Diarrhea Causes Diagnosis Symptoms Treatment

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Diarrhea is passage of abnormally liquid or unformed stools at an increased frequency.

The following definitions have been suggested according to the duration of diarrhea
Acute — ≤ 14 days in duration
Persistent diarrhea — more than 14 days in duration
Chronic — more than 30 days in duration
The weight of stool is more than 200 gm/day.
Acute diarrhea is diarrhea of <2 weeks.
Chronic diarrhea is of >4 weeks duration.
Persistent diarrhea is diarrhea for 2-4 weeks.
Pseudodiarrhea is frequent passage of small volume of stool as in irritable bowel syndrome and proctitis.
Fecal incontinence is the involuntary passage of stools due to neuromuscular disorders or structural abnormalities.
Abnormal increase in stool frequency or liquidity in an otherwise healthy individual
Often self-limiting; <14 days duration
Acute viral diarrhea (50–70%):
Most common form; usually occurs for 1–3 days; self-limited
Causes changes in small intestinal cell morphology, such as villous shortening and an increase in the number of crypt cells
passage of fluid or unformed stools. In acute diarrhea, the frequency of bowel movements and the volume of fluid lost determine the severity of the illness.

ACUTE DIARRHEA

Loose liquid stools ± blood or mucus
Fever
Abdominal pain and distension
Determine hydration status; look for decreased skin turgor, dry mucous membranes, hypotension, or decreased urination.
In children: absence of tears, depressed fontanelles, dry diapers.
Abdominal exam to rule out potential surgical causes of diarrhea such as appendicitis or pelvic abscess
Frequent watery bowel movements or stools with pus, blood, oils, or mucus are characteristic of diarrhea,
as are abdominal cramping, bloating, or rectal discomfort.
When volume losses from diarrhea are large, symptoms of dehydration or electrolyte imbalance, such as dizziness, thirst, and prostration, are common.

Passage of ≥ 6 unformed stools per 24 hours or a duration of illness >48 hours
· Gross examination of stool
· Microbiologic analysis of stool
· Culture for bacteria and virus
· Immunoassay
· Sigmoidoscopy
· Biopsy
· Upper GI endoscopy with – Biopsy, duodenal aspirates
·CT scan. :
Profuse watery diarrhea with signs of hypovolemia
Passage of many small volume stools containing blood and mucus
Bloody diarrhea
Temperature ≥ 38.5ºC (101.3ºF)
Systemic illness with diarrhea, especially in pregnant women (in which case listeriosis should be suspected)

· Medications
· Infections
· Bowel resection
· Mucosal disease – Crohn’s disease and regional ileitis
· Idiopathic secretory diarrhea
· Metastatic gastrointestinal carcinoid tumors
· Primary bronchial carcinoids
· Pancreatic cholera
· VIP oma – Vasoactive intestinal peptide tumor
· Medullary carcinoma of thyroid
· Lactase deficiency – carbohydrate malabsorption
· Steatorrhea – stool fat exceeding – 7 g/day
· Celiac sprue – gluten-sensitive enteropathy
Tropical sprue .
Whipple’s disease – Treponema infection Mycobacterium avium Abetalipoproteinemia
Hyperthyroidism
~ Irritable bowel syndrome
. y Munchausen syndrome – Made-up diarrhea, false diarrhea.