The most common cause of acute diarrhea is an
Infections agent. It is also caused by ingested drugs or toxins, chemotherapy and resumption of feeding following a prolonged fast.
Acute diarrhea may represent the onset of a chronic diarrhea.
Antibiotic therapy is generally not necessary in acute diarrhea. It is needed only in shigellosis, travelers diarrhea, cholera, and parasitic diseases.
More than antibiotics acute diarrhea needs rest and fluid replacement. Since death can occur due to dehydration. I.V. fluid therapy is needed in severely dehydrated individuals [infants and the elderly].
3. Infections –
Diarrhea, nausea, vomiting, fever, abdominal pain .
a. Bed rest,
b. Fluid replacement
c. Oral sugar electrolyte solution
3. . Parasitic diseas
Laxatives, ampicillin, NSAIDS
Stop the drug.
Organophosphorus insecticides, mushrooms, arsenic
Nausea and vomiting as prominent symptoms but no high fever
6. Lactose intolerance
Diarrhea within several hours of ingesting
Milk or milk products. Associated with
cramps, abdominal pain and flatus.
Diarrhea that persists for weeks or months. [either constant or intermittent] In majority of cases it is due to irritable bowel syndrome.
2. Osmotic :-
Results into malabsorption of fats or carbohydrates.
3. Secretory :-
4. Altered intestinal mobility :-
Due to irritable bowel syndrome.
Self induced by the use of laxatives. Usually an H/o psychiatric diseases present.
Radiation entero colitis
Infection associated with AIDS
Bulky, greasy, foul smelling stools. weight loss
Improvement with fasting
e.g. – Pancreatic
Watery diarrhea persists with fasting. Dehydration present.
e.g. – Microscopic colitis
Protein losing enteropathy –
Peripheral edema, ascites
3. Altered intestinal motility –
Alternating diarrhea and constipation urinary bladder symptoms
e.g. – Irritable bowel syndrome
Self induced due to laxative abuse. Watery diarrhea with hypokalemia, weakness, edema.
5. Drug induced
Laxatives, digitalis, beta blockers, ACE inhibitors, diuretics, ampicillin, lovastatin, fluoxetine, theophylline, NSAIDS
Of specific nutrients present as anemia, bleeding tendency, amenorrhea
1. Bulky, greasy, foul smelling stools that
are difficult to flush
3. Weight loss
7. Diabetic diarrhea
Symptoms of autonomic dysfunction such as postural hypotension, impotence, disordered sweating.
To assess volume depletion as indicated by postural hypotension, tachycardia, mental lethargy, generalized weakness.
1. Complete blood count
2. Peripheral smear
3. Serum electrolytes
4. Decreased levels of irons, folate, vitamin B12
and vitamin D suggest malabsorption.
5. Stool PH less than 5.3 suggests
6. Assay for µ 2 antitrypsin, an endogenous
protein confirms protein-losing enteropathy.
7. Measurement of fecal fat confirms
8. Small intestinal biopsy is a diagnostic test
9. Presence of blood and leukocytes in stool
suggests inflammatory diarrhea.
1. Diphenoxylate and loperamide in secretory
2. Clonidine [an alpha-adrenergic agonist] for
3. Cholestyramine in diarrhea caused by bile