Overview of Diarrhea
Slides prepared by Dr. Ashok Moses
for Franco Indian Pharmaceuticals
Ltd.
Overview of Diarrhea
• Diarrhea is a common symptom that can
range in severity from an acute, self-limited
episode to a se...
Overview of Diarrhea
• Clinical features vary depending on the cause,
duration and severity of the diarrhea, and on
the pa...
Overview of Diarrhea
• Accurately defining and classifying diarrhea
provides the basis for appropriate approach
on the dia...
How Diarrhea develops
• Diarrhea may be defined as acute if the
episode is <2 weeks, persistent if 2–4 weeks,
and chronic ...
How Diarrhea develops
• Chronic diarrhea is seen in conditions such as
inflammatory bowel disease, celiac disease,
irritab...
Causes of Diarrhea
• Diarrhea results from an imbalance in the
absorption and secretion properties of the
intestinal tract...
Osmotic diarrhea
• Osmotic diarrhea occurs when ingested
solute, which is not fully absorbed, draws fluid
into the small i...
Secretory diarrhea
• Secretory diarrhea occurs when the intestine
secrete rather than absorb electrolytes and
water as tha...
Exudative diarrhea
• Exudative diarrhea observed in inflammatory
diseases when mucosal inflammation and
ulceration cause o...
Motility disorder
• Motility disorder caused by conditions such as
diabetic neuropathy.
Symptoms of Diarrhea
• Patients with diarrhea present with various
symptoms (clinical features) depending on the
underlyin...
Symptoms of diarrhea
• Diarrhea due to small intestinal disease is typically watery and
often associated with dehydration....
Diagnosis of Diarrhea
• Although most diarrheal episode is benign, a
thorough history and physical examination will
identi...
Management of Diarrhea
• The goals of treatment are
• To maintain hydration
• Treat the underlying causes and
• Relieve th...
Non pharmacologic approach
• Avoid high-fiber foods, fats, milk, caffeine and alcohol.
• A bland diet such as bananas, toa...
Pharmacologic approach
• The anti-motility agents such as loperamide are
generally not indicated. However, it may be
helpf...
Saccharomyces Boulardii (Lactiviest)
• Saccharomyces Boulardii is a unique, non –
pathogenic yeast that has many beneficia...
Saccharomyces Boulardii (Lactiviest)
• A common supplement regimen lasts 3 to 4
weeks or for up to two weeks after diarrhe...
Saccharomyces Boulardii (Lactiviest)
• As a transient yeast organism that passes through the
intestines after ingestion, S...
Saccharomyces Boulardii
• Animal studies have shown that S boulardii
actually plays a role in preventing the Candida
yeast...
Saccharomyces Boulardii
• Lactiviest’s S. Boulardii is free of lactose,
casein, gluten, corn, soy, egg, sugar and
maltodex...
Suggested use:
• S Boulardii is generally used for short term gastro
intestinal support. Daily doses ranging from at least...
How does Saccharomyces boulardii
work?
• S. boulardii benefits the gastrointestinal tract
in a variety of ways. S. boulard...
How does Saccharomyces boulardii
work?
• It reduces the ability of disease-causing micro-
organisms to adhere to and invad...
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Diarrhea and it treatment. lactiviest and its benefits (1)

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Diarrhea and it treatment. lactiviest and its benefits (1)

