DIARRHEA

What is DIARRHEA?
Diarrhea is a condition
that involves the
frequent passing of
loose or watery stools.

It comes from the Greek

word diarrhoia. Dia means
"flow" and rrhoia means
"through". The term
"flowing through" was
coined by Hippocrates.
MOST CAUSATIVE
AGENT
E.COLI causing
TRAVELLER'S
DIARRHEA  
- 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 isolated
pathogen. Most cases are self-limited; treatment is not
routinely prescribed nor the pathogen identified unless
symptoms become severe or persistent.
 Pathophysiology:
OSMOTIC DIARRHEA
Absorption of water in the
intestines is dependent on
adequate absorption of
solutes. If excessive
amounts of solutes are
retained in the intestinal
lumen, water will not be
absorbed and diarrhea 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 of
diarrhea, but it can result virtually any
type of malabsorption.
SECRETORY DIARRHEA
Diarrhea occurs when secretion of
water into the intestinal lumen 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
 Agents inducing
SECRETORY DIARRHEA

hormones a broad range certain metals,

some secreted by of drugs (e.g. organic toxins,
certain types of and plant
laxatives tumors
some types of
asthma products (e.g.
(e.g. vasoactive medications, arsenic,
intestinal antidepressant insecticides,
peptide) s, cardiac mushroom
toxins, caffeine)
drugs)
 INFLAMMATORY &
INFECTIOUS DIARRHEA
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 very
Absorption of widespread common cause
water occurs destruction of of diarrhea in
absorptive all species.
very epithelium.
inefficiently
and diarrhea
results.
PATHOGENS ASSOCIATED
W/ INFECTIOUS DIARRHEA
Bacteria: Salmonella, E. coli,
Campylobacter

Viruses: rotaviruses, coronaviruses,

parvoviruses (canine and feline),
norovirus

Protozoa: coccidia
species, Cryptosporium, Giardia
DIARRHEA W/ DERANGED
MOTILITY
Alterations in
intestinal motility
(usually increased
propulsion) are
observed.

the intestinal contents

must be adequately
exposed to the mucosal
epithelium and retained
long enough to allow
absorption.
EPIDEMIOLOGY
FACTORS 

Emotional Bacterial
distress infection

Food/lactose Viral flu

intolerance (gastroenteritis)
EPIDEMIOLOGY
TRANSMISSION
- occurs when food or
drinking water contaminated
by fecal/vomit diarrhea.
Direct transmission can also
occur when contaminated
hands used to buy food.
MANIFESTATIONS
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, a
person's stools are as a result
of food particles that are
retained as excretion after
initial assimilation of nutrients
on their passage to the colon.
MANIFESTATIONS

STOMACHACHE is
ONE ALSO FEELS THE
intermittent
URGE TO VISIT THE
depending on the TOILET after short
seriousness of the intervals.
disease.
experiences NAUSEOUS FEELING which leads
to their throwing out frequently to remove
what they have eaten.
 AGE GROUP

Some cause severe

diarrhea mostly in
children, while some
affect all age groups
equally.
 LAB DIAGNOSIS
The medical staff must
determine a reasonable approach
to the evaluation of diarrheal
stools since the cost to rule out
all potential pathogens is
prohibitive and control of the
use of laboratory services is now
a major focus in all institutions.

All stool cultures should be examined for

Campylobacter, Salmonella, and Shigella
LAB DIAGNOSIS

For patients with a history of If a child has

raw seafood ingestion or
foreign 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 laboratory
should specifically state what is indicated.
enteropathogens have been
excluded, for example, "No
Salmonella, Shigella, or
Campylobacter isolated."
LAB DIAGNOSIS
Clinicians are
encouraged to discuss
these issues with the
pathologist or
microbiologist and be
familiar with community
microbiology practice,
particularly which
organisms require a
special request for the
laboratory to attempt
identification.
 TREATMENT
PREVENT OR TREAT
DEHYDRATION

Give a child or adult plenty of clear

fluid

Avoid milk or milk-based products,

alcohol, apple juice, and caffeine

Give an infant frequent sips of

water

If they are unable to keep up with

their losses, call a doctor.
 TREATMENT
2. REST
“Always laugh when you can, it is the
cheap medicine.” 

― George Gordon Byron

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