M AUBF: FECALYSIS

• Human feces is called stool.
• Feces is plural of latin term "faex" meaning residue.
• Feces - IT IS THE WASTE RESIDUE OF INDIGESTIBLE MATERIALS OF AN ANIMAL’S DIGESTIVE TRACT EXPELLED THROUGH THE ANUS DURING DEFECATION.
• Meconium is newborn's first feces.
• Scatology or Corpology is the study of feces.
• Bacterial metabolism: Lactose intolerance leads to excessive gas production
• Small intestine is the major site for finals breakdown and reabsorption of compounds.
• Digestive enzymes: TRYPSIN, CHYMOTRYPSIN, LIPASE, AND AMINO PEPTIDASE
• Diarrhea - increase in daily stool (above 200g)
• Diarrhea - INCREASED LIQUIDITY AND FREQUENCY OF MORE THAN THREE TIMES PER DAY.
• Classification of Diarrhea:

  • ILLNESS DURATION

  • MECHANISM

  • SEVERITY

  • STOOL CHARACTERISTIC
• Major Mechanism:

  • SECRETORY

  • OSMOTIC

  • INTESTINAL HYPERMOTILITY
• SECRETORY - BACTERIAL, VIRAL, AND PROTOZOAN INFECTIONS PRODUCE INCREASED SECRETION OF WATER AND ELECTROLYTES, WHICH OVERRIDE THE REABSORPTIVE ABILITY OF THE LARGE INTESTINE
• MECHANISM OF SECRETORY DIARRHEA: USUALLY CAUSED BY AN ORGANISM THAT PRODUCES A TOXIN THAT STIMULATES ADENYLASE CYCLASE ENZYME THAT LEADS TO CRAMPY DIARRHEA & SECRETION OF INTESTINAL FLUID
• SECRETORY DIARRHEA: STOOLS ARE CHARACTERIZED AS WATERY AND VOLUMINOUS WITH NO RBC, WBC & MUCUS
• CAUSATIVE AGENT OF SECRETORY DIARRHEA:

  • VIBRIO CHOLERAE

  • ETEC (TRAVELER’S BACTERIAL DIARRHEA)

  • GIARDIA LAMBLIA
• INVASIVE DIARRHEA: MOSTLY CAUSED BY BACTERIA
• MECHANISM OF INVASIVE DIARRHEA: INVASIVE ORGANISMS DESTROYS THE MUCOSAL LINING OF THE INTESTINES PRODUCING PUS, BLOOD AND MUCUS IN STOOL.
• INVASIVE DIARRHEA: STOOL MAY CONTAIN WBC, RBC, & SPECKS OF MUCUS; AND SOMETIMES THE ORGANISM
• INVASIVE DIARRHEA: PATIENT IS EXPERIENCING TENESMUS
• OSMOTIC - INCOMPLETE BREAKDOWN OR REABSORPTION OF FOOD PRESENTS INCREASED FECAL MATERIAL TO THE LARGE INTESTINE, RESULTING IN THE RETENTION OF WATER AND ELECTROLYTES IN THE LARGE INTESTINE
• MECHANISM OF OSMOTIC DIARRHEA: USUALLY CAUSED BY INEFFICIENT REABSORPTION OF AN OSMOTIC SUBSTANCE DUE TO AN ENZYME DEFICIENCY
• OSMOTIC DIARRHEA: STOOL SAMPLES ARE WATERY & GASEOUS WITH NO WBC, RBC & MUCUS
• OSMOTIC DIARRHEA: POSITIVE FOR THE SUBSTANCES NOT REABSORBED (LACTOSE; A REDUCING SUGAR, FAT GLOBULES AND MUSCLE FIBERS)
• OSMOTIC DIARRHEA CAUSES:

  • LACTOSE INTOLERANCE

  • PANCREATIC INSUFFICIENCY
• ALTERED MOTILITY DESCRIBES CONDITIONS OF ENHANCED MOTILITY (HYPERMOTILITY OR SLOW MOTILITY (CONSTIPATION)
• IRRITABLE BOWEL SYNDROME - A FUNCTIONAL DISORDER IN WHICH THE NERVES AND MUSCLES OF THE BOWEL ARE EXTRA SENSITIVE, CAUSING CRAMPING, BLOATING, FLATUS, DIARRHEA, AND CONSTIPATION
• STEATORRHEA: INCREASE FAT IN STOOL (>6G/DAY)
• STEATORRHEA: ABSENCE OF BILE SALTS THAT ASSIST PANCREATIC LIPASE IN THE BREAKDOWN AND SUBSEQUENT REABSORPTION OF TRIGLYCERIDES
• CONDITIONS ASSOCIATED IN STEATORRHEA:

  PANCRETIC DISORDERS:

  • CYSTIC FIBROSIS

  • CHRONIC PANCREATITIS

  • CARCINOMA THAT DECREASE THE PRODUCTION OF PANCREATIC ENZYMES
• D-XYLOSE TEST: DISTINGUISH STEATORRHEA IN MALDIGESTION AND MALABSORPTION CONDITION
• D-XYLOSE IS A SUGAR THAT DOES NOT NEED TO BE DIGESTED BUT DOES NEED TO BE ABSORBED TO BE PRESENT IN THE URINE
• A NORMAL D-XYLOSE TEST INDICATES PANCREATITIS
• QUANTITATIVE FECAL FAT ANALYSIS - 72-HOUR SPECIMEN
• MACROSCOPIC EXAMINATION:

  • COLOR

  • CONSISTENCY

  • FORM
• MACROSCOPIC SCREENING: COLOR

  Black/ Tarry

  • UGIT
  • Iron therapy
  • Charcoal Intake
  • Bismuth intake
• MACROSCOPIC SCREENING: COLOR

  Red

  • LGIT
  • Beets intake
  • Rifampin intake
• MACROSCOPIC SCREENING: COLOR

  Pale Yellow, White, Gray

  • Bile duct obstruction
  • Barium intake
• MACROSCOPIC SCREENING: COLOR

  Green

  • Biliverdin
  • Oral antibiotics
  • Green vegetables
• PALE COLOR SIGNIFIES BILIARY OBSTRUCTION