This common problem has a negative impact on patients' quality of life and results in considerable health care costs. 1-3 Chronic diarrhea presents difficulties for clinicians as well as for patients. [patientcareonline.com]

The typical presentation of celiac disease in children is failure to thrive, diarrhea and abdominal distension. However, the presentation of disease seems to have changed over the past few years. [oatext.com]

A nonexhaustive list of medication categories commonly associated with diarrhea is presented in Table I. [cancertherapyadvisor.com]

Snapshot A 25-year-old man presents to his primary care physician for evaluation of diarrhea. He had recently gone to Mexico for spring break, where he stayed in a hostel with his friends. [step1.medbullets.com]

If an enteroenteric fistula is present, as may occur in Crohn's disease, whole sections of intestinal absorptive surface can be bypassed. [ncbi.nlm.nih.gov]

• Food Poisoning

  Acute diarrhea lasts for no longer than 14 days and is typically caused by viral or bacterial infection or food poisoning. [amboss.com]

  Symptoms usually appear within several hours when food poisoning is caused by toxins that are formed in the food before it is eaten. [medicinenet.com]

  Infections combined with food poisoning are the most common causes of acute diarrhea ( 4 days in duration). Most enterotoxins block sodium-potassium exchange, which is an important driving force for fluid absorption in the small bowel and colon. [msdmanuals.com]

  Bacillus cereus produces two toxins: a preformed one that causes an illness similar to staphylococcal food poisoning and one more like that seen with C. perfringens infections. [ncbi.nlm.nih.gov]

  […] or contaminated water A doctor’s examination Sometimes examination and testing of stool Food poisoning Diarrhea that started suddenly, often with vomiting, within 4 to 8 hours of eating contaminated food Often present in other people Typically lasting [merckmanuals.com]

• Hypotension

  • Hypotension and hypokalemia are common co-presenting features. • they benefit from psychiatric counseling 8. OSMOTIC GAP • 290 mosm/kg - 2 x (Na+ K) = Osmotic Gap • 125 mosm/kg = Osmotic diarrhea • 50 mosm/kg = Secretory diarrhea 9. [slideshare.net]

  Exceptions are patients with signs of dehydration, bloody stool, fever, severe pain, hypotension, or toxic features—particularly those who are very young or very old. [msdmanuals.com]

  Measurement of blood pressure in the sitting and then then the upright positions can demonstrate orthostatic hypotension (a marked drop in blood pressure) and confirm the presence of dehydration. [medicinenet.com]

  Additionally, it is important to assess for secondary effects, such as signs and symptoms of dehydration, including orthostatic hypotension, dry mouth, excessive thirst, dizziness, feelings of weakness, decreased urination, or weight loss. 10 A comprehensive [oncology.tv]

  As the fluid deficit approaches 10% of body weight, dehydration becomes severe and anuria, hypotension, a feeble and very rapid radial pulse, cool and moist extremities, diminished consciousness, and other signs of hypovolaemic shock appear. [rehydrate.org]

• Orthostatic Hypotension

  Measurement of blood pressure in the sitting and then then the upright positions can demonstrate orthostatic hypotension (a marked drop in blood pressure) and confirm the presence of dehydration. [medicinenet.com]

  Additionally, it is important to assess for secondary effects, such as signs and symptoms of dehydration, including orthostatic hypotension, dry mouth, excessive thirst, dizziness, feelings of weakness, decreased urination, or weight loss. 10 A comprehensive [oncology.tv]

• Oliguria

  Isotonic dehydration is manifested first by thirst, and subsequently by decreased skin turgor, tachycardia, dry mucous membranes, sunken eyes, lack of tears, a sunken anterior fontanelle in infants, and oliguria. [rehydrate.org]

Workup revealed a glucose level of 1904 mg/dL, and hyperglycemic hyperosmolar syndrome was diagnosed. [unboundmedicine.com]

We then describe an appropriate workup for each of the basic types of diarrhea. PATHOPHYSIOLOGY OF DIARRHEA The fundamental pathophysiology of all diarrheal illnesses is incomplete absorption of water from the lumen. [patientcareonline.com]

