loss
- increased intestinal motility
What is the primary aim of diarrhoea treatment?
To prevent dehydration
How does Loperamide work?
Increases salt and water reabsorption by decreasing motility of gut longitudinal and circular muscles
Loperamide is an OTC medicine that can be given to children. True or false?
False, OTC but not for children
Loperamide is a synthetic opioid but has no opiate activity at therapeutic doses. True or false?
True
If symptoms of overdose of loperamide occur, what drug is given?
Naloxone
Other than loperamide and oral rehydration therapy, what is available for treatment of diarrhoea?
Antispasmodics, morphine, Diphenoxylate, antibiotics, adsorbents
What does ORT generally contain?
sodium and potassium to replace essential ions, citrate/bicarbonate for acidosis, glucose or another carbohydrate
What are the characteristics of an ORT solution?
should enhance absorption of water and electrolytes, replace electrolyte deficit, contain agent to reverse acidosis, be slightly hypo-osmolar to prevent osmotic diarrhoea, be simple to use, readily available, palatable
Loperamide and antispasmodics can be used for treatment of acute diarrhoea in young children. True or false?
False, neither can be used in young children
Acute diarrhoea that is infectious is caused by a virus. True or false?
true, eg Norovirus, rotavirus
Traveller’s diarrhoea is usually caused by a virus. True or false?
False, usually by a bacteria e.g. E.coli, 10% of cases are viral
What advice should be given to prevent travellers’ diarrhoea?
hand washing with soap, avoid drinking local water, avoid ice cubes, dairy products, ice cream, salad, eat fresh foods, avoid fish and shellfish
What are some causes of chronic diarrhoea?
IBS, IBD, malabsorption syndromes, metabolic diseases and laxative abuse
What questions should you ask a patient concerning their chronic diarrhoea?
medication, recent travel, stool frequency, onset, duration, food, nature, occurrence
What drug is used adjunct to oral rehydration therapy in children aged 3 months and over?
Racecadotril
What does racecadotril do?
– It is an enkephalinase inhibitor. It reduces hypersecretion of water and electrolytes into the intestinal lumen. Given orally
The rotavirus is a live vaccine given IV. True or false?
false, given orally
The rotavirus vaccine should be started in children over 15 weeks old, given in two divided doses. True or false?
false, should not be started in children over 15 weeks
What is the recommended schedule for rotavirus vaccine?
The first dose at 2 months of age (must be given between 6 weeks-15 weeks). The second dose 3 months of age