Diarrhea

Diarrhea is a common gastrointestinal disorder that characterized by loose to watery stools that occur more frequently than usual and in a larger amount. Diarrhea results in loss of fluids that causes dehydration and electrolyte imbalances. It can happen as acute or chronic.

Causes and Risk Factors

There are numerous reasons and risk factors to cause diarrhea. Here is a list from Medscape:

    • Causes of diarrhea with acute onset include the following:
      • Infections
        • Enteric infections (including food poisoning
        • Extraintestinal infections
      • Drug-induced
        • Antibiotic-associated
        • Laxatives
        • Antacids that contain magnesium
        • Opiate withdrawal
        • Other drugs
      • Food allergies or intolerances
        • Cow's milk protein allergy
        • Soy protein allergy
        • Multiple food allergies
        • Olestra
        • Methylxanthines (caffeine, theobromine, theophylline)
      • Disorders of digestive/absorptive processes
        • Glucose-galactose malabsorption
        • Sucrase-isomaltase deficiency
        • Late-onset (adult-type) hypolactasia, resulting in lactose intolerance
      • Chemotherapy or radiation-induced enteritis
      • Surgical conditions
        • Acute appendicitis
        • Intussusception
      • Vitamin deficiencies
        • Niacin deficiency
        • Folate deficiency
      • Vitamin toxicity
        • Vitamin C
        • Niacin, vitamin B3
      • Ingestion of heavy metals or toxins (eg, copper, tin, zinc)
      • Ingestion of plants (eg, hyacinths, daffodils, azalea, mistletoe,Amanita species mushrooms)
    • Infectious causes of acute diarrhea in developed countries
      • Viruses
        • Rotavirus - 25-40% of cases
        • Norovirus - 10-20% of cases
        • Calicivirus - 1-20% of cases
        • Astrovirus - 4-9% of cases
        • Enteric-type adenovirus - 2-4% of cases
      • Bacteria
        • Campylobacter jejuni - 6-8% of cases
        • Salmonella - 3-7% of cases
        • E Coli - 3-5% of cases
        • Shigella - 0-3% of cases
        • Y enterocolitica - 1-2% of cases
        • C difficile - 0-2% of cases
        • Vibrio parahaemolyticus - 0-1% of cases
        • V cholerae - Unknown
        • Aeromonas hydrophila - 0-2% of cases
      • Parasites
        • Cryptosporidium - 1-3% of cases
        • G lamblia - 1-3% of cases

Signs and Symptoms

Signs and symptoms associated with diarrhea may include:

  • Fever
  • Chills
  • Loose to watery stools
  • Abdominal pain or cramp
  • Nausea
  • Vomiting
  • Rash
  • Dehydration
  • Blood in the stool
  • Weight loss

Diagnosis and Treatment

Diagnosis is based on a history and physical examination, with one or more of the following tests:

  • Blood works
  • Stool studies
  • X-ray
  • CT scan
  • Endoscopy
  • Colonoscopy

Treatment is based on the cause, and focused on getting rid of the causative factor, hydration, relief of symptoms, etc.

References:

  1. Medscape.
  2. Wikipedia.
  3. Mayo clinic online health information.
  4. Sleisenger and Fordtran's Gastrointestinal and Liver Disease- by Mark Feldman MD, et al.
  5. The Little Black Book of Gastroenterology-by David W. Hay.
  6. Principles of Clinical Gastroenterology by Tadataka Yamada, et al.


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