MedLecturesMadeEasy's video: Diarrhea

This is an overview of diarrhea. Presentation created in Google Slides. Graphics were created or adapted from Wikimedia Commons. ADDITIONAL TAGS: Diarrhea Definition Frequent stool liquid stools Bristol stool scale Relative causes diarrhea Definition Types Infectious Gastroenteritis Malabsorption Secretory Inflammatory bowel disease Osmotic Malabsorption osmole sugar salt artificial sweetener draws water bowels EX lactase def celiac tropical sprue whipples pancreatic consuming sugar food drink gum DX fecal osmolar gap plasma osmolality x stool Na K goes w NPO diarrhea Secretory luminal ion channels are disrupted secretion absorption ions follows ions structural damage Cholera stimulates Cl sec body responds Nawater rotavirus C diff carcinoid gastrinoma VIPoma blood WBC Inflammatory Damage mucosal lining brush border Exudative Oozing blood mucus pus protein IBD UC infxns ischemic colitis diverticulitis radiation colitis blood WBC mucus colonoscopy Are alarm sx abd pain fever days immunocompromised dehydrated recent travel abx hospitalization Likely viral adeno noro entero rotavirus Tx rehydrate POIV loperamide BRAT bananas rice applesauce toast self limiting wait Yes bacterial parasitic C diff nucleic acid amplification tests NAAT c diff flora bug spreads hospitals thrives overgrows abx Characteristic smell Pseudomembranes scope Leukocytosis CBC Dx NAAT toxin PO vancomycin metronidazole fidaxomicin transplant severe toxic megacolon sepsis IV vanc Occult blood leukocyte lactoferrin fever r o culture biopsy invasive Salmonella Raw poultry Osteomyelitis SCA mainly supportive Shigella Hemolytic Uremic Syndrome similar TTPanemia MAHAschistocytes thrombocytopenia renal failureuremia EHEC OH Shigalike toxinHUS Uncooked Hamburgers MAHA schistocytes smear shiga toxin assay supportive steroids plasmapheresis dialysis abx risk HUS Entamoeba histolytica Protozoa HIV AIDS Travel S America progress liver abscess RUQ R lobe antigen serology metronidazole Campylobacter jejuni precedes GBS ascending weakness dysarthria resp weakness Tx GBS IVIG paralysis calcium osteoporosis dermatitis herpetiformis papulovesicular extensor knee antitissue transglutaminase TTG antiendomysial IgA Abs def biopsy loss surface area blunting stop mo Tropical sprue Carribean PR Caused infxn celiac blunted dx malabsorption stopping doesnt help abx tetracycline smx tmp Whipples dz Rarer T whipplei Malabsorp steatorrhea arthralgias lymphadenop K B Fe Ca Mg Zinc dehydration teduglutide bowel diet supplements Def vit D osteoporosis E nystagmus night blindness K bleed Medications induce malabsorption orlistat inhibits lipase loss steatorrhea AlphaGlucosidase inhibitor inhibit carb absorp diabetes gas Carcinoid intestine tumor met secretes serotonin blood flushing wheezing heart problems compared carcinoid lung affects sided HIAA urine imaging find tumor Octreotide symptoms resection Gastrinoma ZollingerEllison gastrin gastric acidity Acid inactivates peptic ulcer gastrin gastrin response secretin gastrin sans PPIs Exclude mets somatostatin receptor scintigraphy SRS endoscopic ultrasound remove surgically else cancer VIPoma vasoactive peptide VIP increases electrolyte relaxes muscle sphincters n v K achlorhydria VIP image lesion fluids octreotide lanreotide surg Crohns Ulcerative Demographics Ages Age Symptoms steatorrhea onset loss crampy RLQ pain Mucuslike bloody sudden tenesmus fever severe LLQ Origin Terminal ileum Rectum Inflammation distribution pattern complications Patchy skip lesions cobblestoning mouth anus spares rectum nonnecrotizing granuloma biopsy fistulas skin organs bowel deficiencies based s affected Continuous inflammation always colectomy is curative increased colorectal cancer depth Transmural extends tissues Mucosal shallow friable pseudopolyps Xray String sign Lead pipe Fistula Common Extraintestinal Ankylosing spondylitis Primary sclerosing cholangitis pANCA Erythema nodosum iritis uveitis Smoking Makes worse Decreases Treatment Mild ASA compounds sulfasalazine aspirin variants breaks gut places reduce inflammation UC Moderate Immunomodulators mercaptopurine azathioprine methotrexate Flares Prednisone rule infxn antiTNF infliximab surgery Annual yr Colectomy Radiation enteropathy proctitis tx damages anorectum Acute tenesmus weeks rad tx Chronic hematochezia strictures fibrosis neovascularization telangiectasia occurring months years Ischemic Vascular MI CVA infarct mesentery dies Risk afib postprandial angina gut proportion exam angiogram leukocytosis lactic acid exlap resection stenting bypass Hyperthyroidism Heat intolerance palpitations tachycardia diaphoresis hunger hyperactivity restlessness exophthalmos insomnia tremor skin Irritable Associated stress functional disorders pregnancy intermittent cramping constipation alternating relieved movement exclusion inflam reassurance exercise modification symptomatic relief side effects antibiotics inflammatory chemotherapy Factitious laxatives Colon Fecal impaction