Diarrhoea
Passage of abnormally liquid or unformed stools at an increased frequency.
90% acute diarrhoea are caused by infectious agents.
90% acute diarrhoea are caused by infectious agents.
Causes
|
1. Acute: inf, drug
2. Chronic: IBD, coeliac, malignancy |
Pathogenesis
|
Inc stool water (due malabsorption)
|
Clinical features
|
1. Diarrhoea
2. Fever? 3. Dehydration? |
Investigations
|
Bloods
1. FBC (Fe def, MCV inc in coeliac, IBD) 2. UEC (K+) 3. ESR (Cancer, IBD) 4. CRP (IBD, inf) Others 1. Stool 2. Colonoscopy is Ca indicated |
Management
|
1. Treat causes
2. Oral rehydration 3. Coedine phosphate/ loperamide *Avoid abx except in systemic illness* |
Complications
|
Red flags:
1. Blood (may be CAmpylobacter, Shigella, Salmonella, E coli, amoebiasis, IBD, Ca) 2. Mucus (IBS, Ca, polyps) 3. Pus (IBD, diverticulitis) |
References
1. Dennis L. Kasper, 2004. Harrison's Principles of Internal Medicine 16th Edition. 16 Edition.
2. McGraw-Hill Professional.2. Murray Longmore, 2010. Oxford Handbook of Clinical Medicine (Oxford Handbooks Series). 8 Edition. Oxford University Press, USA.
1. Dennis L. Kasper, 2004. Harrison's Principles of Internal Medicine 16th Edition. 16 Edition.
2. McGraw-Hill Professional.2. Murray Longmore, 2010. Oxford Handbook of Clinical Medicine (Oxford Handbooks Series). 8 Edition. Oxford University Press, USA.