Table of Contents
Definition / general | Terminology | Etiology | Diagrams / tables | Additional referencesCite this page: Gulwani H. Diarrhea / dysentery. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/colondiarrheageneral.html. Accessed March 4th, 2021.
Definition / general
- Normal intestines receive 9 liters of fluid per day (oral intake: 2 L, saliva: 1L, gastric juices: 2L, pancreatic juices: 2L, intestinal juices: 1L); most is reabsorbed in small intestine and colon
Terminology
- Diarrhea: 3 or more loose stools / day; also increase in stool mass, fluidity or frequency of defecation (Wikipedia - Diarrhea, eMedicine - Diarrhea)
- Chronic diarrhea: decrease in stool consistency for more than four weeks (Am Fam Physician 2011;84:1119, Best Pract Res Clin Gastroenterol 2012;26:551, Arch Pathol Lab Med 2013;137:83)
- Secretory diarrhea: >500 ml of fluid stool per day, isotonic with plasma, persists during fasting
- Dysentery: low volume, painful, bloody diarrhea (Wikipedia - Dysentery)
Etiology
- Infectious (viral damage to epithelium): enteric adenoviruses, Norwalk virus, rotavirus
- Infectious (enterotoxin): Bacillus cereus, Clostridium perfringens, E. coli, Vibrio cholera
- Neoplasm: tumor production of peptides, villous adenoma in distal colon
- Excessive laxatives
Causes of specific types of diarrhea:
- Osmotic diarrhea: gut luminal solutes create high stool osmolality, abates with fasting; caused by lactase deficiency, lactulose therapy, gut lavage, antacids, primary bile acid malabsorption
- Exudative disease: purulent bloody stools, persist with fasting; caused by bacteria (Salmonella, Shigella, Campylobacter), Entamoeba histolytica, idiopathic inflammatory bowel disease, typhlitis (neutropenic colitis in immunosuppressed)
- Malabsorption: bulky stools, abates with fasting; caused by defective intraluminal digestion, primary mucosal cell abnormalities, reduced small intestinal surface area, lymphatic obstruction, Giardia lamblia (PubMed Health - Malabsorption Syndromes, Wikipedia - Malabsorption)
- Deranged motility: improper gut neuromuscular function; caused by surgical resection of gut (decreased transit time), irritable bowel syndrome (neural dysfunction), hyperthyroidism, diabetic neuropathy, carcinoid syndrome; small intestine diverticula (decreased motility), blind loop, bacterial overgrowth
Additional references