  1. 1. Overview of Diarrhea Slides prepared by Dr. Ashok Moses for Franco Indian Pharmaceuticals Ltd.
  2. 2. Overview of Diarrhea • Diarrhea is a common symptom that can range in severity from an acute, self-limited episode to a severe, life-threatening illness. A symptom of different diseases, diarrhea is characterized as an increase in the volume, consistency or frequency of fecal excretion compared to the patient’s normal stools.
  3. 3. Overview of Diarrhea • Clinical features vary depending on the cause, duration and severity of the diarrhea, and on the patient’s general health. • Diarrhea is potentially serious if it leads to dehydration or electrolyte imbalances, particularly in infants, children, elderly or other at risk groups.
  4. 4. Overview of Diarrhea • Accurately defining and classifying diarrhea provides the basis for appropriate approach on the diagnostic and therapeutic options. • In general, supportive treatment is usually sufficient. However, antibiotic or probiotic may be considered in selected patients.
  5. 5. How Diarrhea develops • Diarrhea may be defined as acute if the episode is <2 weeks, persistent if 2–4 weeks, and chronic if >4 weeks in duration. • Acute diarrhea with a sudden onset is often acquired by fecal-oral transmission via direct contact or through ingestion of food or water contaminated with fecal pathogens.
  6. 6. How Diarrhea develops • Chronic diarrhea is seen in conditions such as inflammatory bowel disease, celiac disease, irritable bowel syndrome and diabetic diarrhea or with certain medications.
  7. 7. Causes of Diarrhea • Diarrhea results from an imbalance in the absorption and secretion properties of the intestinal tract. • There are four types of diarrhea: • Osmotic diarrhea: • Secretory diarrhea: • Exudative diarrhea: • Motility disorder:
  8. 8. Osmotic diarrhea • Osmotic diarrhea occurs when ingested solute, which is not fully absorbed, draws fluid into the small intestine as seen in lactose intolerance.
  9. 9. Secretory diarrhea • Secretory diarrhea occurs when the intestine secrete rather than absorb electrolytes and water as that seen with bacterial toxins.
  10. 10. Exudative diarrhea • Exudative diarrhea observed in inflammatory diseases when mucosal inflammation and ulceration cause outpouring of plasma, mucus and blood into the stool.
  11. 11. Motility disorder • Motility disorder caused by conditions such as diabetic neuropathy.
  12. 12. Symptoms of Diarrhea • Patients with diarrhea present with various symptoms (clinical features) depending on the underlying cause.
  13. 13. Symptoms of diarrhea • Diarrhea due to small intestinal disease is typically watery and often associated with dehydration. • Diarrhea of the large intestine is associated with frequent small- volume stools, urgency and the presence of blood. • Patients with acute infectious diarrhea typically present with nausea, vomiting, abdominal pain and fever. • Parasites such as Giardia lamblia and Cryptosporidium spp. usually cause only mild abdominal discomfort associated with steatorrhea and bloating. Dehydration can occur if diarrhea is severe and when oral intake is limited due to nausea and vomiting. • Symptoms of dehydration Dehydration is manifested as increased thirst, decreased urinary output and orthostatic changes. In severe cases, it may lead to acute renal failure and mental status changes.
  14. 14. Diagnosis of Diarrhea • Although most diarrheal episode is benign, a thorough history and physical examination will identify those cases requiring early diagnostic evaluation or aggressive management. • The presence of comorbid diseases and associated symptoms increase the urgency for diagnostic workup and management. Abnormal vital signs, high fever, presence of moderate-to-severe dehydration or bloody diarrhea identify patients at higher risk who require early therapeutic intervention.
  15. 15. Management of Diarrhea • The goals of treatment are • To maintain hydration • Treat the underlying causes and • Relieve the symptoms of diarrhea • Rehydration and correction of any electrolyte imbalance is the core in the management of diarrhea. If diarrhea is secondary to another condition, treatment of the primary disorder is important.1 •
  16. 16. Non pharmacologic approach • Avoid high-fiber foods, fats, milk, caffeine and alcohol. • A bland diet such as bananas, toast, salted crackers, clear soups and boiled vegetables may be helpful. • Children who are not dehydrated should continue to be fed age-appropriate diets. • Oral rehydration therapy (ORT) is the preferred treatment for replacement of fluid and electrolyte losses in those with mild-to-moderate dehydration. • Intravenous fluid therapy is required for severe dehydration. •
  17. 17. Pharmacologic approach • The anti-motility agents such as loperamide are generally not indicated. However, it may be helpful in patients with mild-to-moderate secretory diarrhea. • Specific antibiotic treatment is not usually required, except for invasive or dysenteric diarrhea and in immunosuppressed patients. • Probiotic (Lactiviest) preparations may be effective in restoring normal bowel flora when diarrhea is due to the administration of antibiotics.
  18. 18. Saccharomyces Boulardii (Lactiviest) • Saccharomyces Boulardii is a unique, non – pathogenic yeast that has many beneficial actions in the intestinal tract. • S. boulardii has been utilized worldwide as a probiotic supplement to support gastrointestinal health. • It benefits the gastrointestinal tract by increasing intestinal populations of healthy bifido bacteria while decreasing numbers of disease-causing organisms.
  19. 19. Saccharomyces Boulardii (Lactiviest) • A common supplement regimen lasts 3 to 4 weeks or for up to two weeks after diarrhea has resolved. It can be taken with antibacterial antibiotics. It is compatible with probiotic supplements.
  20. 20. Saccharomyces Boulardii (Lactiviest) • As a transient yeast organism that passes through the intestines after ingestion, S boulardii does not attach to the mucosal cells lining the intestinal lumen, but exerts its beneficial effects on the host as it moves through the gastrointestinal tract. • S boulardii is completely unrelated to Candida albicans, C. tropicalas, C. kruise and other Candida species, that cause disease and overgrowth species decrease the acidity of the gastrointestinal mucosal membrane susceptible to invasion by disease-causing bacteria and yeast. • S boulardii exerts the opposite effect. It produces lactic and other acids know to inhibit disease causing Candida yeast species.
  21. 21. Saccharomyces Boulardii • Animal studies have shown that S boulardii actually plays a role in preventing the Candida yeast from reproducing in the gut. Lactiviest’s S boulardii is made with certified S Boulardii to ensure maximum potency, efficacy and safety. • Although S Boulardii is closely related to S cerevisiae, commonly known as bakers yeast or brewers yeast the two strains have different genetic make-up and enzyme profile.
  22. 22. Saccharomyces Boulardii • Lactiviest’s S. Boulardii is free of lactose, casein, gluten, corn, soy, egg, sugar and maltodextrin. It is safe for use in children and adults following a gluten-free or casein-free diet.
  23. 23. Suggested use: • S Boulardii is generally used for short term gastro intestinal support. Daily doses ranging from at least 2.5 billion CFU’s taken once to four times per day have be reported in medical literature. A common supplement regimen lasts 3 to 4 weeks or for up to two weeks after diarrhea has resolved. • S. boulardii should be taken at least one hour before and two hours after any antifungal agent. • S boulardii can be taken along with antibacterial antibiotics. It is compatible with other probiotic supplements.
  24. 24. How does Saccharomyces boulardii work? • S. boulardii benefits the gastrointestinal tract in a variety of ways. S. boulardii increases intestinal populations of healthy bifido bacteria while decreasing numbers of disease- causing organisms. • It inactivates bacterial toxins, inhibits toxin binding to intestinal receptors and lessens toxin-induced inflammation.
  25. 25. How does Saccharomyces boulardii work? • It reduces the ability of disease-causing micro- organisms to adhere to and invade intestinal cells. S. boulardii stimulates host immune defenses and intestinal enzymes that enhance nutrient digestion and absorption. • It produces acids that combat disease-causing micro-organisms, assist in mineral absorption and nourish the colon.

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