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
It’s 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 traveler’s 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 dehydration’s 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% fluid’s 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