This workup should include complete blood count, examination of stool for occult blood, metabolic panel to assess electrolyte levels, BUN/creatinine, albumin, stool cultures for enteric pathogens, C difficile, and ova and parasites, and a flat plate of [oncology.tv]

[…] cause Diagnosis Treatment Laxative abuse Substances Clinical features Osmotic diarrhea, meteorism Dehydration Hypokalemia Melanosis coli : benign hyperpigmentation of the colonic mucosa caused by anthraquinone abuse References: [12] [13] Diagnostics The workup [amboss.com]

It is unclear whether these patients had a prior workup for chronic diarrhea. 2 Secretory diarrhea was the most common etiology overall in the 2 series (21% and 45%, respectively). [mdedge.com]

• Hyponatremia

  ODS occurs predominantly in patients with extreme chronic hyponatremia which is corrected too fast with isotonic saline. Most patients survived and became functionally independent. [unboundmedicine.com]

• Entamoeba Histolytica

  histolytica, idiopathic inflammatory bowel disease, typhlitis (neutropenic colitis in immunosuppressed) Malabsorption: bulky stools, abates with fasting; caused by defective intraluminal digestion, primary mucosal cell abnormalities, reduced small intestinal [pathologyoutlines.com]

  histolytica, and Cryptosporidium Osmotic causes of diarrhea can include: Intolerances to certain compounds in food, such as lactose (milk sugar) and artificial sweeteners Medications, such as antibiotics, blood pressure medications, and some antacids [drweil.com]

  Chronic Inflammatory Diarrhea • The pathogens most likely to cause chronic inflammatory diarrhea : • C. difficile • Cytomegalovirus • Entamoeba histolytica • Yersinia spp • Mycobacterium tuberculosis 30. [slideshare.net]

  Some Causes of Diarrhea* Type Examples Acute Viral infection Norovirus, rotavirus Bacterial infection Salmonella, Campylobacter, or Shigella sp; Escherichia coli ; Clostridium difficile Parasitic infection Giardia sp, Entamoeba histolytica, Cryptosporidia [msdmanuals.com]

  Testing for ova and parasites is routinely done in refractory diarrhea and can direct toward a positive diagnosis for certain agents, such as Strongyloides, although some parasites (e.g., Entamoeba histolytica) are endemic in developing countries. [cancertherapyadvisor.com]

References: [14] [2] Treatment Since most cases of acute diarrhea are self-limited, treatment is mostly symptomatic, focusing on oral rehydration, and rarely requires medication. [amboss.com]

Recommended guidelines for the treatment of cancer treatment-induced diarrhea. J Clin Oncol. 2004;22:2918-2926. [oncology.tv]

Treating diarrhea in children Diarrhea treatment is generally supportive, meaning that we give appropriate fluids and nourishment without specific therapy directed at an underlying cause. [notes.childrenshospital.org]

The purpose of the electrolytes in the solution is the prevention and treatment of electrolyte deficiencies. [medicinenet.com]

Often, especially when treatment is empiric and diarrhea is functional, these endpoints are achieved over months or years or are only partially met, and a combination of treatment agents is needed to reach acceptable symptom control. [cancertherapyadvisor.com]

It is a rare condition and carries a poor prognosis. Tropical sprue: It is a rare condition in children and coliform organisms are implicated in its etio- pathogenesis. [oatext.com]

Etiologies for diarrhea in the remaining cases were infectious (11.8%), idiopathic (8.9%), celiac (7.3%), and other (10.2%). [mdedge.com]

[…] fat malabsorption watery diarrhea osmotic diarrhea due to osmotic pull of water into the intestinal lumen etiologies giardiasis laxatives lactose intolerance secretory diarrhea due to active secretion of water etiologies infectious ( i.e., enterotoxic [step1.medbullets.com]

Etiologies The most common cause of osmotic diarrhea is due to malabsorption of lactose derived from dairy products, known as lactose intolerance. [pathwaymedicine.org]

