DiarrheaGastroenterologists define diarrhea as passage of more than 200g of stool daily. But this definition usually applies for acute diarrhea. In chronic diarrhea the amount of stool passed may be less than 200 g.
Types:There are mainly two types of diarrheas:
1. Acute diarrhea
2. Chronic / Relapsing Diarrhea.
Acute Diarrhea:Extremely common and a predominant sign of infective gastroenteritis.
Symptoms of acute diarrhea:1. Urgency of defecation
2. Faecal incontinence
Causes of acute diarrhea:
1. Infective diarrhea:Transmission of infection by the fecal-oral route and transmitted either on fomites, on contaminated hands, or in food or water.
2. Non-infective diarrhea:
a. Plant toxins present in legumes and beansb. Chemical toxins
-Paralytic shellfish toxin
-Ciguatera fish poisoning
-Scombrotoxic fish poisoning
-Heavy metals like thallium and cadmium
c. Drug associated diarrhea:
The drugs are:
- Antibiotics, especially the broad spectrum antibiotics(most common)
- Proton pump inhibitors like omeprazole
- Non steroidal Anti-inflammatory drugs like aspirin
- Cytotoxic drugs.
One important point:Infective diarrhea is short lived and usually lasts for less than 10 days. Patient with diarrhea lasting more than 10 days rarely have an infective cause.
Chronic Diarrhea:Most common cause is irritable bowel syndrome.
The usual symptoms of chronic diarrhea are:1. Increased frequency of defecation
2. Loose, watery or pellet stools
3. Diarrhoea occurs rarely at night and is most sever before and after breakfast.
3. The 24 hour stool volume is less than 200g.