Diarrhoea

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Gastroenterology Flashcards on Diarrhoea, created by Jenna Paterson on 19/10/2020.
Jenna Paterson
Flashcards by Jenna Paterson, updated more than 1 year ago
Jenna Paterson
Created by Jenna Paterson about 4 years ago
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Question Answer
What is steatorrhea, its pathophysiology and potential causes? - Pale, fatty stools which are difficult to flush - Caused by malabsorption of fat in the small intestine --> greater - Seen in: ○ Pancreatic insufficiency ○ Coeliac disease ○ Infection such as giardiasis
Several symptoms can be associated with diarrhoea. What conditions often have associated N&V? Infection, small bowel CD, small intestine bacterial overgrowth (SIBO), diabetes (causing autonomic dysfunction)
Several symptoms can be associated with diarrhoea. What conditions often have associated abdominal pain? Infection, coeliac disease, IBD, malignancy, diverticulitis (sharp, constant and in LIF)
Several symptoms can be associated with diarrhoea. What conditions often have associated abdominal distension/bloating? IBS, SIBO
Several symptoms can be associated with diarrhoea. What conditions often have associated weight loss? Malignancy, coeliac, chronic pancreatitis, IBD, ischaemia
Why might you see blood in the stools? Invasive pathogens IBD Malignancy Ischaemia Haemorrhoids/piles
Why might you see mucus/pus in the stools? Seen when colon becomes inflammed or infected
What systemic diseases can cause diarrhoea and why? Hyperthyroidism Adrenal disease Diabetes Systemic sclerosis Various mechanisms including bacterial overload, autonomic dysfunction and contaminant drug use.
What surgeries may predispose someone to diarrhoea and why? Vagotomy: upper GI surgery done to reduce rate of gastric secretions (cutting one or more branches of the vagus nerve) --> 'dumping syndrome' - rapid gastric emptying of liquids and diarrhoea Cholecystectomy, ileal resection --> bile acid malabsorption, which stimulates secretion of fluid and colonic motility Abdominal surgery --> SIBO due to post-op adhesions, blind loop syndrome (food doesn't follow normal digestion route and bypasses a section of intestine due to bacterial overgrowth) Small bowel resection --> short bowel syndrome, as resulting length is not long enough to preserve fluid and electrolyte homeostasis.
What drugs are important to consider in a diarrhoea history? Antibiotics esp. macrolides including erythromycin, and recent therapy - risk of C diff infection with cephalosporins, clindamycin, fluoroquinolones NSAIDs, Mg-containing products, Hypoglycaemic agents e.g. metformin, gliptins, anti-neoplastic agents
Is smoking a risk factor for UC or Crohn's Crohn's - 2x risk
What is the definition of diarrhoea? "The abnormal passage of ≥3 loose stools per day and/or increased stool frequency from what is normal for the individual lasting <14 days and/or stool weight >200g/day."
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