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Introduction

Normal

Anatomy and Physio Definition of Diarrhea Causes Pathophysiology Signs and Symptoms Management Cases

is

the passage of 3 or more loose or liquid stools per day, or more frequently than is normal for the individual. It is usually a symptom of gastrointestinal infection, which can be caused by a variety of bacterial, viral and parasitic organisms. (WHO, 2011) Defined as an increase in stool mass, frequency, or fluidity, typically greater than 200 g per day.

Second

leading cause of death in children under five years old. Two billion cases of diarrheal disease every year. Mainly affects children under two years old Leading cause of malnutrition in children under five years old.

SECRETORY OSMOSIS

MOTILITY-RELATED
MALABSORPTIVE INFLAMMATORY EXUDATIVE

Secretory
There

is an increase in the active secretion, or there is an inhibition of absorption. It occurs when the small and large bowel secrete rather than absorb electrolytes and water. The most common cause of this type of diarrhea is a cholera toxin.

Osmotic It occurs when too much water is drawn into the bowels. Due to the excessive osmotic forces exerted by unabsorbed luminal solutes such as that which occurs with lactase deficiency

Motility-related
It

is caused by the rapid movement of food through the intestines (hypermotility).

Malabsorptive
Follows

generalized failures of nutrient absorption and is associated with steatorrhea and is relieved by fasting

Inflammatory
This

type occurs when there is damage to the mucosal lining or brush border, which leads to a passive loss of protein-rich fluids, and a decreased ability to absorb these lost fluids.

Exudative
Mucosal

inflammation and ulceration caused by inflammatory diseases and cancers may result in the outpouring of plasma, proteins, mucus and blood into the stool, resulting in exudative diarrhea.

Infection

- escherichia coli, rotavirus, vibrio cholerae, salmonella typhi, etc. Food poisoning Underlying disease Food Intolerance Medication Laxative abuse

Increased

Gastrointestinal Motility Deficient Fluid Volume Loose Watery Stool Composition Acid Base Imbalance: Metabolic Acidosis Electrolyte Imbalance: Hypokalemia

Increased

frequency and fluid content of

stool Abdominal cramps, distention, intestinal rumbling Voluminous greasy stool, which suggest intestinal malbsorption Painful spasmodic contraction of the anus May or may not be associated with vomiting

Impairment
Electrolyte

of Skin (Anal) Integrity


Imbalance

Dehydration

The

most severe threat posed by diarrhea is dehydration. 1. Early dehydration


thirst dry mouth

2.

Moderate dehydration

thirst restless or irritable behavior decreased skin elasticity sunken eyes

3. Severe Dehydration
symptoms

become more severe

shock, with diminished consciousness lack of urine output cool, moist extremities a rapid and feeble pulse low or undetectable blood pressure pallor

Ways to prevent diarrhea include: Proper hygiene Proper food handling (preparation & storage) Observance of strict environmental sanitation Access to clean water

Drink plenty of fluids. Eat food that is easy to digest. Use probiotics. Avoid anti-diarrheal medication. Zinc supplement

Cholera
is an important infectious disease endemic in certain Asian countries and other parts of the world. Fecal-oral route.

Massive

amounts of NaCl accumulate inside the lumen of the intestine, attracting water by osmosis and contributing to the liquid stools characteristic of cholera.

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