Diarrhea is a condition that involves the frequent passing of loose or watery stools. It comes from the Greekword 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 isolatedpathogen. Most cases are self-limited; treatment is notroutinely prescribed nor the pathogen identified unless symptoms become severe or persistent.
Absorption of water in the intestines is dependent on adequate absorption ofsolutes. If excessive amountsof solutes are retained in the intestinal lumen, water will not be absorbed anddiarrhea 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 ofdiarrhea, but it can result virtually any type of malabsorption.
Diarrhea occurs when secretionof water into the intestinallumen 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
hormones secreted by certain certain metals, organic types of tumors (e.g. vasoactive a broad range toxins, and plant products (e.g. some intestinal peptide) of drugs (e.g. arsenic, insecticides, mushroom toxins, caffeine)laxatives some types of asthma medications, antidepressant s, cardiac drugs)
It is the disruption of the epithelium It results not only of the intestine in exudation of due to serum and blood microbial or into the lumen viral pathogens but with that is a veryAbsorption of widespread common causewater occurs destruction of of diarrhea invery absorptive all species. epithelium.inefficientlyand diarrhearesults.
Alterations in intestinal motility (usually increased propulsion) are observed. the intestinal contents must be adequatelyexposed to the mucosalepithelium and retained long enough to allow absorption.
TRANSMISSION - occurs when food ordrinking 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, apersons stools are as a result of food particles that are retained as excretion afterinitial assimilation of nutrients on their passage to the colon.
STOMACHACHE is ONE ALSO FEELS THEintermittent depending URGE TO VISIT THE on the seriousness of TOILET after short the disease. intervals.
experiences NAUSEOUS FEELING which leads to their throwing out frequently to remove what they have eaten.
Some cause severediarrhea mostly in children, while some affect all age groups equally.
The medical staff mustdetermine a reasonable approach to the evaluation of diarrhealstools since the cost to rule out all potential pathogens is prohibitive and control of theuse of laboratory services is now a major focus in all institutions.All stool cultures should be examined forCampylobacter, Salmonella, and Shigella
For patients with a history of raw seafood ingestion or If a child hasforeign travel, the laboratory bloody should be asked to screen specimens for Vibrio and diarrhea, a Plesiomonas species. The search for E coli report from the laboratoryshould specifically state what is indicated. 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 befamiliar with community microbiology practice, particularly which organisms require a special request for the laboratory to attempt identification.
PREVENT OR TREATDEHYDRATIONGive a child or adult plenty of clearfluidAvoid milk or milk-based products,alcohol, apple juice, and caffeineGive an infant frequent sips of waterIf they are unable to keep up withtheir losses, call a doctor.