Diarrhoea Flashcards
What are the essentialy features (or definition) of diarrhoea?
Increase in frequency of bowel motions
Increase in softness, fluidity or volume of stools
What is the most common type of diarrhoea seen in Australia?
Infectious. Acute and self-limiting, typically resolving within days. Usually viral.
What is a simple classification of the broad disorders of acute, infective diarrhoea?
Gastroenteritis = vomiting and diarrhoea
Enteritis = diarrhoea only
What kind of stool is associated with upper GIT disorders?
Copious, watery or fatty, pale yellow or green
What kind of stool/diarrhoeal symptoms are associated with disorders of colon?
Small, of variable consistency, brown, may contain blood or mucous
Experience of frequency and urgency, but passing only small amounts of faeces at a time
Chronic infective diarrhoea is most likely caused by what?
Protozoa - giardia, amoebiasis
rather than bacillary
C difficile infection associated with which drugs?
Clindamycin, cephalosporins
What are the 4 main types of diarrhoeal faeces?
Acute water diarrhoea
Bloody diarrhoea (acute or chronic)
Chronic watery diarrhoea
Steatorrhoea
What are the most common causes of acute diarrhoea in Australia?
Viral or bacterial gastroenteritis / enteritis
Common bacteria: salmonella, shigella, e.coli, staph aureas (food poisoning)
Dietary indescretions - e.g. binge eating
Antibiotic reactions - e.g. clostridium difficile infection after cephalosporins/clindamycin Abx treatment
Most common causes of chronic diarrhoea?
Irritable bowel syndrome
Drug reactions - e.g. laxatives, alcholism, Abx, thyroxine, etc.
Chronic infections - e.g. giardia lamblia (protozoan infections usually cause the chronic infective diarrhoeas)
What are the serious disorders, not to be missed, that can cause diarrhoea?
MALIGNANCY:
Colon cancer, peritoneal cancer, ovarian cancer
HIV infection
INFECTIONS:
Cholera, typhoid, amoebiasis, malaria, enterohaemorrhagic e.coli enteritis
INFLAMMATORY BOWEL DISEASES
UC
Crohn’s
Intussusception
Pelvic Appendicitis / Pelvic Abscess
Commonly missed diagnoses with patients presenting with diarrhoea
Coeliac disease (commonly associated w/ failure to thrive in children, but can present at any age) and other malabsorption states
Fecal impaction resulting in spurious diarrhoea
Lactase deficiency (lactose intolerance)
Giardia lamblia infection (protozoan, causes chronic diarrhoea)
Cryptosporidium infection (again, protoxzoan, causing chronic…)
What are red flags to look out for in patients presenting with diarrhoea, and why are they considered red flags?
Unexpected weight loss Persistent / unresolved diarrhoea Fever Overseas travel Severe abdo pain FHx of bowel cancer, Crohn Disease, etc.
Can indicate serious disorders not to be missed: malignancy, chronic protozoan infection, tropical disease, serious non-infective inflammations like abscesses (e.g. appendicitis), etc.
Drugs + other ingested agents that can cause ongoing diarrhoea?
Laxatives Thyroxine Osmotic agents like sorbitol and lactose found in chewing gum Abx Alcohol Vit C Magnesium-containing antacids NSAIDs Fucking heaps.
Persistent diarrhoea with insidious onset - consider what?
Colorectal cancer
