Diarrhea is defined as an increased frequency and decreased consistency of fecal discharge as compared with an individual's normal bowel pattern.
Frequency and consistency are variable within and between individuals. For example:
Some individuals defecate as many as three times a day, while other defecate only 2 or 3 times per week. Most cases of acute diarrhea are caused by infections resulting from viruses, bacteria or protozoa and are generally self limited.
Diarrhea is an imbalance in absorption and secretion of water and electrolytes. Diarrhea may be associated with a specific disease in the GIT tract or with a disease outside the GI tract.
Usually acute diarrheal episodes subside within 72 hours of onset, whereas chronic diarrhea involves frequent attacks over extended time periods.
Signs & Symptoms:
Abrupt onset of nausea
vomiting
Abdominal pain
Headache
Fever
Chills
Malaise
Bowel movements are frequent and never bloody
Diarrhea lasts for 12-60 hrs
Clinical findings:
Stool analysis studies includes examination for
Microorganisms
Blood
Mucous
Fat
Osmolarity
Electrolyte and mineral concentration
cultures
Drugs causing diarrhea:
Laxatives
Antacids containing magnesium
Anti-neoplastics/Anticancer
Antibiotics
Anti-hypertensive
Cholinergic
NSAIDS
PPIs
Cardiac agents
Treatment:
Management of the diet is the first priority for the treatment of diarrhea as recommended by various health articles.
Patient should stop taking solid foods for 24 hours and avoiding dairy products.
When nausea and vomiting is mild, a digestible and low-residue diet is administered for 24 hrs.
Various drugs are used to treat diarrhea. These drugs are grouped into several categories:
Ant motility agents
Adsorbents
Anti-secretory compounds
Antibiotics
Enzymes
Intestinal micro flora
According to health articles these drugs are not curative but palliative:
LOPERAMIDE is often recommended for managing acute and chronic diarrhea. Diarrhea lasting for 48 hours beyond initiating
Loperamide warrants medical attention.
Adsorbents (such as Kaolin pectin) are used for symptomatic relief.
Bismuth sub salicylate is often used for treatment and prevention of diarrhea (traveler's diarrhea) and has antisecretory, anti-inflammatory and antibacterial effects.
Lactobacillus preparation is intended to replace colonic microbial flora. This supposed restores intestinal functions and
Suppresses the growth of pathogenic microorganism.
Ant cholinergic drugs such as atropine block vagal tone and prolong gut transit time.
Health articles say chronic diarrhea is that which last for at least 14 days.
Possible causes of diarrhea:
Following are a few causes of diarrhea...
Intestinal infection
Inflammatory bowel disease
Malabsorption
Secretory hormonal tumor
Drug
Motility disturbances
Select appropriate diagnostic studies e.g.:
Stool culture/ova/parasites/WBCs/RBCs/fat
Sigmoidoscopy
Intestinal biopsy