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ADULT DIARRHEA

Citra Yulia Sari 16-061


DEFINISI DIARE
Let’s start with the first set of slides

Diare adalah pengeluaran tinja yang sering dan abnormal.
Diare berasal dari bahasa Yunani diarroia yang berarti
mengalir terus (to flow through). Perubahan transport air
dan elektrolit dalam usus menyebabkan diare. Diare dapat
didefinisikan infeksi lambung dan usus dengan pengeluaran
tinja lunak sampai cair tiga kali atau lebih dalam 24 jam dan
dapat disertai muntah.

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ETIOLOGI
Infeksi (bakteri, protozoa, virus, dan
parasit), alergi, malabsorpsi, keracunan,
obat dan defisiensi imun adalah kategori
besar penyebab diare. Pada balita,
penyebab diare terbanyak adalah infeksi
virus terutama Rotavirus.

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EPIDEMIOLOGY
▪Mortality/Morbidity
Mortality from acute diarrhea is overall globally declining but
remains high. Most estimates have diarrhea as the second
cause of childhood mortality, with 18% of the 10.6 million
yearly deaths in children younger than age 5 years.
▪Sex
Most cases of infectious diarrhea are not sex specific.
Females have a higher incidence of Campylobacter species
infections and hemolytic uremic syndrome (HUS).
▪Age
Viral diarrhea is most common in young children. Rotavirus
and adenovirus are particularly prevalent in children younger
than 2 years. Astrovirus and norovirus usually infect children
younger than 5 years. Yersinia enterocolitis typically infects
children younger than 1 year, and the Aeromonas organism
is a significant cause of diarrhea in young children.

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CLASSIFICATION
Of Diarrhea

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Berdasarkan Onset
▪ACUTE DIARRHEA ▪CHRONIC DIARRHEA
▪More than 90% of cases of acute ▪Diarrhea lasting >4 weeks
diarrhea are caused by infectious warrants evaluation to exclude
agents; these cases are often serious underlying pathology.
accompanied by vomiting, fever,
In contrast to acute diarrhea,
and abdominal pain. The
most of the causes of chronic
remaining 10% or so are caused
by medications, toxic ingestions, diarrhea are noninfectious.
ischemia, food indiscretions, and
other conditions.

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RISK

▪TRAVELLING
▪UNCOMMON FOOD
▪HOMOSEKSUAL
▪PENGGUNAAN
ANTIMIKROBA
▪KELUARGA ADA YG
MENDERITA

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Berdasarkan Mekanisme atau Klasifikasinya

▪Osmotic Diarrhea ▪Secretory Diarrhea


▪Absorption of water in the ▪Large volumes of water are
intestines is dependent on normally secreted into the small
adequate absorption of intestinal lumen, but a large
majority of this water is efficienty
solutes. If excessive amounts
absorbed before reaching the
of solutes are retained in the
large intestine. Diarrhea occurs
intestinal lumen, water will when secretion of water into the
not be absorbed and diarrhea intestinal lumen exceeds
will result. absorption.

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▪Inflammatory and Infectious Diarrhea
▪The epithelium of the digestive tube is protected from insult by a
number of mechanisms constituting the gastrointestinal barrier, but like
many barriers, it can be breached. Disruption of the epithelium of the
intestine due to microbial or viral pathogens is a very common cause of
diarrhea in all species. Destruction of the epithelium results not only in
exudation of serum and blood into the lumen but often is associated
with widespread destruction of absorptive epithelium. In such cases,
absorption of water occurs very inefficiently and diarrhea results.

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▪Diarrhea Associated with Deranged Motility
▪In order for nutrients and water to be efficiently absorbed, the
intestinal contents must be adequately exposed to the mucosal
epithelium and retained long enough to allow absorption.
Disorders in motility than accelerate transit time could decrease
absorption, resulting in diarrhea even if the absorptive process
per se was proceeding properly.

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PATHOPHYSIOLOGY
Of Diarrhea

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SYMPTOMS

▪The symptoms depend on the ▪dehydration


cause. It’s common to feel one ▪a fever
or more of the following: ▪bloody stools
▪nausea ▪a frequent urge to evacuate
▪abdominal pain your bowels
▪cramping ▪a large volume of stools
▪bloating

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How is the cause of diarrhea diagnosed?

ANAMNESIS
1. Waktu dan frekuensi
2. Bentuk tinja
3. Keluhan yang menyertai diare
4. Obat-obatan
5. Lain2
Px Fisik
Px Tinja
- Dari pH

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▪a stool culture to check for bacteria, parasites, or signs of disease
▪a colonoscopy to check the entire colon for signs of intestinal disease
▪a sigmoidoscopy to check the rectum and lower colon for signs of
intestinal disease
▪A colonoscopy or sigmoidoscopy is especially helpful for determining if
you have an intestinal disease if you have severe or chronic diarrhea

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Treatment
For Diarrhea

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The treatment for diarrhea usually requires ▪the frequency of the diarrhea and related
replacing lost fluids. This simply means you condition
need to drink more water or electrolyte ▪the degree of your dehydration status
replacement beverages, such as sports drinks. ▪your health
In more serious cases, you may get fluids ▪your medical history
through intravenous therapy. If a bacterial ▪your age
infection is the cause of your diarrhea, your ▪your ability to tolerate different procedures or
doctor may prescribe antibiotics. medications
Your doctor will decide your treatment based ▪expectations for improvement of your
on: condition
▪the severity of the diarrhea and related
condition

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How can I prevent diarrhea?

▪Although diarrhea can occur for various reasons, there are actions that you
can take to prevent it:
▪You can avoid developing diarrhea from food poisoning by washing the
cooking and food preparation areas more frequently.
▪Serve food immediately after preparing it.
▪Refrigerate leftovers promptly.
▪Always thaw frozen food in a refrigerator.

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