SMALL INTESTINE

• Acute diarrhoea is often caused by viral infections such as E. coli, Salmonella, and C. difficile, transmitted through contaminated food or water
• Risk factors for acute diarrhoea

  • Poor sanitation
  • Crowded living conditions
  • Travel to areas with inadequate hygiene standards
• Acute diarrhoea typically lasts less than 14 days and presents with symptoms like fever, abdominal pain, vomiting, and loose, watery stools
• Dehydration is a common complication of acute diarrhoea and can be severe, especially in vulnerable populations
• Diagnosis of acute diarrhoea

  1. Stool examination

  2. Microbiological testing
• Treatment of acute diarrhoea

  1. Focuses on oral rehydration therapy

  2. Potentially antibiotics for bacterial infections

  3. Antimotility agents for symptom relief
• Pathogenesis of acute diarrhoea

  • Involves invasion and colonization of the gastrointestinal tract by pathogenic microorganisms
  • Pathogens produce toxins or inflammatory mediators that disrupt normal intestinal function, leading to increased fluid secretion and decreased absorption
• Pathophysiology of acute diarrhoea

  • Primarily driven by alterations in intestinal fluid and electrolyte balance
  • Increased secretion of fluid into the intestinal lumen, coupled with impaired absorption, results in the passage of loose or watery stools
• Main complication of acute diarrhoea is dehydration, which can be life-threatening if not promptly treated
• Severe dehydration


  May lead to electrolyte imbalances, kidney failure, and shock
• Acute diarrhoea

  In some cases, particularly in immunocompromised individuals, can progress to systemic infection and sepsis
• Diagnosis of acute diarrhoea is based on clinical presentation, stool examination, and microbiological testing
• Stool microscopy, culture, and sensitivity testing can identify the causative organism and guide appropriate treatment
• Acute diarrhoea must be differentiated from other causes of gastrointestinal illness, such as viral gastroenteritis, food poisoning, and inflammatory bowel disease
• Management of acute diarrhoea focuses on supportive care and symptom relief
• Oral rehydration therapy is the cornerstone of treatment for acute diarrhoea, aimed at correcting fluid and electrolyte imbalances
• Antibiotics may be indicated in cases of bacterial or parasitic infection in acute diarrhoea
• Antimotility agents such as codeine or loperamide can help reduce stool frequency in acute diarrhoea
• If you add up marginal utility for each unit, you get total utility
• Chronic diarrhoea persists for more than 30 days and has diverse causes including irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), medications, and dietary factors
• Diagnosis of chronic diarrhoea

  Necessitates a comprehensive evaluation
• Management of chronic diarrhoea

  Entails identifying and addressing the underlying cause, which may involve dietary modifications, adjustments to medications, or psychological interventions
• Chronic diarrhoea can significantly impact quality of life and may lead to complications such as dehydration, malnutrition, and electrolyte imbalances
• The etiology of chronic diarrhoea is multifactorial, with various underlying conditions contributing to its development
• Risk factors for chronic diarrhoea

  • Age
  • Genetics
  • Dietary habits
  • Medical history
• Classification of chronic diarrhoea

  Depends on its duration, underlying cause, and clinical presentation
• Pathogenesis of chronic diarrhoea

  • Varies depending on the underlying condition but often involves disruption of normal intestinal function, leading to altered fluid and electrolyte balance
• Pathophysiology of chronic diarrhoea

  • May include increased intestinal motility, impaired absorption, or inflammation
• Clinical signs of chronic diarrhoea may include frequent bowel movements, urgency, abdominal pain, and bloating
• Symptoms of chronic diarrhoea can range from mild discomfort to severe debilitation, depending on the underlying cause and duration of symptoms
• Complications of chronic diarrhoea can include dehydration, electrolyte imbalances, malnutrition, and impaired quality of life
• Diagnosis of chronic diarrhoea requires a thorough medical history, physical examination, and diagnostic testing
• Differential diagnosis should consider a wide range of gastrointestinal disorders, including infectious, inflammatory, and functional conditions
• Management of chronic diarrhoea aims to identify and treat the underlying cause, alleviate symptoms, and prevent complications
• Treatment strategies for chronic diarrhoea may include dietary modifications, medications, probiotics, and lifestyle changes
• Long-term management of chronic diarrhoea often requires a multidisciplinary approach
• Management of chronic diarrhoea

  1. Identify and treat the underlying cause

  2. Alleviate symptoms

  3. Prevent complications
• Treatment strategies for chronic diarrhoea

  • Dietary modifications
  • Medications
  • Probiotics
  • Lifestyle changes
• Long-term management of chronic diarrhoea

  Requires a multidisciplinary approach involving gastroenterologists, dietitians, and mental health professionals
• Complications of chronic diarrhoea

  • Dehydration
  • Malnutrition
  • Electrolyte imbalances
  • Impaired quality of life