Dharma Permana, PhD, Apt

In

diarrhea, the food and fluids you ingest pass too quickly or in too large an amount or both through your colon

Viruses. Common viruses that cause diarrhea are the Norwalk virus, cytomegalovirus, viral hepatitis and the herpes simplex virus. Rotavirus is the most common cause of acute childhood diarrhea. Viral diarrhea spreads easily. Bacteria and parasites. Contaminated food or water can transmit bacteria and parasites to your body. - Parasites such as Giardia lamblia and cryptosporidium can cause diarrhea. -Common bacterial causes of diarrhea include campylobacter, salmonella, shigella, vibrio cholerae and Escherichia coli. This type of diarrhea can be common for people traveling to developing countries.

Common causes of travelers diarrhea

Bacteria (70%)
E. coli Salmonella spp Campylobacter jejuni Shigella spp Vibrio cholerae and other spp

Parasites

Viruses

Giardia lamblia Noro-viruses Cryptosporidium parvum Rotavirus Entamoeba hystolitica Cyclospora cayetanensis

Other causes of diarrhea:

Lactose. A sugar found in milk and milk products, lactose is a common cause of diarrhea in some people. Medications. Diarrhea can also be a side effect of many medications, particularly antibiotics. Antibiotics destroy both good and bad bacteria, which can disturb the natural balance of bacteria in your intestines. This disturbance sometimes leads to an infection with bacteria called Clostridium difficile, which can also cause diarrhea. Artificial sweeteners. Sorbitol and mannitol, artificial sweeteners found in chewing gum and other sugar-free products, can cause diarrhea in some otherwise healthy people. Surgery. Some people may experience diarrhea after undergoing abdominal surgery or gallbladder removal surgery. Other digestive disorders. Chronic diarrhea has a number of other causes, such as Crohn's disease, ulcerative colitis, celiac disease and irritable bowel syndrome.

 Oralit
Adsorben

dan Pembentuk masa Anti Spasmodik/ anticholinergic Anti Motilitas Anti Microbabakteri, amuba

Pertolongan pertama pada diare Komposisi oralit

WHO: NaCl 3,5 g; KCl 1,5 g; Na-bikarbonat 2,5 g dan glukosa 20 g dalam 1 liter air masak. Emergency: garam dapur (NaCl) 2 g, dengan gula putih 20 g dalam 1 liter air masak. Campuran air teh dengan susu sapi (1:1). Oralit tidak menghentikan diare, tetapi mengantikan cairan tubuh yg hilang bersama tinja Tiap kali BAB diberi Oralit Dehidrasi ringan/ sedang < 1th min 300 ml, 1-4 th min 600ml 5-12 th min 1,2 L dan Dewasa 2,4 L

 Adsorben

Norit tdk diserap usus, eksresi melalui tinja -menyerap toksin Pembentuk Masa Tinja -Kaolin -Attapulgit tdk diserap usus, eksresi melalui tinja

 Menghambat

peristaltik usus dan lambung Penghambatan thd asetilkolin eksogen ( ester kolin) - Bekerja pada reseptor muskarinik anti muskarinik -Mudah diserap, eksresi melalui ginjal (sebagian dlm bentuk asal ) -Efek sampingmulut kering, dilatasi pupil dan rasa haus

 Atropin0,25mg

dan 0,5 mg Inj dan tab Ekstrak belladon10 mg/tab Hyosin n-butil bromida 10 mg/tab dan 20mg/tab Papaverin HCl 40 mg/tab

 Memperlambat

motilitas saluran cerna dgn mempengaruhi otot sirkuler dan longitudinal usus decreases colonic mass movements and suppresses the gastrocolic reflex Berkaitan dgn reseptor opioid u reseptor Kontraksi sal cerna berkurang

1.Loperamid (Imodium) Tidak diserap baik secara oral ekresi ( tinja) Loperamide is a synthetic anti-diarrheal indicated for the control and symptomatic relief of acute nonspecific diarrhea and of chronic diarrhea associated with inflammatory bowel disease. Sediaan tab 2mg & sirup 1 mg/5 ml Tdk dianjurkan utk anak2 Side effects: constipation; difficulty breathing , dizziness , drowsiness
2.Codein Phospat Tdk dianjurkan utk anak2 3.Morfin