DIARRHEA

What is Diarrhea?
A condition in which feces are discharged from
the bowels frequently and in a liquid form.
When you have diarrhea, your bowel
movements (or stools) are loose and watery.
It’s very common and usually not serious.

Many people get diarrhea once or twice each

year. It normally lasts 2 to 3 days, and you can
treat it with over-the-counter medicines. Some
people get it more often as part of irritable
bowel syndrome (IBS) or other conditions.
 Definition
 διάρροια; literally meaning "through-flowing"
 Stool looses its normal consistence
 Weight usually increases: >235g/d (♂), >175g/d
(♀)
 Frequency increases: >2/d
 Often associated with imperative urge to
defecate
 Can contain blood, pus and mucous
 Symptoms
 Symptoms
 Bloating in your belly
 Cramps
 Thin or loose stools
 Watery stools
 An urgent feeling that you need to have a bowel movement
 Nausea and throwing up
 More serious symptoms include:
 Blood or mucus in your stool
 Weight
 Fever
 If you have watery stools more than three times a day and you're not
drinking enough fluids, you could become dehydrated. That can cause
serious complications if it's not treated.
 Causes
 Usually, diarrhea is caused by a virus that infects your gut. Some people call it "intestinal flu" or
"stomach flu.”
 Other causes include:
 Alcohol abuse
 Allergies or certain foods
 Diabetes
 Diseases of the intestines (such as Crohn's disease or ulcerative colitis)
 Eating foods that upset the digestive system
 Infection by bacteria (the cause of most types of food poisoning) or other organisms
 Laxative abuse
 Medications
 Overactive thyroid (hyperthyroidism)
 Radiation therapy
 Running (Some people get “runner’s diarrhea” for reasons that aren’t clear)
 Some cancers
 Surgery on your digestive system
 Trouble absorbing certain nutrients, also called “malabsorption”
 Diarrhea may also follow constipation, especially for people who have irritable bowel syndrome.
 When Should I Call My

Doctor?
Call your doctor immediately if you have:
 Blood in your diarrhea or black, tarry stools
 A fever that is high (above 101 F) or that lasts more than 24 hours
 Diarrhea lasting longer than 2 days
 Nausea or throwing up that prevents you from drinking liquids to replace lost fluids
 Severe pain in your abdomen or rectum
 Diarrhea after coming back from a foreign country
 Also, call your doctor right away if you have diarrhea and any of these signs of dehydration:
 Dark urine
 Smaller than usual amounts of urine or fewer wet diapers than usual in a child
 Rapid heart rate
 Headaches
 Dry skin
 Irritability
 Confusion
 Types of diarrhea
 Osmotic diarrhea: occurs when there is a loss of
water due to heavy osmotic load, e.g. due to
maldigestion or due to high uptake of sorbitol,
fructose etc.
 Secretory diarrhea: due to increased active
secretion and/or inhibition of absorption; little to
no structural damage; e.g. cholera-toxin
activates adenylatcyclase, higher cAMP-level,
decreased Na-absorption & increased Cl-
secretion, high osmotic gradient leads to water-
inflow
 Types of diarrhea
 Motility-related diarrhea: occurs due to abnormal
motility of GIT, if food moves to quickly there is
not enough contact-time for water & nutrients to
be absorbed; e.g. after vagotomy or diabetic
neuropathy
 Inflammatory diarrhea: damage of mucosal
lining or brush-border leads to a passive loss of
protein-rich fluids and decreased ability to
absorb these fluids; features of the other three
types can be found in this one; it can be caused
by bacterias, viruses, parasites and
autoinflammatory diseases
 Acute diarrhea
 Lasts less than 4 weeks; aka enteritis
 Usually caused by infections (>90%) or food poisoning
with bacterial toxins (Salmonella)
 Most of non-febrile diarrheas are caused by viruses (viral
gastroenteritis); most common reason for diarrhea in
children is Rotavirus (~40%)
 Febrile types (invasive pathogenes) are usually caused
by Campylobacter or Salmonella
 Severe types are cholera, typhus and intestinal
tuberculosis
 Cause for bloody diarrhea can be e.g. EHEC and
dysentery
 Chronic diarrhea
 Lasts longer than 4 weeks
 Reasons can be: stress, food intolerance
(e.g. lactose intolerance), disorders of
pancreas/liver/gallbladder, chronic
intestinal infections (Morbus Crohn, Colitis
ulcerosa), bowel cancer
 Complications
 Loss of water: dehydration (dizzyness,
unconsciousness)
 Loss of electrolytes: cramps
 In severe cases both can lead to death
 Worldwide 3mio children die due to
diarrhea (per year)
 Treatment
 In case of severe diarrhea suckling babies,
children, old people should always go to a
doctor
 Most important is sufficient uptake of
water and electrolytes (salt)
 Antidiarrhoetics are not always
recommendable, cause pathogenes stay in
the intestine
 In case of bacterial infection: antibiotics