gi diarrhea

Question 1

bile salt vs fatty acid diarrhea

which is assoc with cholecystectomy

Answer 1

bile salt unable to be completely reabsorbed by ileum. increased bile salts stimulate secretion of cl-, followed by na+ and water (all in colon). secretory diarrhea. tx with bile salt binder. this can be assoc. with cholecystectomies

fatty acid diarrhea: large resection of bowel: bile salt deficiency: cannot solubilize fat properly so steatorrhea. FA in colon stimulate Na+ secretion making diarrhea worse.
tx with medium chain triglycerides

Question 2

describe sxs of SIBO

Answer 2

b12 defic. bc bacteria prematurely cleave the IF from B12; also, get steatorrhea because bacteria deconjugate bile salts in intestine. Get increase folate bc bacteria make this

Question 3

list some possible examples of secretory diarrhea

Answer 3

Infectious (V. cholera, enterotoxigenic E. coli)
Neuroendocrine tumors (VIPoma, gastrinoma, Carcinoid syndrome)
Microscopic colitis (collagenous colitis, lymphocytic colitis)
Bile salt diarrhea
Laxative abuse (senna)

Question 4

list some possible examples of osmotic diarrhea

Answer 4

Medications (laxatives, antacids, sorbitol)

Lactose intolerance