Definition / general Normal intestines receive 9 liters of fluid per day (oral intake: 2 L, saliva: 1L, gastric juices: 2L, pancreatic juices: 2L, intestinal juices: 1L); most is reabsorbed in small intestine and colon Etiology Infectious (viral damage [pathologyoutlines.com]

Certain findings raise suspicion of an organic or more serious etiology of diarrhea: Blood or pus in stool Fever Signs of dehydration Chronic diarrhea Weight loss Acute, watery diarrhea in an otherwise healthy person is likely to be of infectious etiology [msdmanuals.com]

[…] other E. coli strains (e.g., EAEC ), protozoa (e.g., Giardia ), viral diarrhea ( norovirus, rotavirus, astrovirus ) Factitious diarrhea Definition : self-induced diarrhea, usually by laxative abuse ; often occurs in individuals with factitious disorders Epidemiology [amboss.com]

[…] acute diarrhea is characterized by acute onset of >3 bowel movements/day lasting persistent diarrhea lasts 2-4 weeks chronic diarrhea lasts >4 weeks and is often caused by underlying conditions such as inflammatory bowel disease or fat malabsorption Epidemiology [step1.medbullets.com]

Epidemiology and Recurrence Rates of Clostridium difficile Infections in Germany: A Secondary Data Analysis. Infect Dis Ther. 2016 Oct 21. [Medline]. Esposito DH, Holman RC, Haberling DL, Tate JE, Podewils LJ, Glass RI, et al. [medscape.com]

Clinical Classification Clinically, it may be useful to classify diarrhea: by time course (acute vs. chronic), by volume (large vs. small), by pathophysiology (secretory vs. osmotic), by epidemiology, and by stool characteristics (watery vs. fatty vs. [bioline.org.br]

Epidemiological history can be useful in eliciting clues supporting the presence of chronic infection, such as C. difficile, Campylobacter, Aeromonas, Giardia, ameba, Cryptosporidium, and Cyclospora. [cancertherapyadvisor.com]

PATHOPHYSIOLOGY OF DIARRHEA The fundamental pathophysiology of all diarrheal illnesses is incomplete absorption of water from the lumen. [patientcareonline.com]

Pathophysiology Recall from GI Water and Electrolyte Absorption that intestinal water absorption occurs purely passively. Thus water absorption occurs via osmosis, following resorption of osmotically active electrolytes, principaly sodium. [pathwaymedicine.org]

Abstract The purpose of these studies was to gain insight into the pathophysiology of pure osmotic diarrhea and the osmotic diarrhea caused by carbohydrate malabsorption. [jci.org]

Complex Diarrhea Rather than being produced by a single pathophysiologic mechanism (osmotic or secretory), most diarrheas are complex; and are produced by a combination of mechanisms. [bioline.org.br]

There are multiple causes for diarrhea and there may be multiple pathophysiologic mechanisms for a single disease entity. [ncbi.nlm.nih.gov]

Preventing viral diarrhea Wash your hands to prevent the spread of viral diarrhea. [mayoclinic.org]

Prevention The best way to prevent diarrhea is thorough hand washing on a regular basis. Properly cooking meats, drinking bottled water while on vacation and avoiding spoiled food can help, as well. [livescience.com]

Vaccines for preventing rotavirus diarrhoea: vaccines in use. Cochrane Database of Systematic Reviews. 2012. Platts-Mills JA, Babji S, Bodhidatta L, et al. [medscape.com]

Definition Osmotic Diarrhea occurs due to ingestion of poorly absorbable yet osmotically active solutes that prevent proper GI water and electrolyte absorption. Clinical Consequences Osmotic Diarrheas are typically large volume and watery. [pathwaymedicine.org]

As WHO points out, the most important thing is to begin preventing dehydration as early as possible. [17] In another example of prompt ORS hopefully preventing dehydration, CDC recommends for the treatment of cholera continuing to give Oral Rehydration [en.wikipedia.org]