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Pa Tho Physiology and Pa Tho Genesis of Diarrhea

Pa Tho Physiology and Pa Tho Genesis of Diarrhea

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Published by hitsugayat_7

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Published by: hitsugayat_7 on Jan 05, 2011
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03/19/2013

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PATHOPHYSIOLOGY PATHOPHYSIOLOGY  AND PATHOGENESIS AND PATHOGENESISOF DIARRHEA OF DIARRHEA 
 
Osmotic DiarrheaOsmotic Diarrhea
 Absorption of water in the intestines is dependent on adequate Absorption of water in the intestines is dependent on adequateabsorption of solutes.absorption of solutes.
Ingestion of a poorly absorbed substrateIngestion of a poorly absorbed substrate
usually a carbohydrate or divalent ion.usually a carbohydrate or divalent ion.
examples include mannitol or sorbitol, epson salt (MgSO4) andexamples include mannitol or sorbitol, epson salt (MgSO4) andsome antacids (MgOH2).some antacids (MgOH2).
M
alabsorption
M
alabsorption
I
nability to absorb certain carbohydrates
I
nability to absorb certain carbohydrates
lactose intolerance resulting from a deficiency in the brushlactose intolerance resulting from a deficiency in the brushborder enzyme lactase.border enzyme lactase.
 The osmotically  The osmotically--active lactose is retained in the intestinal lumen,active lactose is retained in the intestinal lumen,  where it "holds" water. where it "holds" water.
 
Secretory DiarrheaSecretory Diarrhea
Occurs when secretion of water into the intestinalOccurs when secretion of water into the intestinallumen exceeds absorption.lumen exceeds absorption.
secretory diarrhea associated with cholerasecretory diarrhea associated with cholera
 Vibrio cholerae => cholera toxin => activates adenylyl Vibrio cholerae => cholera toxin => activates adenylylcyclase => increase in intracellular concentration of cyclase => increase in intracellular concentration of cyclic AMP => prolonged opening of the chloridecyclic AMP => prolonged opening of the chloridechannels => secretion of water from the cryptschannels => secretion of water from the crypts
 Additionally, cholera toxin affects the enteric nervous Additionally, cholera toxin affects the enteric nervoussystem, resulting in an independent stimulus of system, resulting in an independent stimulus of secretion.secretion.

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