F3: Fecalysis (Part 1: Intro-Mechanisms of Diarrhea) Flashcards
Familiarize the importance of fecalysis
For detection of
* Bleeding in the GIT
* Disorders in the liver and biliary duct
* Maldigestion/malabsorption syndromes
* Pancreatic diseases
* Inflammation in the GIT
* Causes of diarrhea and steatorrhea
* Infestation by bacteria, viruses, and parasites
IMPORTANCE OF FECALYSIS
Which is/are false regarding importance of fecalysis
a. Bleeding in the GIT
b. Disorders in the liver and heart
c. Maldigestion/malabsorption syndromes
d. Heart diseases
e. Inflammation in the GIT
f. Causes of diarrhea and steatorrhea
g. Infestation by bacteria, viruses, and parasites
b. Disorders in the liver and heart
d. Heart diseases
IMPORTANCE OF FECALYSIS
- Tests which detects bleeding in the GIT
- Detects minor amount of blood in the stool
Fecal occult blood test (FOBT)
This organ produces bile, it is responsible for the digestion of fats
Liver
IMPORTANCE OF FECALYSIS
T or F
In case of biliary obstruction, stercobilin and urobilinefficiently comes out
F (In case of biliary obstruction stercobilin & urobilin cannot come
out)
IMPORTANCE OF FECALYSIS
2 pigments that gives the stool its characteristic color
Stercobilin, Urobilin
IMPORTANCE OF FECALYSIS
In biliary obstruction, since there is absence oef sertcobilin and urobilin, the stoll appears as ?
what specific term
Acholic
absence of substance that produces pigment ( pale, yellow, grayish)
IMPORTANCE OF FECALYSIS
Absence of substance that produces stool pigment
Acholic
IMPORTANCE OF FECALYSIS
Stool color produced in biliary obstruction
pale, yellow, grayish
IMPORTANCE OF FECALYSIS
- Due to pancreatic insufficiency
- Food are not breakdown easily
- Not fully digested and not fully absorbed
Maldigestion
IMPORTANCE OF FECALYSIS
T or F
If not fully digested = not fully absorbed
T
IMPORTANCE OF FECALYSIS
Refers to large amounts of fats in the stool
Steatorrhea
COMPOSITION
Familiarize the following composition of stool
- Bacteria
- Cellulose and other undigested foodstuffs
- Gastrointestinal secretions
- Bile pigments
- Cells from the intestinal walls
- Electrolytes
- Water
COMPOSITION
(1) Food enters the mouth and is incorporated with what making it into a bolus
Incorporated with saliva
COMPOSITION
(2) What is the product formed when food is incrporated with saliva?
Bolus
COMPOSITION
(3) After formation of bolus, it travels down to where
Esophagus
esophageal sphincter will open and let the bolus into the stomach
COMPOSITION
(4) Esophageal sphincter in esophagus allows bolus to enter in what organ of the body?
Stomach
COMPOSITION
The acidity of the stomach is by the action of?
Hydrochloric acid
COMPOSITION
(5) The bolus will incorporate with the digestive juices (stomach fluid) will result to formation of?
Chyme
COMPOSITION
(6) After mixing with jucies in stomach, it will proceed to what next organ? and what part of that organ?
Specific
Small intestine (Duodenum)
- First part of the small intestine
- Responsible for breaking down of food
What organ is this
Duodenum
COMPOSITION
(7) After passing through duodenum, what other 2 sections of the small intestine does it pass through?
Jejunum, Ileum
COMPOSITION
2 parts of the small intestine that is responsible for the absorption of nutrients to the bloodstream
Jejunum, Ileum
COMPOSITION
(8) After the small intestine, it would go to the large intestine, which consists of what (4) parts?
clue: A T D S
Ascending, Transverse, Sescending and Sigmoid colon
COMPOSITION
(9) Organ where further absoportion of water takes place
Colon
COMPOSITION
(10) After the colon, it would be transmitted to the (blank) and eventually will enter (blank)
Rectum
Anus
COMPOSITION
T or F
When the ascending colon is filled with fecal matter, it will be stimulated to enter the rectum, then the anus
F (When the descending colon is filled with fecal matter, it will be stimulated to enter the rectum, then the anus)
COMPOSITION
(11) Is considered to be last part of digestion
Anus
COMPOSITION
While the food is in the small intestine, these (2) other organs will release enzymes to further break down the food
- Liver
- Pancreas
COMPOSITION
Length of small intestine?
20 ft long
FECAL FORMATION
Volume of secretions that enter the GIT/day
9000 mL (8-10L)
FECAL FORMATION
Volume of secretion that reaches the large intestine
500mL to 1,500mL
FECAL FORMATION
Volume of secretion that large intestine can absorb
up to 3000mL
FECAL FORMATION
Normal stool volume?
100-150mL
FECAL FORMATION
T or F
The reason why initial volume (9000ml) is reduced to 500-1500 mL is due to excretion of nutrients and substances
F (The reason why initial volume (9000ml) is reduced to 500-1500 mL is due to absorption of nutrients and substances)
FECAL FORMATION
Abnormal condition where:
* Increased frequency of defecating (>3 times a day)
* Increased liquidity (watery stool)
* > 200g/day
Diarrhea
CLASSIFICATIONS OF DIARRHEA
What are the (4) parameters in classifying diarrhea
- Illness duration
- Mechanism
- Severity
- Stool characteristics
CLASSIFICATIONS OF DIARRHEA
Classification of diarrhea that determines if diarrhea is either acute or chronic
Illness duration
CLASSIFICATIONS OF DIARRHEA
Acute or Chronic Diarrhea?
