Presentation
Poster session presented at Keystone Symposium on Microbial Communities as Drivers of Ecosystem Complexity, Breckenridge, Colorado, USA,. [graz.pure.elsevier.com]
[Case Reports] Proc (Bayl Univ Med Cent) 2019; 32(4):627-628 Reddy A, Finley L, Horrall S P We describe a 6-year-old boy who presented to the emergency department with the complaint of nausea and vomiting with diarrhea. [unboundmedicine.com]
Diarrhea in American infants and young children in the community setting: incidence, clinical presentation and microbiology. Pediatr Infect Dis J. 2006 Jan. 25(1):2-7. [Medline]. [medscape.com]
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]
Gastrointestinal
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Failure to Thrive
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]
[…] to thrive Disease courses can range from mild to severe with need of hospitalization. [amboss.com]
Microvillous Atrophy Davidson et al [11] in Canada, described five infants with severe diarrhea and failure to thrive from birth, leading to death in four cases. [saudijgastro.com]
Skin
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Flushing
Those with ongoing diarrhea should seek medical attention if they experience: Dark urine or small amounts of urine Rapid heart rate Dry, flushed skin Headaches or light-headedness Fatigue Irritability or confusion Severe abdominal or rectal pain Blood [livescience.com]
Diarrhea caused by malabsorption is characterized by oil or grease in the stool and an oily rim around the toilet bowl after stool is flushed. [merckmanuals.com]
Review of systems should seek symptoms suggesting possible causes, including joint pains (inflammatory bowel disease, celiac disease); flushing (carcinoid, vipoma, mastocytosis); chronic abdominal pain (irritable bowel, inflammatory bowel disease, gastrinoma [msdmanuals.com]
Octreotide controls diarrhea and flushing in carcinoid syndrome, and at the 50 to 150 mcg t.i.d. dose is used in many forms of noninfectious, noninflammatory diarrhea with pathophysiology involving the small bowel motility and secretion. [cancertherapyadvisor.com]
The mucosa of the area was flushed gently three times with 20 ml of physiological saline solution before two biopsies were taken. [journals.plos.org]
Workup
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]
Workup of cases of chronic diarrhea Diagnosis of factitious diarrhea (where patient adds water to stool to simulate diarrhea) The concentration of electrolytes in fecal water and their rate of excretion are dependent upon 3 factors: -Normal daily dietary [mayocliniclabs.com]
Serum
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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]
Other Test Results
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Decreased Plasma Volume
plasma volume and central venous pressure. [scielo.br]
Treatment
Probiotics for prevention and treatment of diarrhea. J Clin Gastroenterol. 2011 Nov. 45 Suppl:S149-53. [Medline]. Ruiz-Palacios GM, Perez-Schael I, Velazquez FR, et al. [medscape.com]
It generally responds to simple home treatments including diet adjustment and over-the-counter (OTC) medications such as loperamide (Imodium) and bismuth subsalicylate (Kaopectate, Pepto-Bismol ). [healthline.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]
Prognosis
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]
Etiology
Etiologies The most common cause of osmotic diarrhea is due to malabsorption of lactose derived from dairy products, known as lactose intolerance. [pathwaymedicine.org]
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]
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]
Epidemiology
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]
Giardia ), viral diarrhea ( norovirus, rotavirus, astrovirus ) Factitious diarrhea Definition : self-induced diarrhea, usually by laxative abuse ; often occurs in individuals with factitious disorders Epidemiology Clinical findings : chronic watery [amboss.com]
Overview 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]
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
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]
PATHOPHYSIOLOGY OF DIARRHEA The fundamental pathophysiology of all diarrheal illnesses is incomplete absorption of water from the lumen. [patientcareonline.com]
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]
Prevention
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]
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]
This can be prevented by replacing potassium and correcting the base deficit at the same time. [rehydrate.org]