| Revision as of 06:08, 9 September 2005 view sourceWwoods (talk | contribs)Administrators46,160 edits In the Third World, diarrhea is the most common cause of death among infants, killing more than 1.5 million per year.← Previous edit | Revision as of 06:00, 10 September 2005 view source 206.28.58.90 (talk)No edit summaryNext edit → | ||
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| Diarrhea is when you shit bad and it's all gooey and tastes bad. You're gay. | |||
| '''Diarrhea''' (]) or '''diarrhoea''' (]) is a condition in which the sufferer has frequent and watery or loose bowel movements (from the ancient ] word διαρροή = leakage; lit. "to run through"). In the ], diarrhea is the most common cause of death among infants, killing more than 1.5 million per year. | |||
| ==Causes== | |||
| This condition can be a ] of injury, ] or ] and is usually accompanied by abdominal pain, and often ] and vomiting. There are other conditions which involve some but not all of the symptoms of diarrhea, and so the formal medical definition of diarrhea involves defecation of more than 200 grams per day (though formal weighing of stools to determine a diagnosis is never actually carried out). | |||
| It occurs when insufficient fluid is absorbed by the colon. As part of the ] process, or due to fluid intake, ] is mixed with large amounts of water. Thus, digested food is essentially liquid prior to reaching the colon. The colon absorbs water, leaving the remaining material as a semisolid stool. If the colon is damaged or inflamed, however, absorption is inhibited, and watery stools result. | |||
| Diarrhea is most commonly caused by myriad ] infections but is also often the result of ]l toxins and sometimes even infection. In sanitary living conditions and with ample food and water available, an otherwise healthy patient typically recovers from the common viral infections in a few days and at most a week. However, for ill or malnourished individuals diarrhea can lead to severe ] and can become life-threatening without treatment. | |||
| It can also be a symptom of more serious diseases, such as ], ], or ] and can also be indicative of a chronic syndrome such as ]. It is also an effect of severe ]. | |||
| It can also be caused by excessive alcohol consumption, especially in someone who doesn't eat enough food. | |||
| Symptomatic treatment for diarrhea involves the patient consuming adequate amounts of water to replace that lost, preferably mixed with ]s to provide essential ]s and some amount of ]s. For many people, further treatment and formal medical advice is unnecessary. The following types of diarrhea generally indicate medical supervision is desirable: | |||
| *Diarrhea in infants. | |||
| *Moderate or severe diarrhea in young children. | |||
| *Diarrhea associated with blood. | |||
| *Diarrhea that continues for more than 2 weeks. | |||
| *Diarrhea that is associated with more general illness such as non-cramping ], ], ], etc. | |||
| *] (more likely to have exotic infections such as parasites) | |||
| *Diarrhea in food handlers (potential to infect others) | |||
| *Diarrhea in institutions (Hospitals, child care, mental health institutes, geriatric and convalescent homes etc). | |||
| Since most people will ignore very minor diarrhea, a patient who actually presents to a doctor is likely to have diarrhea that is more severe than usual. | |||
| ==Mechanism== | |||
| To evacuate the contents of the lower digestive tract, the fluidity of the contents of the small and large intestines is increased. ] of Na{{sup|+}} back into the gut intiates a reverse sodium transport. This causes both ] and ] to follow passively, as well as water. Now in the intestines, the water dilutes toxins as well as triggers contractions of the intestine due to increase in intestinal distension. These contractions push the contents of the lower GI tract towards and out of the anal canal. ]s such as ] are designed to prevent such contractions in response to the distension, and should not be used to prevent diarrhea. Such inhibition actually prolongs the infection or irritation, and can cause a worsening over time because the evacuation of the bowel contents has been delayed. | |||
| == Acute diarrhea == | |||
| This may be defined as diarrhea that lasts less than 2 weeks, and is also called ]. | |||
| This can nearly always be presumed to be infective, although only in a minority of cases is this formally proven. | |||
| It is often reasonable to reassure a patient, ensure adequate fluid intake, and wait and see. | |||
| In more severe cases, or where it is important to find the cause of the illness, stool cultures are instituted. | |||
| The most common organisms found are ] (an organism of animal origin), ] (also often of animal origin), ] (animal origin), ] (lives in drinking water). ] (dysentery) is less common, and usually human in origin. ] is rare in Western countries. It is more common in travelers and is usually related to contaminated water (its ultimate source is probably sea water). ] is probably a very common cause of diarrhea, especially in travelers, but it can be difficult to detect using current technology. The types of E. coli vary from area to area and country to country. | |||
| ]es, particularly ], are common in children. (Viral diarrhea is probably over-diagnosed by non-doctors). The ] is rare. | |||
