Diarrhea

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

Published by Steve Johnson

I am a doctor who like to organise knowledges and share ideas with others. As a doctor, a lot of knowledges influx everyday and need some patient to organise and absorb. Here was my notes to share with you and hope to save your time to know it.

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