Presentation on theme: "Diarrhea is a condition that involves the frequent passing of loose or watery stools. It comes from the Greek word diarrhoia. Dia means "flow" and rrhoia."— Presentation transcript:
Diarrhea is a condition that involves the frequent passing of loose or watery stools. It comes from the Greek word diarrhoia. Dia means "flow" and rrhoia means "through". The term "flowing through" was coined by Hippocrates.
- is defined as three or more unformed stools in 24 hours passed by a traveler, commonly accompanied by abdominal cramps, nausea, and bloating. - most common illness affecting travelers. An estimated 10 million people develop it annually. -ESCHERICHIA COLI is the most commonly isolated pathogen. Most cases are self- limited; treatment is not routinely prescribed nor the pathogen identified unless symptoms become severe or persistent.
Absorption of water in the intestines is dependent on adequate absorption of solutes. If excessive amounts of solutes are retained in the intestinal lumen, water will not be absorbed and diarrhea will result from one of two situations:
INGESTION OF A POORLY ABSORBED SUBSTRATE: The offending molecule is usually a carbohydrate or divalent ion. Common examples include mannitol or sorbitol, epson salt (MgSO4) and some antacids (MgOH2). MALABSORPTION: Inability to absorb certain carbohydrates is the most common deficit in this category of diarrhea, but it can result virtually any type of malabsorption.
Diarrhea occurs when secretion of water into the intestinal lumen exceeds absorption. Large volumes of water are normally secreted into the small intestinal lumen, but a large majority of this water is efficiently absorbed before reaching the large intestine. VIBRIO CHOLERAE, produces cholera toxin, which strongly activates adenylyl cyclase, causing a prolonged increase in intracellular concentration
some laxatives hormones secreted by certain types of tumors (e.g. vasoactive intestinal peptide) a broad range of drugs (e.g. some types of asthma medications, antidepressant s, cardiac drugs) certain metals, organic toxins, and plant products (e.g. arsenic, insecticides, mushroom toxins, caffeine)
It is the disruption of the epithelium of the intestine due to microbial or viral pathogens that is a very common cause of diarrhea in all species. It results not only in exudation of serum and blood into the lumen but with widespread destruction of absorptive epithelium. Absorption of water occurs very inefficiently and diarrhea results.
Bacteria: Salmonella, E. coli, Campylobacter Viruses: rotaviruses, coronaviruses, parvoviruses (canine and feline), norovirus Protozoa: coccidia species, Cryptosporium, Giardia
Alterations in intestinal motility (usually increased propulsion) are observed. the intestinal contents must be adequately exposed to the mucosal epithelium and retained long enough to allow absorption.
TRANSMISSION - occurs when food or drinking water contaminated by fecal/vomit diarrhea. Direct transmission can also occur when contaminated hands used to buy food.
Diarrhea is manifested by the passage of fluid stools due to the effects of toxic matter and other infectious substances that have been ingested into the digestive system. NORMALLY, a person's stools are as a result of food particles that are retained as excretion after initial assimilation of nutrients on their passage to the colon.
STOMACHACHE is intermittent depending on the seriousness of the disease. ONE ALSO FEELS THE URGE TO VISIT THE TOILET after short intervals.
experiences NAUSEOUS FEELING which leads to their throwing out frequently to remove what they have eaten.
Some cause severe diarrhea mostly in children, while some affect all age groups equally.
The medical staff must determine a reasonable approach to the evaluation of diarrheal stools since the cost to rule out all potential pathogens is prohibitive and control of the use of laboratory services is now a major focus in all institutions. All stool cultures should be examined for Campylobacter, Salmonella, and Shigella
If a child has bloody diarrhea, a search for E coli is indicated. For patients with a history of raw seafood ingestion or foreign travel, the laboratory should be asked to screen specimens for Vibrio and Plesiomonas species. The report from the laboratory should specifically state what enteropathogens have been excluded, for example, "No Salmonella, Shigella, or Campylobacter isolated."
Clinicians are encouraged to discuss these issues with the pathologist or microbiologist and be familiar with community microbiology practice, particularly which organisms require a special request for the laboratory to attempt identification.
PREVENT OR TREAT DEHYDRATION Give a child or adult plenty of clear fluid Avoid milk or milk-based products, alcohol, apple juice, and caffeine Give an infant frequent sips of water If they are unable to keep up with their losses, call a doctor.