Acute diarrhoea

• What is the definition of acute diarrhea?

  Temporary malabsorption of water and nutrients
• What can significant fluid and electrolyte loss lead to?

  Dehydration and weight loss
• What are the infectious causes of acute diarrhea?

  • Viral: Rotavirus, enterovirus, adenovirus, etc.
  • Bacterial: E. coli, Salmonella, Shigella, etc.
  • Parasitic: Giardia lamblia, Entamoeba histolytica, etc.
  • Fungal: Candida albicans
• What are examples of parenteral infections that can cause acute diarrhea?

  Rhinopharyngitis, otitis, bronchopneumonia
• What are qualitative dietary errors that can lead to acute diarrhea?

  Incorrect milk formula preparation or excessive fruits
• What are quantitative dietary errors that can lead to acute diarrhea?

  Overfeeding or underfeeding
• Which antibiotics are common culprits for causing diarrhea?

  Ampicillin, tetracycline, neomycin
• What food allergies can trigger diarrhea?

  Cow's milk protein allergy and soy protein allergy
• What are the other determinant factors for acute diarrhea?

  • Dystrophy: Malnutrition or improper support
  • Inadequate Care: Poor hygiene, extreme temperatures
  • Predisposing Factors: Young age, prematurity, rickets
• What are common clinical signs of acute diarrhea?

  Watery stools, dehydration, lethargy
• What is the typical stool frequency in acute diarrhea?

  4–10 times per day
• What are the systemic signs of acute diarrhea?

  Dehydration, electrolyte imbalance, fever
• What are the diagnostic tests for acute diarrhea?

  • Stool culture
  • ELISA for rotavirus or Giardia
  • Blood/urine cultures
• What is assessed to determine the severity of acute diarrhea?

  Hemoconcentration and renal/liver function tests
• What is the general approach to treating acute diarrhea?

  • Hydration and electrolyte balance
  • Gradual refeeding with appropriate diets
  • Avoid routine antibiotics
• What are some medications used in treating acute diarrhea?

  Probiotics, zinc supplementation, racecadotril
• When are antibiotics indicated in acute diarrhea treatment?

  For severe bacterial infections like Shigella
• Why should antibiotics be avoided for enterohemorrhagic E. coli?

  To prevent hemolytic-uremic syndrome
• What are common complications of acute diarrhea?

  • Acute dehydration syndrome
  • Metabolic acidosis
  • Toxic megacolon, intestinal perforation
• What is a rare complication of acute diarrhea?

  Thrombocytopenic purpura
• What are the prevention strategies for acute diarrhea?

  • Exclusive breastfeeding for 4–6 months
  • Proper hygiene and adequate nutrition
  • Vaccination against rotavirus
• What is the cytotoxic mechanism in acute diarrhea?

  1. Germ ingestion
  2. Intraluminal germ proliferation
  3. Adhesion to intestinal mucosa
  4. Cytotoxin production
  5. Action of cytotoxins
  6. Resulting effects
• What happens during germ ingestion in the cytotoxic mechanism?

  Pathogenic bacteria are consumed and reach the GI tract
• What occurs during intraluminal germ proliferation?

  The bacteria multiply within the intestinal lumen
• What is the significance of adhesion to the intestinal mucosa?

  Pathogens attach and produce cytotoxins
• How do cytotoxins affect normal cellular functions?

  They stimulate secretory protein synthesis and induce inflammation
• What are the actions of cytotoxins in the body?

  Inhibit cell functions or lead to cell death
• What are the resulting effects of cytotoxin action?

  Loss of cellular integrity and severe intestinal damage
• How does damage to the mucosal lining contribute to diarrhea?

  Increases fluid and electrolyte secretion
• What are examples of pathogens using the cytotoxic mechanism?

  • Shigella (some strains)
  • Enteropathogenic E. coli (EPEC)
  • Enterohemorrhagic E. coli (EHEC)
  • Clostridium difficile
• How does reduced absorption lead to diarrhea?

  Lower gut capacity to absorb nutrients and water
• What causes increased secretion in acute diarrhea?

  Toxin-mediated pathways force excess chloride secretion
• How does inflammation contribute to diarrhea?

  Increases gut permeability and reduces functional integrity
• What is the effect of loss of the mucosal barrier?

  Increases fluid leakage into the lumen