DIARRHEA

definition
 διάρροια; literally meaning "through-flowing"
 Stool looses its normal consistence
 Weight usually increases: >235g/d (♂),
>175g/d (♀)
 Frequency increases: >2/d
 Often associated with imperative urge to
defecate
 Can contain blood, pus and mucous
 Types of diarrhea
 Osmotic diarrhea: occurs when there is a loss of
water due to heavy osmotic load, e.g. due to
maldigestion or due to high uptake of sorbitol,
fructose etc.
 Secretory diarrhea: due to increased active
secretion and/or inhibition of absorption; little to
no structural damage; e.g. cholera-toxin
activates adenylatcyclase, higher cAMP-level,
decreased Na-absorption & increased Cl-
secretion, high osmotic gradient leads to water-
inflow
 Types of diarrhea
 Motility-related diarrhea: occurs due to abnormal
motility of GIT, if food moves to quickly there is
not enough contact-time for water & nutrients to
be absorbed; e.g. after vagotomy or diabetic
neuropathy
 Inflammatory diarrhea: damage of mucosal
lining or brush-border leads to a passive loss of
protein-rich fluids and decreased ability to
absorb these fluids; features of the other three
types can be found in this one; it can be caused
by bacterias, viruses, parasites and
autoinflammatory diseases
 Acute diarrhea
 Lasts less than 4 weeks; aka enteritis
 Usually caused by infections (>90%) or food poisoning
with bacterial toxins (Salmonella)
 Most of non-febrile diarrheas are caused by viruses (viral
gastroenteritis); most common reason for diarrhea in
children is Rotavirus (~40%)
 Febrile types (invasive pathogenes) are usually caused
by Campylobacter or Salmonella
 Severe types are cholera, typhus and intestinal
tuberculosis
 Cause for bloody diarrhea can be e.g. EHEC and
dysentery
 Chronic diarrhea
 Lasts longer than 4 weeks
 Reasons can be: stress, food intolerance
(e.g. lactose intolerance), disorders of
pancreas/liver/gallbladder, chronic
intestinal infections (Morbus Crohn, Colitis
ulcerosa), bowel cancer
 Complications
 Loss of water: dehydration (dizzyness,
unconsciousness)
 Loss of electrolytes: cramps
 In severe cases both can lead to death
 Worldwide 3mio children die due to
diarrhea (per year)
 Treatment
 In case of severe diarrhea suckling babies,
children, old people should always go to a
doctor
 Most important is sufficient uptake of
water and electrolytes (salt)
 Antidiarrhoetics are not always
recommendable, cause pathogenes stay in
the intestine
 In case of bacterial infection: antibiotics