This document discusses the pathophysiology, etiology, epidemiology, causative organisms, symptoms, diagnosis, and treatment of diarrhea. It states that the fundamental process causing diarrhea is incomplete absorption of water from the intestinal lumen. It categorizes diarrhea as either acute or chronic based on duration, and infectious or non-infectious based on cause. Common causes of acute diarrhea include viral infections while chronic diarrhea is often due to malabsorption, inflammatory bowel disease, or medications. Diagnosis depends on severity and symptoms, and treatment focuses on oral rehydration and addressing the underlying cause.

1. BY : CHARU KAIM
2nd year medial student

2. PATHOPHYSIOLOGY
The fundamental process causing all diarrheal diseases is
incomplete absorption of water from intestinal luminal
contents.
• Water itself is not actively transported across the intestinal mucosa
but moves across secondary to osmotic forces generated by the
transport of solutes, such as electrolytes and nutrients.
• Normally, absorption and secretion take place simultaneously, but
absorption is quantitatively greater.
Either a decrease in absorption or an increase in secretion
leads to additional water within the lumen and diarrhea
• Excess stool water then causes decreased stool consistency.

3. Flow Chart of Pathophysiology

4. ETIOLOGY
*Diarrhea is categorized into acute or chronic
and infectious or non-infectious based on the
duration and type of symptoms.
#Acute diarrhea is defined as an episode lasting less than 2 weeks.
An infection most commonly causes acute diarrhea.
-Most cases are the result of a viral infection, and the course is self-
limited.
#Chronic diarrhea is defined as a duration lasting longer than
4 weeks and tends to be non-infectious.
-Common causes include malabsorption, inflammatory
bowel disease, and medication side effects.

7. EPIDEMIOLOGY

10. CAUSABLE ORGANISMS OF DIARRHEA

11. PATHOGEN & INCUBATION PERIOD

12. SYMPTOMS
Projectile
Vomiting
Abdominal
cramps &
Bloating
Headache,
Fever & Achy
Joints
Dizziness &
Nausea
Loose or
Liquid Bowel
Movements

13. DIAGNOSIS
DIAGNOSISOFACUTE
DIARROHEA
In patients with mild, acute
diarrhea, no immediate
laboratory evaluation is needed
as the results often will become
available only after symptoms
have subsided.
Laboratory evaluation should
be restricted to patients with
severe diarrhea or when illness
is complicated by the presence
of dysentery or fever, or when
the duration of illness becomes
protracted.
Stool cultures are not routinely
indicated. They should be
performed in patients with
severe diarrhea and fever,
dysentery, fecal leukocytes or a
prolonged (greater than 14
days) diarrheal illness.
DIAGNOSISOF
CHRONICDIARROHEA
a) to assess the impact of chronic
diarrhea on the patient's overall
nutritional and electrolyte status,
and
b) to form a preliminary
judgment about the
characteristics of the diarrhea.
A complete blood count should
be obtained to look for evidence
of anemia or an abnormal white
blood cell count.
Biochemical screening should
include serum electrolytes, tests
of renal function (blood urea
nitrogen and creatinine) and a
basic nutritional assessment,
consisting of a lymphocyte count
and measurements of
serum calcium, phosphorus, total
protein and albumin levels.

14. STOOL TEST

15. TREATMENT
 ORAL REHYDRATION WITH ZINC
 Nitazoxanide, a newer anthelmintic, is effective against C parvum
 Aeromonas species: Use cefixime and most third-generation and fourth-generation
cephalosporins
 Campylobacter species:Erythromycin shortens illness duration and shedding
 Entamoeba histolytica: Metronidazole followed by iodoquinol or paromomycin is
administered in symptomatic patients.
 E coli: Trimethoprim-sulfamethoxazole (TMP-SMX) should be administered if
moderate or severe diarrhea i

16. REFERENCES
 http://www.worldgastroenterology.org/guidelines/global-guidelines/acute-
diarrhea/acute-diarrhea-english
 http://www.zen104556.zen.co.uk/Medicine/Pathology/Microbiology/Diarrhoea.html
 Diarrhea
 Valerie Nemeth; Nicholas Pfleghaar1.
 https://www.ncbi.nlm.nih.gov/books/NBK448082/
 Evaluating the Patient With Diarrhea: A Case-Based Approach
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538472/
 https://emedicine.medscape.com/article/928598-
treatment?pa=eT8Wqu6zXg1MqeTtyzimWAT1LoCLbrgh82evQGTQgIVsyV%
2BchIRn0Rs3rIBx7kYc2tgf%2BCCur4%2BoFHkvqNu5YRfnSE30kjrIlVY6fLg
rATI%3D
 Diarrhea Treatment & Management Author: Stefano Guandalini, MD; Chief Editor:
Carmen Cuffari, MD

17. Thank You !!