Description of diarrhea
Diarrhea usually can not be described as a separate disease. It may be signs (symptoms) of many diseases. It is a disorder of defecation and among the most common disorders of the digestive system function.
Such as diarrhea can be described frequent loose stools (usually at a number greater than two per day). The stool decides the amount of water contained therein. With increasing water content of feces becomes thinner until watery.
According to the speed of the difficulties, the severity and course of the duration of diarrhea can be divided into acute and chronic.
acute diarrhea
Occurs most frequently on the basis of infection. The process is generally very fast. Originator are Salmonella, Shigella, Camplylobacter jejuni, Yersinia enterocolitica, some strains of Escherichia coli.Of the viral infections that may be rotavirus, echovirus, and Coxsackie viruses.
Sometimes it can be caused by ingestion of certain drugs. The most common are primarily laxatives, certain types of antibiotics and cytostatics.
chronic diarrhea
Most often caused structural damage to the small or large intestine. Causing diseases are ulcerative colitis, Crohn’s disease, Celiac sprue (Celiac disease), Colorectal cancer.
Chronic diarrhea can also occur after surgery, it may be caused by liver disease, gall bladder disabilities, impaired endocrine system. Also, one of the complications of diabetes (diabetes mellitus).
Can also functional damage of the intestines such as the so-called. Irritable bowel syndrome, wherein the disorder in the autonomic nervous system, which acts on the intestine.
According to the mechanism diarrhea can be divided into several groups, which differ course and treatment. Usually it is present several mechanisms simultaneously.
Disorder of intestinal motility
Motility digesta passage expresses the ability of the digestive system.
Intestinal contents passes faster and intestinal wall nestíha absorb water and ions. This type is most often caused by a defect in the innervation (irritable bowel syndrome) and the consumption of drugs (group prokinetics).
The opposite case is decreased motility. Blind loop syndrome (syndrome contaminated loops, bacterial overgrowth syndrome) is caused by reduced motility in the small intestine, there is a stagnation content and non-physiological growth of bacteria. In some cases the only manifestation of diarrhea.
osmotic diarrhea
Some substances unless lining (epithelium) absorbed by the intestinal walls, retain water in the intestine and there is diarrhea. Substances with these properties is so called. Osmotically active substance. Very often, this problem concerns sugars (significantly osmotically active substance).
secretory diarrhea
In the intestinal wall dominates the secretion of water and ion absorption (expenditure over income). Since osmotic are best differentiated by the fact that its intensity does not decrease at reducing food intake. The most famous example is cholera.
exudative diarrhea
Inflammations, ulcers, and cancer of the intestinal mucosa caused by pathologic mucus.Furthermore, the present admixture of blood.
Travellers’ diarrhea
Situations where diarrhea can be described as a separate disease is called. Travellers’ diarrhea.According to the tourist area, where travelers in effect has its own name (Mexico – Montezuma’s Revenge, Egypt – Pharaoh’s Curse). Most often occur at the beginning pobytku in a given destination. Originator are Salmonella, Shigella, Camplylobacter jejuni, Yersinia enterocolitica, some strains of Escherichia coli and viruses. These are usually acute diarrhea and is not determined as the cause.
Risk factors for diarrhea
Risk is for travelers, especially in countries renowned travel-diarrhea local drinking water, eating local food specialties and non-compliance with hygiene rules.
Risk is the administration of certain drugs. In some diseases the triggering moment of non-diet.
For the development of bowel disease are most at risk of food composition and irregularity.Important is safe food preparation ad održování date. Dangerous food consumption is rotten with mold or incompletely cooked (for meat). Sometimes overlooked is also irregular bowel movements.
prevention of diarrhea
Generally for the prevention of diarrhea same principles as in the prevention of diseases of the digestive tract and in particular the intestines. These behaviors include regular bland food balanced composition (especially adequate protein and fiber). Neglect is also an effort by a regular bench. It is important to avoid risky foods.
symptoms of diarrhea
Průjmovitého symptom of the disease is more than two thin to watery stools per day. They are usually present crampy abdominal pain (intestinal colic). Can be accompanied by nausea (urge to vomit) and vomiting significantly. Before defecation is present quite a strong urge upon the throne, and her sense of relief is not obtained (for cancer and inflammatory causes).
Concomitants are weakness, fatigue, weight loss, malnutrition (malabsorption, lack of absorption of certain vital substances from food). After prolonged diarrhea decreases the immune system and is typical of formation of associated infectious diseases.
What is important is the nature of liquid stool, which varies according to cause (see the description of the most common disease-associated diarrhea)
Průjmovitá disease
malabsorption syndrome
Celiac disease (endemic sprue, gluten enteropathy, celiac sprue)
Hereditary inflammatory autoimmune disease of the small intestine. It manifests as nesnášelnivost gluten in the diet. Manifested weight loss, weakness and diarrhea noticeably greasy nature (steatoroická stool).
tropical sprue
Non-hereditary diseases of tropical areas with similar symptoms as celiac disease. Diarrhea is the first symptom.
lactase deficiency
Damage to the enzyme that cleaves lactose in the intestine. The undigested lactose attracts water, creating an osmotic diarrhea after drinking milk.
Primary bile acid malabsorption
When the non-absorbed bile acids in the small intestine occurs in the colon to the secretion of water and ions (secretory diarrhea). The manifestation is a severe watery diarrhea.
Blind loop syndrome
Sometimes the only symptom is diarrhea steatoroický.
Similar symptoms are also short bowel syndrome, Whipple’s disease, scleroderma and Amyloidosis,
Ulcerative colitis (ulcerative colitis, ulcerative colitis)
Unexplained inflammatory disease with ulcers in the lining of the colon and rectum. According to the affected area will vary symptoms. When left-sided colitis is mucopurulent bloody watery diarrhea (kolitický syndrome). Pancolitis manifests purulent bloody (hemorrhagic) diarrhea. When proctitis(handicap only the rectum) may be diarrhea, which is sometimes to take effect spread to other segments of the bowel.