- sudden onset
- < 4 weeks
Acute Diarrhea
Illness duration
CLASSIFICATIONS OF DIARRHEA
What are the 3 mechanisms of diarrhea
Mechanism
clue: SOA
- Scretory
- Osmotic
- Altered motility
CLASSIFICATIONS OF DIARRHEA
Severity of diarrhea can either be?
dalawa
Mild or Severe
Mechanism of diarrhea referring to hypermotility
Altered motility
MECHANISM OF DIARRHEA
- Increased secretion of water
- Bacterial, viral and protozoan infestation produce increased secretion of water and electrolytes
- Caused by organisms that produce toxin
- Stools are water and voluminous
- Contributes even when there is no oral food intake
- It is caused by microorganism toxin
Secretory Diarrhea
MECHANISM OF DIARRHEA
In secretory diarrhea, this causes electrolyte channel to prolong its opening (Specifically chloride channel since the toxins make the channels prolong their opening, the chloride will keep on going out)
SECRETORY DIARRHEA
Toxins produced by the microorganisms
MECHANISM OF DIARRHEA
Toxins produced by microorganisms microorganisms cause
a. Electrolyte channel to prolong closing
b. Potassium channel is affected, hence sodium then water will follow
c. both
d. NOTA
SECRETORY DIARRHEA
d. NOTA
TO BE CORRECT, IT SHOULD BE:
Toxins from microorganisms cause
a. Electrolyte channel to prolong OPENING
b. CHLORIDE channel is affected, hence sodium then water will follow
T or F
Secretory diarrhea still can happen even if you do not eat anything for a few days because of the toxin in the system
T
MECHANISM OF DIARRHEA
Stool result of patient can possibly be positive to what (3) parameters
SECRETORY DIARRHEA
WBC, RBC, mucus
Causes of Secretory diarrhea
(3) Microorganisms that cause secretory diarrhea?
clue: VEG
- Vibrio cholerae (eneterotoxigenic toxin)
- Enterotoxigenic e. coli
- Giardia lamblia
Causes of Secretory diarrhea
T or F
Invasive diarrhea causes secretory diarrhea
T
Causes of Secretory diarrhea
(2) examples of bacteria causing invasive diarrhea which also leads to secretory diarrhea are what?
Salmonella, shigella
Causes of Secretory diarrhea
Causes of Secretory diarrhea
a. drugs (stimulant laxatives)
b. Hormones, inflammatory bowel disease
c. both
d. NOTA
c. both
Causes of Secretory diarrhea
What are the hormnes or inflammatory diseases that cause secretory diarrhea?
- Crohn disease
- Ulcerative colitis
- Lymphocytic colitis
- Diverticulitis
Familiarize Causes of Secretory diarrhea
- Vibrio cholerae (enterotoxigenic toxin)
- Enterotoxigenic E. coli
- Giardia lamblia
- Invasive diarrhea
- Drugs, stimulant laxatives
- Hormones, inflammatory bowel disease
MECHANISM OF DIARRHEA
- Results from the presence of osmotically active, poorly absorbed solutes in the bowel lumen that inhibit normal water and electrolyte absorption
- Increased retention of water and solute in the large intestine due to an enzyme deficiency
- Associated with malabsorption and maldigestion
- Watery and gaseous stool with NO WBC, RBC, and mucus
- Positive for the substance that is not reabsorbed
- Presence of undigested food
Osmotic Diarrhea
CAUSES OF OSMOTICALLY ACTIVE SUBSTANCE
What are the 2 causes of osmotically active substances
- Maldigestion
- Malabsorption
CAUSES OF OSMOTICALLY ACTIVE SUBSTANCE
- Enzyme deficiency
- Ex. lactose intolerance - deficient of lactase whic breaks down lactose in simple forms
Maldigestion
CAUSES OF OSMOTICALLY ACTIVE SUBSTANCE
- Comes together with maldigestion
- In order for you to absorb a substance, it should be in the simplest form
- If you cannot digest properly, you will not be able to absorb it.
Malabsorption
Causes of Osmotic diarrhea
Familiarize the Causes of Osmotic diarrhea
- Disaccharide deficiency (lactose intolerance)
- Pancreatic insufficiency: pancreas does not produce that is
necessary to breakdown the food
Malabsorption (celiac disease, tropical sprue)
Poorly absorbed sugars (lactose, sorbitol, mannitol)
Laxatives
T or F
Fasting does not stop osmotic diarrhea
F (Fasting DOES stop it)
MECHANISM OF DIARRHEA
- Describes conditions of either enhanced motility (hypermotility) or slow motility (constipation)
- Can be seen in patients with irritable bowel syndrome (IBS)
Altered Motility
MECHANISM OF DIARRHEA
- A functional disorder in which the nerves and muscles of the bowel are extra sensitive
- Causes cramping, bloating, flatus, diarrhea and constipation
- Can be triggered by food, chemicals, emotional stress and exercise
ALTERED MOTILITY
Irritable bowel syndrome (IBS)
