Acute DiarrheaThe most common causes of acute diarrhea are infectious agents. Acute diarrhea also may be caused by ingested drugs or toxins, the administration of chemotherapy, resumption of enteral feeding following a prolonged fast, fecal impaction (overflow diarrhea), or particular situations, such as marathon running. Additionally, acute diarrhea may represent the onset of a chronic diarrheal illness.
Contributing factors include inadequate sewage disposal and water supplies, lack of refrigeration, overcrowding and lack of personal hygiene, poverty, lack of access to health care, and lack of education.
Patients with acute infectious diarrhea typically present with nausea, vomiting, abdominal pain, fever, and diarrhea, which may be watery, malabsorptive, or bloody, depending on the specific pathogen.Abdominal pain is mild, diffuse, and crampy and results from the high volumes of secreted fluid that stimulate peristalsis and cause watery diarrhea.
Chronic DiarrheaDiarrhea that persists for weeks or months, whether constant or intermittent, requires evaluation. Although in the majority of cases the cause will prove to be irritable bowel syndrome, diarrhea may represent a manifestation of an underlying serious illness, and a careful search for disease should be undertaken.
Chronic diarrhea can be categorized pathophysiologically as inflammatory, osmotic (malabsorption), secretory due to intestinal dysmotility, or factitious .
Inflammatory diarrheas are characterized generally by the presence of fever, abdominal tenderness, and blood or leukocytes in the stool, with inflammatory lesions on intestinal mucosal biopsy. In addition to inflammation, the mechanism of diarrhea may also be malabsorption or increased intestinal secretion.Inflammatory diarrhea is seen in patients with chronic radiation enterocolitis as a result of pelvic irradiation for malignancies of the female urogenital tract or the male prostate. The segments usually involved are the terminal ileum, cecum, and rectosigmoid because they are fixed in the pelvis.
Osmotic diarrhea occurs when an orally ingested solute is not fully absorbed in the small intestine and thereby exerts an osmotic force that draws fluid into the intestinal lumen.The increased luminal fluid volume overwhelms the capacity of the colon for reabsorption. The nonabsorbed solute can be a maldigested or malabsorbed nutrient or drug.Osmotic diarrhea may result from the chronic ingestion of certain fruits or candy, gum, dietetic foods, and medications sweetened with unabsorbed carbohydrates such as sorbitol or fructose
Secretory diarrhea is characterized by a large volume of fecal output caused by abnormal fluid and electrolyte transport not necessarily related to the ingestion of food.Therefore, diarrhea usually persists with fasting. The term watery diarrhea is often used synonymously with secretory diarrhea.The classic examples of secretory diarrhea are those mediated by hormone. Patients with metastatic carcinoid tumors of the gastrointestinal tract may have watery diarrhea as part of the carcinoid syndrome
Altered Intestinal Motility Diarrhea may be associated with disorders that affect intestinal motility.he most common of these is irritable bowel syndrome, in which diarrhea typically alternates with constipation and is associated with abdominal pain, the passage of mucus, and a sense of incomplete evacuation.
Factitious diarrhea is self-induced by the patient and may result from intestinal infection, the addition of water or urine to the stool, or self-medication with laxatives.
Homeopathy is well known for the cure of these diarrhea.The best remedy that has given wonderful results are ARS ALB , NUX VOMICA, PULSATILLA, MERC SOL; MERC COR, ALOE, PODOPHYLLUM,IPEC,BRY,CHAM,VERAT.With the most appropriate single remedy and with appropriate repetition of the dose the case of diarrhea can be cured with great ease.