Diarrhea
Mervyn Dean, Juan-Diego Harris, Claud Regnard, Jo Hockley in Symptom Relief in Palliative Care, 2018
Diarrhea occurs in up to 10% of cancer patients, but up to 38% in acquired immune deficiency syndrome (AIDS). It is distressing for both patients and carers and causes dehydration, electrolyte disturbances and loss of comfort and dignity. A wide range of drugs can cause diarrhea and the drugs usually need to be stopped. Previous surgery can cause diarrhea through a number of mechanisms. Gastrectomy patients can sufer from food being 'dumped' into the bowel, causing nausea, bloating and diarrhea. Loperamide increases water absorption by slowing forward peristalsis. Caution is necessary with infective diarrhea since slowing peristalsis can cause overgrowth of dangerous pathogens and increased absorption of bacterial toxins. Octreotide has been used in AIDS-related diarrhea, cancer, in postgastrectomy dumping, and may also have a role to play in other causes of severe refractory diarrhea, although more evidence of eicacy is needed.
Diarrhoea
Wesley C. Finegan, Angela McGurk, Wilma O’Donnell, Jan Pederson, Elizabeth Rogerson in Care of the Cancer Patient, 2018
This chapter describes the medical condition of diarrhoea. Diarrhoea refers to the passage of more than three unformed stools in 24 hours. Spurious diarrhoea, due to faecal impaction, is mainly a profuse watery mucoid discharge. Steatorrhoea is characterised by offensive stools that are pale, fatty and difficult to flush away. It is worth noting that diarrhoea due to either Shigella or Clostridium difficile may be exacerbated by opioids. It is interesting to note that colestyramine, when used to treat pruritus resulting from obstructive jaundice, can actually cause diarrhoea. Opioid drugs are the mainstay of symptomatic management of diarrhoea. Most cases of infectious diarrhoea are viral and will resolve before the organism has been isolated. Bowel flora can be altered and diarrhoea will settle when the antibiotic course is completed, but it excludes Clostridium difficile.
Vomiting, diarrhoea and constipation
Hugh McGavock, Dennis Johnston in Treating Common Diseases, 2017
Vomiting and diarrhoea of acute onset, lasting 24—48 hours, without fever, are not diseases, but symptoms indicating that the body is expelling toxic or infected material from the intestine, and clearing the intestine of the substrate on which bacteria feed. 'Constipation' is one of the vaguest symptoms, and needs careful history-taking to explore what the patient is actually experiencing. Anti-emetics like prochlorperazine can give short-term relief of vomiting. It is one of several dopamine-receptor blockers that act on the chemoreceptor trigger zone of the brainstem, which is part of the vomiting control mechanism. A variety of chronic symptoms may present, including variable and varying abdominal pain, usually poorly localised, a sense of bloating, diarrhoea, constipation or a sense of incomplete defecation. A gastroenterologist might consider Irritable bowel syndrome as a diagnosis in the proven absence of structural, medical or neurological disease.
Collagenous colitis without diarrhoea at diagnosis – a follow up study
Published in Scandinavian Journal of Gastroenterology, 2019
Mari Thörn, Daniel Sjöberg, Tommy Holmström, Anders Rönnblom
Objective: Chronic watery diarrhoea is a classical symptom of collagenous colitis (CC). However, in some cases, the typical histologic findings of CC can be found in patients without this symptom. In this study we have performed a follow up on patients with a confirmed histological diagnosis of CC without the typical symptom watery diarrhoea. Patients and methods: A structured medical record follow-up was performed on the subgroup of patients without watery diarrhoea but diagnosed with the typical CC histologic appearance in a previous study of microscopic colitis. Results: At follow up after a median time of 8 years (range: 0.33–12 years), five of these fifteen patients developed bowel symptoms but only two developed characteristic CC symptoms with watery diarrhoea. Conclusion: The majority of patients without chronic watery diarrhoea at diagnosis remained free from this symptom during follow up and only in a few cases symptoms attributed to CC developed.
Multiorganism HIV-associated diarrhea and telescoping bowel
Published in Baylor University Medical Center Proceedings, 2020
Ahmed Noor, Davsheen Bedi, Mohamed H. Yassin
Diarrhea in individuals with human immunodeficiency virus (HIV) remains a diagnostic challenge. We treated a 53-year-old woman from Africa who presented with acute diarrhea, which yielded a diagnosis of HIV and severe immune deficiency. The patient’s diarrhea resulted in hypovolemic shock and acute abdominal pain. Evaluation revealed an intestinal intussusception. Pathology findings were consistent with Cryptosporidium, Entamoeba, Giardia, and cytomegalovirus infections. The actual prevalence of multiple microorganisms causing HIV-associated diarrhea is unknown. A nonmalignant-related adult intussusception in this context is exceedingly rare and of noteworthy significance.
Causes and management of diarrhoea in children in a clinical setting
Published in South African Journal of Clinical Nutrition, 2010
Diarrhoeal disease and its complications remain a major cause of morbidity and mortality in children, especially in developing countries. Diarrhoea is characterised by an increased frequency and volume, and decreased consistency of stool from the norm. Pathogens vary between developed and developing world settings. Rotavirus diarrhoea is the most important aetiological agent implicated in severe dehydrating diarrhoea. Although it is important to recognise the specific microbiological causation of diarrhoea in order to target appropriate treatment, the broader preventive aspects put forward by the World Health Organization (WHO) indicate the fundamental contributors to the massive burden of disease in developing countries. The management of a child presenting with acute diarrhoea must include a thorough history and examination with evaluation of hydration status, nutritional status and comprehensive clinical evaluation for any complications or associated illnesses. The most recent advances in the area of acute diarrhoeal disease include zinc supplementation, reduced osmolarity oral rehydration solution (ORS) and rotavirus vaccination.
Related Knowledge Centers
- Body Fluid
- Defecation
- Dehydration
- Gastroenteritis
- Feces
- Digestive Signs & Symptoms
- Oral Rehydration Therapy