DIARRA

DEFINITION
• bulky stools liquid consistency AND TOGETHER WITH AN INCREASED NUMBER OF DEPOS
ITION • No DEFINING NORMAL OBJECTIVE Deposition • MAS BY THE VOLUME OF WATER +15
0 ml / day
CLASSIFICATION
• On time: Acute Chronic • According to the Clinic • According to the Pathogenes
is: 5. Osmotic Diarrhea 6. Secretory Diarrhea 7. Motor Diarrhea
Osmotic Diarrhea
• fecal volume is less than 1000 ml / day • Cede with fasting • osmotic gap more
than 100 mmol / L causes poor digestion of ingested food intake solutes: laxati
ves Mg, SO4, PO4
Secretory Diarrhea
• • • • fecal volume increased to 1000 ml / day with fasting gave no tendency to
hyponatremia and acidosis osmotic gap less than 50 mmol / L causes bacterial po
isoning Drugs: caffeine, diuretics, laxatives
Endocrine Sind.Carcinoide, Z-E, VIPoma., Sind. MalaAb.
Motor Diarrhea
• • Minor shortened intestinal transit time of contact between the mucosa and in
testinal content • Increased neuronal activity that inhibits the absorption of w
ater. Causes
Hyperthyroidism, cholinergic drugs, S. Carcinoid, Irritable Bowel Sind. Blind lo
op, scleroderma, diabetic enteropathy
Acute diarrhea
• They are episodic, self-limiting and rarely lasts more than 3-7 days. • In suc
h premium treatment and etiologic diagnosis of chronic. • In practice is not eti
ological research, heals before having the result. • Role fundamental health mea
sures • The cause infectious causes death to 10 million a year, 60% are children
FORMS
FOOD TOXOINFECCION
WITH VIRAL BACTERIAL PROLIFERATION
Traveler's Diarrhea
RELATED TO THE USE OF ANTIBIOTICS
INVASIVE MECHANISM
NO INVASIVE MECHANISM
TOXOINFECCIOSA DIARRHEA
• For preformed bacterial toxins on the outside • Top explosive, vomiting, fever
of 2-3 days • outbreaks • In Staphylococcus aureus, Bacillus Cereus.
INVASIVE MECHANISM BY BACTERIAL PROLIFERATION
• Located in the colon, destroyed mucosa with ulcerations and produces a reactio
n inflamtoria. • Fever, diarrhea, rectal tenesmus, blood or a lot of mucus • Sal
monella and Shigella
MECHANISM FOR NON INVASIVE BACTERIAL PROLIFERATION
• Union to the mucosa of the small intestine. • Stimulation of adenylyl cyclase
and guanidilciclasa • Low fever, without bearing down, no blood, mucus, pus, or
fecal leukocytes • V. Angry, E. Coli, C. Difficile
VIRAL
• cause damage in the small intestine villi • Rotavirus, enteric adenovirus
Traveler's Diarrhea
• • • • • Mild and transient secretory rate is 50% E. Coli using a plasmid two t
hermolabile and thermostable toxins diarrhea, vomiting, fever and dehydration
RELATED TO THE USE OF ANTIBIOTICS
• • • • 30% have diarrhea. Of these 30% is C. Difficile Refers to stop the antib
iotic, 60% of colitis is Pseudomenbranosa C. Difficile. • We must look for toxin
s
Diarrhea syndrome
Mucus in stool consistency Leukocyte Volume Diarrhea Fever Abdominal Pain Rare A
bsent Present Present Absent Normal Aqueous fluid, increasing, poor if not non-i
nflammatory Important
toxigenic
inflammatory
invasive
TREATMENT
• • • • health and diet Inhibiting Smooth Muscle CREAM WITH BISMUTH PECTIN oral
rehydration salts
90 mEq. 80 mEq Na. Cl 20 mEq of K 111 mEq of glucose citrate 30 mEq
331 Osm / l
"Antibiotics, when?
• Vulnerability: the elderly, children, diabetics • Depth chart: dysentery, rect
al bleeding,
(To culture and sensitivity)
• Duration of the table: treating more than 7 days in
empirically
• trimethoprim / sulfamethoxazole 160/800 mg c 12 hs. • Quinolones: Ciprofloxaci
n Norfloxacin-• Specific: Vancomycin 2 g / day metronidazole 1 to 1.5 g / day Ba
citracin 2 g / day
CHRONIC DIARRHEA
• It may be continuous or intermittent • MAS DURA 2 O 3 WEEKS • THE CAUSE SERIOU
S ILLNESS MAY BE REQUIRED FOR AN EARLY DIAGNOSIS TREATMENT.
Does this cause of diarrhea in small or large intestine?
• bulky stools, infrequent, grease, food debris, do not respect people's sleep,
isolated and associated with cramping periumbilical pain. • Contains small intes
tine mucus, pus or blood, small volume, liquid and frequent night respects with
frequent cramps relieved by defecation and lower abdominal pain. Large Intestine
"COLON COLON LEFT OR RIGHT?
• IF tenesmus and urgent defecation, DIARRHEA BLOOD RED AND PSEUDO THIS INJURY:
NEAR RIGHT
Is there blood in your stool?
• MORE THAN 40 YEARS IN NEOPLASIA THINK • THINK IF YOUNG in inflammatory bowel d
isease. • IF THE INJURY IS MORE BLACK proximal to the hepatic flexure Blend • IF
THIS IS MORE WITH DISTAL LEE
IS THERE WITH RESPECT TO THE DIET?
• IF CEDE FASTING IS MORE TO OSMOTIC
• RELATIONSHIP WITH SOME THINK FOOD enzyme deficiency (lactose) OR FOOD ALLERGY
WHAT IS THE DURATION OF THE TABLE?
• TOLERANCE IS NO CHANGE SEVERAL YEARS IN THE STATE OF HEALTH OR IF CONDITIONS A
SSOCIATED WITH THE WORK OR CONFLICT IN THE FAMILY:
FUNCTIONAL DISORDER
Diagnostic Pearls 1
• Drugs most common: digital, colchicine, iron, cholestyramine, antibiotics. • T
he study does not require self-limiting diarrhea except: 1. patients with risk f
actors (immunosuppression) 2. criteria of gravity • Staining of great guides onl
y to rule out Staphylococcus • Leukocytes (+) enteroinvasive, (-) toxigenicity.
Protozoa are enteroinvasive but no fecal leukocytes
Diagnostic Pearls 2
• Acute diarrhea + Sind. Hemolytic / uremic suggests Shigella or E. Coli. • Sind
. Reiter + diarrhea: Salmonella, Shigella, Yersinia, Campylobacter. • Acute diar
rhea with pain in FID with pericarditis, thyroiditis or GNF think Yersinia • Rar
e Fungi the cause, but if there is Candida in feces and pharyngeal has 90% chanc
e to be fungal