Di
Passing more watery or frequent stools than is normal for the individual, generally, >3 times a day
What is diarrhoea?
Rotavirus and norovirus
What viruses can cause diarrhoea?
Pictorially, it represents different types of stool. It can be used to more objectively record the number and type of bowel movements.
What is the bristol stool chart?
Coeliac disease, inflammatory bowel disease, cancer, ischaemic colitis, diverticulitis, and constipation with overflow
What GI disorders can cause diarrhoea?
Viral, bacterial, parasitic
What are the infective causes of diarrhoea?
Infection causes account for 90% of acute cases of diarrhoea. Viral infections are most common.
Hypotension, tachycardia, reduced jugular venous pressure, collapsed peripheral veins, cold peripheries, prolonged capillary refill, decreased skin turgor, dry tongue
What are the clinical features of fluid and electrolyte loss?
Antibiotics, PPI, metformin
What are some medications that can cause diarrhoea?
Fluid and electrolytes
What does diarrhoea result in a loss of?
Campylobacter jejuni, Salmonella species, E coli, Shigella species, Clostridium difficilel
What bacteria can cause diarrhoea?
It allows you to monitor illnesses or responses to treatment.
What is the function of the bristol stool chart?
Pancreatic insufficiency, previous surgery leading to short bowel, fructose/artificial sweeteners, bile acid diarrhoea (BAD)
What can lead to diarrhoea from malabsorption?
Increased intestinal secretion and/or decreases absorption via injury to the intestine due to damage to the mucosa
This is all that was given in the lecture on the mechanism (more may be revealed by other cards if it hasn't already).
Cryptosporidiosis, Entamoeba, Giardia
What are the parasites that can cause diarrhoea?
Acute kidney injury from raised urea, raised creatinine, low urine output, increased plasma osmolality, raised plasma proteins, raised haematocrit
What are the biochemical features of diarrhoea?
Produces toxin A which is an enterotoxin that damages villi and toxin B a cytotoxin that gains access once the cell wall is compromised
What are the toxins produced by Clostridium difficile
Osmotic, secretory, inflammation of the intestinal lining and increased intestinal motility
What are the mechanisms that can cause diarrhoea?
The causes discussed can be grouped into these mechanisms; this information is from the NICE guidelines, as it was not in the lecture
It is a notifiable infection which causes diarrhoea (may be bloody) and a fever. It often results from raw, undercooked or improperly stored poultry - especially chicken
What is Campylobacter (Campylobacter jejuni)?
When a soluble compound cannot be absorbed by the small intestine and thus draws fluid into the intestinal lumen e.g., certain laxatives, magnesium based antacids, generalised malabsorption (coeliac disease or pancreatic insufficiency)
What is osmotic diarrhoea?
When there is increased secretion of fluid and electrolytes into the intestine with decreased absorption, e.g., due to infection such as E. Coli and Clostridioides difficile, bile salts in the colon, some drugs including diuretics and caffine
Increased frequency of stool passage without an increase in volume e.g., in diabetes or hyperthyroidism
What is seen in diarrhoea with increased intestinal motility