Crohn’s disease
Unexplained inflammatory disease that can affect any part of the wall of the digestive tract. The disease has a period of the difficulties that alternating periods without symptoms. In the most common form of the disease (inflammatory forms) is the main symptom of chronic, mostly bloodless diarrhea.
Irritable bowel (colon irritabile)
It is a disorder of the autonomic nervous system that controls the activity of the intestine.Symptoms are often thin watery diarrhea (also known as the so-called. Debacles morning, for example. Our way to a job needs to be done a few stops).
dumping syndrome
Or too early postprandial syndrome, distal loop syndrome, gastric incontinence
Occurs after stomach surgery for an unresponsive to treatment of ulcer disease. Commonly stomach to the intestine releases the osmotically active substance gradually. For dumping syndrome, there is no residual stump of the stomach and able to occur osmotic diarrhea.
carcinoid syndrome
It is caused by tumors (carcinoid). Tumor often produces serotonin (hereinafter bradykinin, prostaglandins, histamine and others). The symptoms produced are given drugs, mostly diarrhea is present, binge redness (flush), difficulty breathing and low blood pressure.
Diabetes mellitus (diabetes)
Diabetic diarrhea is one of the manifestations of impaired autonomic nerves of diabetic autonomic neuropathy.
ischemic colitis
This creates a defective blood supply to the intestines, where it is not maintained adequate supply of oxygen. Symptoms include significant abdominal pain with bloody diarrhea.
radiation enterocolitis
It occurs as a side effect of radiotherapy of certain tumors. In the acute stage it comes to bloody diarrhea.
Postantibiotická colitis (pseudomembranous colitis)
The use of antibiotics will destroy the body’s own beneficial bacterial colonization of the colon. A chance to multiply and are alien to the body of harmful bacteria. Symptoms are diarrhea. If there is an overgrowth of bacteria called Clostridium difficile arises. Pseudomembranous colitis. This bacterium damages the intestinal mucosa with their toxic products (toxins). Pablány arise in the mucosa, which gradually separated out. The symptom is significantly fetid mucopurulent stools.Pseudomemranózní variant of the disease can lead to death.
colorectal cancer
This is the most common cancer. According to the localization of the tumor manifests a variety of symptoms. As one of the main symptoms is present with diarrhea (sometimes bloody, with mucus).Unless blood immediately apparent, bleeding can be hidden (known as occult). Given the severity of the disease it would be after him even when diseases are associated diarrhea.
Diarrhea, parasitic origin
The most common causes are diseases associated diarrhea Giardia intestinalis (giardiasis, Lamblióza- chronic diarrhea), Entamoeba histolytica (Amoebiasis, Amoebic dysentery-bloody diarrhea), Cryptosporidium (Kryptosporidióza- watery diarrhea), tapeworms (helmintosis), roundworm (ascariasis).
Diarrhea of bacterial origin
Originators are Salmonella, Shigella, Camplylobacter jejuni, Yersinia enterocolitica, enteropathogenic and enterotoxigenic Escherichia Coli.
Viral diarrhea
Originators rotavirus, echovirus and Coxsackie viruses. Special status has the virus and the disease it caused AIDS. One of the most common symptoms of AIDS diarrhea (caused mostly secondary-CMV, cytomegalovirus or cryptosporidium).
treatment of diarrhea
Some mild forms of acute diarrhea (mainly of infectious origin) is not a cure all and leave them inmaintaining a drinking regime subside.
For all others, it is necessary to treat the primary disease (causal therapy, causal therapy).Treatment of various kinds of diseases is different (from pharmacotherapy after extensive surgical interventions).
Treatment of diarrheal symptoms is symptomatic treatment. Of the drugs are administered in patients at risk for infectious diarrhea antibiotics. It is also possible to administer probiotics (restoring the natural colonization of the intestine by bacteria favorable body). In some diseases may be administered Antidiarrheal drugs (decreasing intestinal motility). For additional therapies are important dietary measures. The most important part of therapy is a profound concern for the patient’s hydration. It is an effort to cover losses sufficient water, minerals and ions (soups, isotonic drinks). For endangered and critically ill patients are administered rehydration solutions with the recommended composition (oral rehydration solution).
How can I help myself
What is important is adequate fluid intake (to cover losses from diarrhea), minerals and ions (such as very sugary drinks, soups and isotonic drinks). In diseases, which are prescribed dietary measures, it is necessary to follow a diet (eg. Celiac disease). But the majority of disease-associated diarrhea is a significant reduction in the food supply rather hurt. It helps only osmotic diarrhea.
complications of diarrhea
In diarrhea consequence of water may cause dehydration. May lead to circulatory collapse from a lack of circulating blood. The loss of water is not only decreases the amount of blood, but also thickens (increases the viscosity of the blood). Increased blood density is accompanied by an increased risk of thrombosis and subsequent myocardial infarction (MI) or to find more frequent cerebrovascular accident (CVA). Besides water losses are substantial loss of vital ions and minerals.Lack of some of them may cause life-threatening condition. For example, potassium deficiency causes heart rhythm disturbances. Vulnerable groups with the appearance of most complications are the elderly, children and the chronically ill.
Other names: Acute diarrhea, chronic diarrhea, osmotic diarrhea, secretory diarrhea, exudative diarrhea, intestinal motility disorder, Traveller’s diarrhea, Ulcerative colitis, ulcerative colitis, ulcerative colitis, Crohn’s disease, Crohn’s disease, Crohn’s disease, Celiac sprue C