Lecture 29 - Diarrhoea

Question 1

Causes of acute diarrhoea?

Answer 1

Bacterial, viral and parasitic infection

Question 2

Causes of chronic diarrhoea?

Answer 2

Mechanisms related to: inflammation, osmosis, secretions and fats

Question 3

Small intestine bacterial overgrowth symptoms?

Answer 3

Bloating, flatulance, discomfort, diarrhoea, steatorrhea, malabsorption

Question 4

SIBO Predispositions?

Answer 4

Impaired motility, anatomic disorders causing stasis, metabolic/systemic diseases, immune deficiency disorders

Question 5

SIBO Maldigestion mechanism?

Answer 5

deconjugated bile salts impair micellar formation and fat digestion, degradation of carbohydrates causes osmotic action, degradation of protein precursors

Question 6

SIBO Malabsorption mechanism?

Answer 6

damaged enterocytes by direct adhesion produces enterotoxins and enzymes

Question 7

SIBO malabsorption leads to malabsorption of?

Answer 7

bile acids, fats, vcarbs, proteins, B12

Question 8

Billroth surgery side effects?

Answer 8

upper abdominal discomfort after meals (rapid gastric emptying and increased osmotic load), osmotic diarrhoea

Question 9

Ileostomy output characteristics?

Answer 9

dark green colour and no smell due to no bacteria, sodium loss compensated by kidneys and increased oral intake

Question 10

B12 malabsorption risk?

Answer 10

removal of terminal ilium w specialised B12/intrinsic factor receptors

Question 11

Bile Salt Malabsorption mechanism?

Answer 11

Reduced re-uptake via enterohepatic circulation, lost through colon/faeces

Question 12

Bile Salt malabsorption results in?

Answer 12

less fat absorption causing sterrhoea, water and electrolyte secretion in colon causing secretory diarrhoea

Question 13

Drug that binds bile acids?

Answer 13

cholestyramine

Question 14

Short bowel syndrome?

Answer 14

loss of small bowel leading to malabsorption, presence of colon and ileocaecal valve helps slow transit

Question 15

Short bowel syndrome - adaptive processes?

Answer 15

villi hypertrophy, colon increasing absorptive capacity

Question 16

Short bowel syndrome management?

Answer 16

diet, anti-motility drugs, acid-suppressants, cholestyramine, TPN