lower GI- diarrhea

Question 1

acute diarrhea

Answer 1

abrupt; < 2 weeks; abdomnal pain, malaise, flatulence, generally resolves in 3 days; causes dietary, infection, toxicity, drugs

Question 2

chronic diarrhea

Answer 2

frequent passage > 4 weeks; tough to diagnose; refer – requires medical evaluation

Question 3

Traveler’s diarrhea

Answer 3

up to 10/day loose stools, w/nausea, abdominal cramps, +/- vomiting, fever; cause generally bacteria

Question 4

referral temp

Answer 4

> 101 F

Question 5

referral stool characteristics

Answer 5

nighttime diarrhea, bloody diarrhea, severe abdom cramps

Question 6

referral time

Answer 6

failure to subside within 3-5 days

Question 7

referral pop

Answer 7

pediatrics, elderly, pregnant

Question 8

referral symptoms

Answer 8

symptoms of dehydration

Question 9

treatment, non-drug

Answer 9

• Clear liquids,
• then BRAT,
• slowly add milk/dairy

Question 10

treatment, pharmacotherapy

Answer 10

bulk forming, loperamide, antibiotics, ORS, diet, digestive enzymes

Question 11

treatment, probiotics

Answer 11

• Used prophylactically, not useful for acute diarrhea
• needs to be active and to be >10 bil cfu/day
• most not FDA approved, don’t know if these products are active

Question 12

treatment, bismuth subsalicylate

Answer 12

• good for preventing Traveler’s diarrhea

- need a lot though

Question 13

treatment, loperamide MOA

Answer 13

Slows intestinal motility; inhibits peristalsis; tolerance doesn’t develop

Question 14

treatment, loperamide warnings

Answer 14

Don’t use in presence of bloody diarrhea, body temperature > 101; with organisms that penetrate the intestinal wall (enteroinvasive E. coli, Salmonella, Shigella, pseudomembranous colitis)

Question 15

treatment, bulk

Answer 15

Polycarbophil, good for diarrhea due to IBS