Diarrhoea

• What is the duration of acute diarrhoea?

  Less than 7 days
• How long does chronic diarrhoea last?

  More than 1 month
• What is the definition of persistent diarrhoea according to some sources?

  More than 14 days
• Why is the exact prevalence of acute diarrhoea unknown?

  Some patients do not seek help and may self-treat
• What is the WHO definition of diarrhoea?

  The passage of three or more loose or liquid stools per day
• What causes an increase in osmotic load in the gut lumen?

  Soluble compounds that cannot be absorbed by the small intestine
• What happens to fluid and electrolytes during diarrhoea?

  Increased secretion into the intestine with decreased absorption
• What is the most common cause of acute diarrhoea globally?

  Infection
• What are some bacterial causes of acute diarrhoea?

  Shigella, Salmonella, E.coli, Bacillus, Clostridium difficile
• What is the most common viral cause of acute diarrhoea?

  Rotavirus
• What are some non-infective causes of diarrhoea?

  Anxiety, alcohol, food allergies, coffee, sweets, medication
• What are some chronic causes of diarrhoea?

  IBS, IBD, coeliac disease, cancer
• What are common symptoms of diarrhoea?

  Frequent, soft, watery stools, stomach cramps, nausea, fever, loss of appetite
• What does the presence of blood or mucus in stool suggest?

  Invasive organism or inflammatory bowel disease
• What is a sign that may suggest bowel cancer?

  Weight loss
• What should be done if dehydration signs are present?

  Refer the patient
• What is the referral time for adults with diarrhoea?

  72 hours
• What is the main priority in managing diarrhoea?

  Identifying patients needing referral
• How long does untreated bacterial diarrhoea usually last?

  1. 7 days
• What practical measures should be taken for managing diarrhoea?


  • Eat small, light meals with plain foods
  • Avoid fruit juice or fizzy drinks
  • Continue breastfeeding or bottle feeding normally
  • Maintain hygiene by washing hands frequently
  • Stay off school/work for at least 48 hours after the last episode
• What is the first-line treatment for diarrhoea, especially in children?

  Oral rehydration therapy
• What is the action of loperamide in treating diarrhoea?

  It slows intestinal transit by decreasing bowel motility

  
• What is a common side effect of bismuth-containing products?

  Blackened stools and tongue
• What are the types of treatments available for diarrhoea?

  • Oral rehydration therapy
  • Symptomatic treatment (e.g., loperamide)
  • Bismuth-containing products
  • Adsorbents (e.g., kaolin, charcoal)
• What are the differences between acute and chronic diarrhoea?

  • Acute: lasts less than 7 days
  • Chronic: lasts more than 1 month
  • Persistent: lasts more than 14 days
• What are the signs of dehydration to look for in patients?

  • Unsatisfied thirst
  • Dry mouth and tongue
  • Poor urine output
  • Rapid breathing and tachycardia
  • Sunken eyes
  • Lethargy and confusion
• What are the referral guidelines for diarrhoea in different age groups?

  • <1 year: 24 hours
  • 1-3 years: 48 hours
  • Adults: 72 hours
  • Elderly: 48 hours
• What dietary advice is recommended for managing diarrhoea?


  • Eat when able
  • Small, light meals
  • Avoid fruit juices and fizzy drinks
  • Continue breastfeeding or bottle feeding normally
• What are the common causes of chronic diarrhoea?

  • IBS
  • IBD
  • Coeliac disease
  • Cancer
  • Malabsorption
• Loperamide


  • First choice
  • Slows small and large intestine transit by decreasing bowel motility through action on opioid receptors in gut (therefore can increase absorption of fluid and electrolytes)
  • Over 12 yrs
• Adsorbents


  • Traditional
  • Add bulk to stool, not absorbed from gut
  • Could still lose fluid from bowel - little therapeutic use
• Bismuth-containing products


  • Used for diarrhoea, heartburn, nausea
  • Reduces intestinal motility
  • Over 16 yrs
• Bulk-forming agent


  • May adsorb water to create a formed stool
  • Also used in constipation
  • Can be useful in conditions with chronic diarrhoea