Enterocolitis (Diarrheal Diseases)

Question 1

5 major types of diarrheal diseases

Answer 1

1. Deranged motility
2. Osmotic
3. Malabsorption
4. Exudative
5. Secretory

Question 2

Deranged Motility

Answer 2

• Decreased intestinal retention time
  
  • Surgical reduction
  • Neural dysfunction (i.e. irritable bowel syndrome)
  • Hyperthyroidism
• Decreased motility (increased intestinal retention time)
  
  • Surgical creation of a “blind” intestinal loop
  • Bacterial overgrowth in small intestine

Question 3

Osmotic Diarrhea

Answer 3

• Lactulose therapy (for hepatic encephalopathy, constipation)
• Antacids (MgSO4 and other magnesium salts)

Question 4

Malabsorption

Answer 4

• Reduced small intestinal surface area
• Lymphatic obstruction
• Infectious: impaired mucosal-cell absorption: Giardia lamblia

Question 5

Exudative Diarrhea

Answer 5

• Exudative: elevated WBC (inflammatory)/occult blood/pus
  
  • Infectious: destruction of the epithelial layer
    
    • Shigella spp.
      
      • Bloody/inflammatory diarrhea
    • Salmonella spp.
      
      • S. Enteritidis = inflammatory diarrhea
      • S. typhi = “pea soup” diarrhea
    • Campylobacter spp.
    • Entamoeba histolytica
  • ​​​Idiopathic inflammatory bowel disease

Question 6

Secretory Diarrhea

Answer 6

• Infectious: viral damage to surface epithelium
  
  • Rotavirus
  • Norwalk virus
  • Enteric adenoviruses
• Infectious: enterotoxin-mediated
  
  • Vibrio cholerae
  • E. coli
  • Bacillus cereus
  • Clostridium perfringens
• Neoplastic: tumor elaboration of peptides or serotonin
• Excessive laxative use