DIARRHEA

ariella krisnanda 1215065

 Definition

consistency frequency diarrhea

loose or watery >2 times a day

>200gr/day adult
>10ml/day child

acute persistent chronic

2 weeks 4 weeks
 Epideimiology

worldwide > 1billion, suffer one or more episodes of acute

diarrhea each year.
US : among 100 million affected by acute, half must restrict
activities, 10% consult to physicians, 250,000 require
hospitalization, and 5000 die (primarily the elderly)
Acute infectious diarrhea remains one of the most common
causes of mortality in developing countries, particularly among
children, 1.8 million deaths per year.
 Pathophysiology

Dismotility Secretory

Osmotic Inflammatory

Diarrhea
 Osmotic
Its caused by the presence of nonabsorable solutes in GI tract
 Secretory

E.coli stable
toxin
Cholera toxin
Prostaglandin

Acetylcholi
ne
 Inflammatory
 Dismotility

Anxiety IBS

Post-
Hyperthyroid Gastrectomy
 Classification

acute
diarrhea

90%
10% non
infectious
infection
agents

medications,
foodallergy,
viral bacterial parasite toxic IBS,IBD
poisoning
ingestion

often accompanied by vomiting, fever, and abdominal pain

 High Risk Group

Travelers
40% of tourists to endemic regions develop travelers diarrhea
Consumers of certain foods
Immunodeficient persons
Daycare attendees and their family members
Institutionalized persons
chronic diarrhea
 THERAPY

DIARRHEA

Rehydration Symptomatic Etiology

Evaluation fluid requirement
Based on dehydrations degree
Minimal dehydration ( < 3% BW )
103% X 30-40 cc/KgBB/d
Mild to moderate dehydration ( 3-9% BW )
109% X 30-40 cc/KgBB/d
Severe dehydration ( > 9% BW )
112% X 30-40 cc/KgBB/d

Given 50% fluids deficit in the first hour, and the rest in the
next 3 hours
Symptomatic
Etiology
Etiology
Colon cutoff sign

Colon cut-off sign

describes gaseous
distension seen in
proximal colon
associated with
narrowing of the
splenic flexure in cases
of acute pancreatitis.
sentinel loop sign