a)NPO improves→ Hypermotility, osmotic
b)NPO cannot improves→ Secretory, inflammatory
c)Fecal WBC/RBC(-)→ Secretory
d)Fecal WBC/RBC(+)→ Inflammatory
1.Osmotic
Mechanism- Absorption↓, non-absorbable material induces fluid secretion into intestine
Etiology- Magnesium oxide, Vitamin C, Mannitol, pancreas function↓, Lactulose, intestinal absorption↓, lactose intolerance, Bacteria↑
Lab- FOG>125
2.Secretory
Presentation- stool volume >1L/day
Etiology- Hyperthyroidism, Zollinger-Ellison syndrome, Villous adenoma, VIPoma, cholera, ETEC, C.difficile, rotavirus, congenital chloride diarrhea, colchicine, neuroblastoma
Lab- FOG<50
3.Inflammatory
Etiology- IBD, Yersinia, Campylobacter, Salmonella, Shigella, EHEC
Lab- CRP, ESR, fecal calprotectin
4. Hypermotility
Mechanism- Lack of absorption of the food due to increase movement of the bowel induces fluid secretion into intestine
Etiology- Salmonella, Campylobacter, C.difficile, IBD, celiac disease
*FOG=290-2(Na+K of stool)
1.Small bowel
Etilogy- Virus, E.coli, Klebsiella, perfringen, cholera, vibrio, giardia, cryptosporidium
Presentation- Watery, of large volume, abdominal cramping, bloating, and gas. Fever, occult blood/inflammatory cell rarely, PH<5.5
2.Large intestine
Etiology- Yersinia, shigella, salmonella, campylobacter, EHEC, difficile, entamoeba
Presentation- Frequent, regular, small volume, painful bowel movements. Fever and bloody or mucoid stools are common, and red blood cells and inflammatory cells,PH>5.5, serum WBC elevated
