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Gastrointestinal Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Gareth Davies, Chris Black, Keeley Fairbrass
Diarrhoea is defined as passage of three or more loose stools a day, or more frequent and looser stool than usual. Acute diarrhoea is usually infective and self-limiting; cultures may be negative and are not routinely required. Any drug recently started must be suspect. A small percentage of patients will develop post-infective IBS.Chronic diarrhoea is defined as over 4 weeks of three or more stools a day with stool weight >200 g. People who pass frequent small hard pellets do not have diarrhoea.Osmotic diarrhoea is when the increased fluid is retained, caused by unabsorbed osmotically active molecules (e.g. lactose in lactase deficiency).
Diarrhea (Chronic)
Published in Charles Theisler, Adjuvant Medical Care, 2023
Diet: Avoidance of excess intake of alcohol or caffeinated beverages. Sugars such as sorbitol (candies, chewing gum, and other sugar-free items), mannitol, fructose (fruit and honey) should be reduced or eliminated. Avoiding fatty foods and dairy products can also help relieve diarrhea.2,3
Symptom Control in Hospice-State of the Art
Published in Inge B. Corless, Zelda Foster, The Hospice Heritage: Celebrating Our Future, 2020
J. Cameron Muir, Lisa M. Krammer, Jacqueline R. Cameron, Charles F. von Gunten
Beyond reversing the underlying etiology, the general treatment of diarrhea includes supportive measures such as replenishing fluid if dehydration is suspected (oral route preferred) and initiating a diet of clear liquids and simple carbohydrates. Persistent diarrhea may require antidiarrheal agents. These agents are classified as absorbent, adsorbent, mucosal prostaglandin inhibitors and opioids. Absorbent agents (methyl cellulose) absorb water to form a colloidal mass. Adsorbent antidiarrheal medications (attapulgite) non-specifically adsorb dissolved substances such as bacteria, toxins, and water. These two categories are only modestly effective for patients with continuous large-volume diarrhea. Mucosal prostaglandin inhibitors (bismuth sub-salicylate) reduce water and electrolyte secretion from the intestinal wall. Opioid agents (e.g., loperamide) decrease peristalsis in the colon by way of specific intestinal receptors. The addition of anticholinergic agents (such as atropine) with an opiate (diphenoxylate) may provide additional benefit, but may also cause cramping. Additionally, secretory diarrhea (such as from chemotherapy or HIV) has been successfully treated with octreotide.39,40 Future research into broader applications of octeotride as well as such novel agents as peptide YY (also thought to reduce intestinal fluid secretion) is needed.
Wide-spectrum antibiotic prophylaxis guarantees optimal outcomes in drowned donor kidney transplantation
Published in Expert Review of Anti-infective Therapy, 2023
Xiaoli Lin, Xinyu Liu, Xiaoying Wu, Xishao Xie, Guangjun Liu, Jianyong Wu, Wenhan Peng, Rending Wang, Jianghua Chen, Hongfeng Huang
Contaminated water included water containing sewage or manure, with a clear source of pollution or with defined pathogen colonization [16]. Delayed graft function (DGF) was defined as requiring dialysis within the first week after transplantation. Recovery time from DGF was the date of the last dialysis. Loose, watery stools three or more times a day were defined as diarrhea. Diagnoses of rejection were proven by biopsy. Recurrent urinary tract infection (UTI) was defined as new episodes of uncomplicated/complicated UTI more than twice within 6 months or more than three times within 1 year [17]. Graft failure referred to kidney function loss requiring renal replacement therapy or death with a functioning graft. Postoperative complications were graded according to the Clavien–Dindo system [18].
Cryptosporidiosis in Finland is predominantly of domestic origin: investigation of increased reporting, 1995–2020
Published in Infectious Diseases, 2023
Kristiina A. Suominen, Marit Björkstrand, Jukka Ollgren, Tiina J. Autio, Ruska Rimhanen-Finne
The route of infection is faecal-oral, and the oocysts shed in faeces remain viable in the environment for several months, especially in water [1,5]. The infective dose is as low as 10 oocysts [6]. Humans are usually infected through direct contact with an infected human or animal or through water or food contaminated by oocysts [7]. Farm animal contact or consumption of food or water contaminated by their faeces is linked to C. parvum infections, while C. hominis transmits between people, or via food or water contaminated with wastewater or human waste [7]. In Europe, cryptosporidiosis is mainly linked to recreational waters and contact with animals [8]. Cryptosporidium is considered an important cause of food- and waterborne outbreaks, and it has caused several large waterborne outbreaks worldwide [2]. In Finland, C. parvum caused a foodborne outbreak with over 250 cases in 2012 [9]. The incubation period for cryptosporidiosis is usually between 1 and 2 weeks [1]. The most common symptoms include watery diarrhoea, nausea, vomiting and abdominal pain [7]. In healthy individuals, the symptoms normally cease without treatment in 1–2 weeks; however, a life-threatening disease may develop in immunocompromised patients [7].
Intestinal accumulation of microbiota-produced succinate caused by loss of microRNAs leads to diarrhea in weanling piglets
Published in Gut Microbes, 2022
Xihong Zhou, Yonghui Liu, Xia Xiong, Jingqing Chen, Wenjie Tang, Liuqin He, Zhigang Zhang, Yulong Yin, Fengna Li
Diarrheal diseases are a global health problem in humans and livestock. Although the mechanisms of diarrhea has been studied for decades, diarrhea still causes substantial mortality and morbidity in humans. This is because the causes of diarrhea are complex, including infection with bacteria and viruses, adverse effects of drugs, alternations of diet composition, and intestinal inflammatory and autoimmune conditions.1 Meanwhile, the diarrhea incidence was significantly increased after antibiotic use was gradually banned worldwide in animal husbandry. Diarrhea can be classified as acute or chronic diarrhea based on the duration, and classified as watery or fatty or inflammatory diarrhea based on the characteristics of the stools. Secretory diarrheas, occurred acutely and caused by reduced absorption or increased secretion of water from the digestive tract, are one of the most important subtypes of diarrhea, particularly in children.1 As pigs have metabolic and genetic features similar to those of humans, they are emerging as an attractive and accurate biomedical model for the study of diseases.2,3 Notably, post-weaning piglets with high incidence of secretory diarrhea could be an appropriate model for studying the mechanisms involved in diarrhea, since infant weaning is one of the major causes of diarrhea in children.4,5