Diarrhoea

2.  Defined as passage of abnormally liquid or
unformed stools more than 3 times in a day.
OR
Stool weight >200g/d

3.  Time :Acute/ Sub acute /Chronic
 Volume: Large v/s Small
 Pathophysiology: Secretory v/s Osmotic
 Stool character: Watery v/s Fatty v/s
Inflammatory

4. APPROACH

5.  Stool microscopy for
Gram positive(Enterococcus, Staphylococcus,
bacillus)
Gram negative(Ecoli, Klebsiella,pseudomonas)
 Stool for ova and cyst (hookworm,roundworm
,nematodes)
 Stool culture and blood culture for Ecoli
(EHEC), Vibrio, Yersinia

6. 1. Not resolving with anti diarrheal medication
2. Bloody diarrhea
3. Non bloody diarrhea in daycare worker, food
handler, health care worker
4. Infective diarrhea
5. Immunocompromised state
6. Persistent diarrhea

7. CLASSIFICATION
1. Secretary diarrhea
2. Osmotic diarrhea
3. Inflammatory diarrhea
4. Motility related diarrhea

8.  Laxative abuse (Stimulant laxatives)
 Bacterial toxins
 Diverticulitis
 Inflammatory bowel disease
 Hyperthyroidism
 Neoplasm (colon,lymphoma)
 Neuroendocrine tumors
 VIPoma
 Somatistatinoma
 Gastrinoma

10.  Osmotic laxatives (Mg, PO4, SO4)ingestion.
 Carbohydrate malabsorption

12.  Inflammatory bowel disease
 Diverticulitis
 Ischemic colitis
 Radiation colitis
 Infections:TB /Herpes/ CMV

14. FATTY DIARRHEA
 Fatty malabsorption may lead to greasy foul
smelling, difficult to flush stool
Causes: pancreatic exocrine deficiency
cystic fibrosis
alcoholic pancreatitis,
pancreatic duct obstruction)

17. THANK YOU