Diarrhea.pptVIP

Diarrhea Normal defecation times：average 1time/day; specific case about 2-3/day or 2-3times/day characters ：normal（forming;shaping、mucus, etc），yellow; moisture content 50-80% quantity：≤200g/day Approach Identify those individuals with diarrhea who need urgent treatment or an acute diagnostic workup. In more than 90% of patients with acute diarrhea, the illness is mild and self-limited and no laboratory evaluation is necessary. Approach The goal of the initial evaluation of the adult with diarrhea, therefore, is to distinguish these patients from those with more serious disorders. Approach: Definition Diarrhea is best defined as an increase in the fluidity, frequency, and volume of daily stool output, where stool weight is greater than 200g. Chronic diarrhea is disting-uished from acute in that it lasts more than 3 weeks. Infection is the leading cause of acute diarrhea, whereas irritable bowel syndrome is the leading cause of chronic diarrhea. 肠内水平衡 分泌吸收 吸收 分泌 Approach: Pathophysiology Osmotic diarrhea Secretory diarrhea Exudative diarrhea Abnormal intestinal motility Approach: Pathophysiology Osmotic diarrhea Secretory diarrhea Exudative diarrhea Abnormal intestinal motility Osmotic diarrhea Increased amounts of poorly absorbable, osmotically active solutes in the gut lumen; stool volume decreases with fasting. can be seen in laxative abuse, fat malabsorption, Norwalk virus, rotavirus Approach: Pathophysiology Osmotic diarrhea Secretory diarrhea Exudative diarrhea Abnormal intestinal motility Secretory diarrhea Increased chloride and water secretion with or out inhibition of normal active sodium and water absorption; large volume stools with little change with fasting. Can be seen in cholera , toxigneic Escherichia coli, gastrinoma, laxatives Approach: Pathophysiology Osmotic diarrhea Secretory diarrhea Exudative diarrhea Abnormal intestinal motility Exudative diarrhea Exudation of mucus, blood, and prote