| Toxins and food poisoning can cause diarrhea. These include ] toxin (often milk products due to an infected wound in workers), and Bacillus cereus (eg rice in Chinese takeaways). Often "food poisoning" is really salmonella infection. | |||
| Parasites and worms sometime cause diarrhea but often present with weight loss, irritability, ]es or anal itching. The commonest is ] (mostly of nuisance value rather than a severe medical illness). Other worms, such as ], ascaria, and ] are more medically significant and may cause weight loss, anemia, general unwellness and allergic problems. ] due to '']'' is an important cause of bloody diarrhea in travelers and also sometimes in western countries which requires appropriate and complete medical treatment. | |||
| ==Chronic diarrhea== | |||
| ===Infective diarrhea=== | |||
| It is not uncommon for diarrhea to persist. Diarrhea due to some organisms may persist for years without significant long term illness. More commonly a diarrhea will slowly ameliorate but the patient becomes a carrier (harbors the infection without illness). This is often an indication for treatment, especially in food workers or institution workers. | |||
| Parasites (worms and amoeba) should always be treated. Salmonella is the most common persistent bacterial organism in humans. | |||
| ===Malabsorption=== | |||
| These tend to be more severe medical illnesses. | |||
| ] is the inability to absorb food, mostly in the small bowel but also due to the pancreas. | |||
| Causes include ] (intolerance to ], a wheat product), ] (Intolerance to milk sugar, common in non-Europeans), ], Pernicious ] (impaired bowel function due to the inability to absorb ]), loss of pancreatic secretions (may be due to cystic fibrosis or pancreatitis), short bowel syndrome (surgically removed bowel), radiation fibrosis (usually following cancer treatment), other drugs such as chemotherapy, and of course, diarrhea-predominant ]. | |||
| ===Inflammatory bowel disease=== | |||
| There are of unknown origin but are likely to be abnormal immune responses to infection. There is some overlap but the two types are ] and ]: | |||
| * ] is marked by chronic bloody diarrhea and inflammation mostly affects the distal ] near the ]. | |||
| * ] typically affects fairly well demarcated segments of bowel in the colon and often affects the end of the small bowel. | |||
| ===Other important causes=== | |||
| *]. This usually affects older people and can be due to blocked arteries. | |||
| *]: Some (but NOT all) bowel cancers may have associated diarrhea. (Cancer of the large colon is most common) | |||
| *Hormone-secreting tumors: some hormones (e.g. ]) can cause diarrhea if excreted to excess (usually from a tumor). | |||
| ==Treatment of diarrhea== | |||
| #Do nothing except ensure adequate fluid intake. This is the most appropriate treatment in most cases of minor diarrhea. | |||
| #Try eating more but smaller portions. Eat regularly. Don't eat or drink too quickly. | |||
| #] or a "drip": Sometimes, especially in children, ] can be life-theatening and intravenous fluid may be required. | |||
| #]: Taking a sugar/salt solution, which can be absorbed by the body. | |||
| #Anti-diarrhea drugs: use cautiously as they are said to prolong the illness and may increase the risk of a carrier state. They are useful in some cases, however, when it is important that you don't have diarrhea (e.g. when traveling on a bus). ] is the most commonly used antidiarrheal. | |||
| #]s: antibiotics may be required if a bacterial cause is suspected and the patient is medically ill. They are sometimes also indicated for workers with carrier states in order to clear up an infection so that the person can resume work. Parasite-related diarrhea (e.g. ]) require appropriate antibiotics. Antibiotics are not routinely used, as the cause is rarely bacterial and antibiotics may further upset intestinal flora and ''worsen'' rather than improve the diarrhea. '']''-associated diarrhea and ] is often caused by antibiotic use. | |||
| #Dietary manipulation: especially avoid wheat products with ]. | |||
| #] and isolation: Hygiene is important in limiting spread of the disease. | |||
| #It is claimed that some fruit, such as ]s, ]es, ] and ] may have positive effects on this condition. Bananas have the merits of being easily obtainable, and they are unlikely to have any other significant unwanted side effects. Bananas are thought to be "binding," as is mucilage, which you can obtain in capsule form. ] can also be used as cereal for babies, as it is easily digested. The high acid content of pineapple may make this food a bad choice for people suffering from chronic diarrhea. | |||
| ==In popular culture== | |||
| While diarrhea humor, a subset of ], is usually confined to the realm of adolescent songs on the schoolyard, it has been mimicked on occasion on recent television comedies, most notably '']'', '']'', and multiple times on '']''. It is also the stuff of many ]s. | |||
| Perhaps the most famous movie scene involving diarrhea is from the film '']'' and involves ] getting poisoned by his friend, portrayed by ], and releasing it painfully into a broken ]. | |||
| ==Related topics== | |||
| * ] | |||
| == External links == | |||
| * 1: ''Bull. World Health Organ.'' 2000;78(10):1246-55. | |||
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Revision as of 06:00, 10 September 2005
Diarrhea is when you shit bad and it's all gooey and tastes bad. You're gay.