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Diarrhea - Causes and Symptoms

Related articles: Diarrhea

Definition

Diarrhea is the emission of watery or liquid stools. In most cases, this disorder occurs in an acute form (with or without blood) and disappears in a few days. Other times, diarrhea can continue and become chronic.

Diarrhea can be associated with an increase in emission frequency, tenesmus (painful abdominal cramp, with ineffective evacuation efforts) and explosive gas expulsion. Sometimes, vomiting, fever, dehydration and electrolyte imbalance may also be present.

Depending on the proportion of non-absorbable substances contained in the diet, normally the quantity of faeces fluctuates between 100 and 300 g per day in healthy adults. Therefore, diarrhea is defined as an emission of liquid stools greater than 300 g / day.

The mechanisms behind this disorder are different:

  • Osmotic load : when poorly reabsorbable solutes remain in the intestine and retain water, diarrheal episodes may occur. Osmotic loading diarrhea occurs in case of lactose intolerance (contained, for example, in milk, ice cream, yogurt and soft cheese). These solutes also include polyethylene glycol (PEG), magnesium salts (hydroxide and sulphate) and sodium phosphate, which are used as laxatives. The same effect is produced by the ingestion of high quantities of sorbitol, mannitol and xylitol (used as sugar substitutes in candies and chewing gum) or fructose (contained in apple and pear juice, grapes, honey, dates, nuts, figs, plums and soft drinks).
  • Increased secretions : diarrhea occurs when the intestine secretes more electrolytes and water than it can absorb. The most common cause is infections (eg gastroenteritis and toxinfections). Non-absorbed food fats and bile acids can also cause secretory diarrhea, as occurs in malabsorption syndromes and after ileal resection. The causes also include various endocrine tumors (eg vipomas, gastrinomas, medullary thyroid carcinoma, mastocytosis and carcinoid tumors) that produce mediators able to accelerate the passage of the small intestine and / or colon. Some drugs can affect intestinal secretions directly or indirectly (eg colchicine, quinine / quinidine and prostaglandin analogues).
  • Reduction of contact time / surface area: a rapid transit and a reduced area of ​​intestinal surface compromise the absorption of liquids and cause diarrhea. Possible causes include inflammatory bowel diseases (eg ulcerative rectocolitis and Crohn's disease) and malabsorption syndromes (celiac disease, Whipple's disease and pancreatic insufficiency). Transit can also be accelerated due to the stimulation of intestinal smooth muscle produced by some drugs (eg antacids containing magnesium, laxatives, cholinesterase inhibitors and SSRIs). Other forms depend on surgery (bypass and intestinal or gastric resections).

Acute diarrhea

The causes of diarrhea in acute form are numerous. In most cases, this manifestation is due to various viral infections (eg Adenovirus and Rotavirus), bacterial infections (eg Salmonella spp., Campylobacter jejuni, Shigella spp., Escherichia coli and Clostridium difficile ) and parasitic (eg Entamoeba histolytica and Giardia lamblia o intestinalis ).

In addition to diarrhea, food poisoning (bacterial and non-bacterial) resulting from the intake of water or contaminated food is characterized by nausea, vomiting, abdominal pain and sometimes fever.

Diarrheal episodes can also be triggered by the presence of fecal impaction and other pathological conditions, such as diverticulitis, intestinal ischemia, allergies or intolerances, mushroom poisoning and toxic agents.

Acute diarrhea can also result from taking antibiotics, laxatives, antacids containing magnesium and antineoplastics.

Excessive intake of some foods can also cause or worsen the disorder. These include products containing caffeine (eg coffee and cola) and fructose (in higher quantities than the absorption capacity of the intestine).

Acute diarrhea with blood can occur in cases of enteroinvasive bacterial infections (eg Shigella and Salmonella ) and heavy metal poisoning.

Chronic diarrhea

The accentuation of intestinal peristalsis can cause chronic diarrhea in some diseases, such as hyperthyroidism, adrenal insufficiency, pernicious anemia, carcinoid and hypoparathyroidism and malabsorption.

If protracted over time, diarrhea can also be a symptom of chronic pancreatitis, inflammatory bowel disease (irritable bowel syndrome, ulcerative colitis and Crohn's disease), tuberculous enteritis, cystic fibrosis, celiac disease, lactose intolerance and colon carcinoma and the sigma.

Possible complications associated with diarrhea

Diarrhea of ​​any aetiology can lead to complications. Sometimes, fluid loss can occur with dehydration, loss of electrolytes (such as sodium, potassium and magnesium) and even circulatory collapse. The latter may occur especially in patients with severe diarrhea (as in the case of cholera), the elderly or very debilitated subjects.

Other possible complications include metabolic acidosis (due to bicarbonate depletion) and hypokalemia (in the case of severe or chronic diarrhea or if the stool contains an excess of mucus). After a particularly prolonged diarrhea, hypomagnesemia can cause tetany.

Diarrhea often leads to numerous sessions of daily evacuation

Possible Causes * of Diarrhea

  • AIDS
  • Food Allergy
  • amebiasis
  • Amyloidosis
  • Anaphylaxis
  • Abdominal angina
  • anisakiasis
  • Anxiety
  • Anthrax
  • Appendicitis
  • Reactive arthritis
  • Botulism
  • Colon cancer
  • Celiac disease
  • Primary biliary cirrhosis
  • Sclerosing cholangitis
  • Cholera
  • Colitis
  • Ischemic colitis
  • Spastic colitis
  • Ulcerative colitis
  • Dengue
  • Diarrhea of ​​the traveler
  • Diverticulitis
  • Meckel's diverticulum
  • sickle cell
  • Ebola
  • Endometriosis
  • Enteritis
  • Hepatitis
  • Lassa fever
  • Crimean-Congo haemorrhagic fever
  • Marburg hemorrhagic fever
  • Cystic fibrosis
  • Gastritis
  • Gastroenteritis
  • Viral gastroenteritis
  • Giardiasis
  • Intestinal Infarction
  • West Nile virus infection
  • Adrenal insufficiency
  • Lactose intolerance
  • Food intolerance
  • Hyperthyroidism
  • Jet lag
  • Legionellosis
  • Venereal lymphogranuloma
  • Listeriosis
  • Malaria
  • Kawasaki disease
  • Whipple's disease
  • Pelvic inflammatory disease
  • Toxic megacolon
  • Molluscum contagiosum
  • Addison's disease
  • Cooley's disease
  • Crohn's disease
  • Graves' disease - Basedow
  • Hirschsprung disease
  • Diabetic neuropathy
  • Pellagra
  • Peritonitis
  • Intestinal polyps
  • proctitis
  • Salmonella
  • Schistosomiasis
  • Shigellosis
  • Irritable bowel syndrome
  • Reiter syndrome
  • Zollinger-Ellison syndrome
  • Hemolytic-uremic syndrome
  • Serotonin syndrome
  • Parainfluenza syndromes
  • Tropical sprue
  • Typhus
  • Adjoining twist
  • trichinosis
  • Colorectal cancer
  • Anus tumor
  • Peptic ulcer