Chronic diarrhoea

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23.2
Averil Tam
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Averil Tam
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Frage Antworten
1. What is the difference between osmotic and secretory diarrhoea? Osmotic diarrhoea (typified by rotavirus) results from malabsorption of sugars in the small intestines with resultant increase in osmolality in the lumen of the small intestine and the flow of water into the lumen. Stopping fluid intake decreases the diarrhoea. Secretory diarrhoea (such as cholera) results from the secretion of electrolytes (eg. chloride ions in cholera) into the lumen of the small intestine and the resultant flow of salt and water into the lumen of the small intestine. Ongoing diarrhoea occurs despite cessation of oral intake.
2. List some causes of osmotic diarrhoea. Rotavirus, genetic causes (eg. lactase deficiency), short gut syndrome, bacterial overgrowth, immune deficiency and severe allergies.
3. List some causes of secretory diarrhoea. Gastroenteritis secondary to infection with certain organisms such as Escherichia coli, Shigella and Vibrio Cholerae. Conditions other than gastroenteritis such as fat malabsorption, laxative abuse, catecholamine producing tumors, congenital chloride diarrhoea, and congenital villus atrophy.
4. TRUE/FALSE? A. Abdominal pain with defecation is common in Crohn disease. False. Abdominal pain is more frequently seen in Crohn disease, however abdominal pain with defecation is characteristic of ulcerative colitis.
4. TRUE/FALSE? B. Lactose intolerance is a common cause of diarrhoea in children. False. Lactose intolerance is a rare cause of diarrhoea in children.
4. TRUE/FALSE? C. Opiates are contraindicated in children with inflammatory bowel disease. True. Opiates are contraindicated in children with inflammatory bowel disease because of increased risk of toxic megacolon which is a life threatening condition. Never administer opioids to these children for management of pain.
4. TRUE/FALSE? D. Stool microscopy is helpful in the diagnosis of fat malabsorption. True. Fatty acid crystals and fat globules may be seen on stool microscopy in cases of fat malabsorption. This is a simple, inexpensive and non-invasive diagnostic test!
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