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DIARRHOEA A common condition that involves unusually frequent and liquid…

- - - - (result of infection or intake of certain drugs) electrolyte absorption is affected
        
        releases water into the small intestine -> loose bowel movements
    - - (hyperthyroidism, irritable bowel syndrome, having partial gastrectomy)
        certain condition
        
        change the function of digestive system
        
        affect processes like absorption
    - - retention of water in the bowel ->; accumulation of non-absorbable substance
    - - (ulcertive colitis, Crohn’s disease) lining of the colon inflamed
        
        cause bloody
        diarrhea
- - - - Viral infection - Norovirus, rotavirus
      - Bacterial infection - Salmonella,Campylobacter, or Shigella sp; Escherichia coli;Clostridium difficile
      - Parasitic infection - Giardia sp, Entamoeba histolytica ,Cryptosporidia sp
      - Food poisoning - Staphylococci, Bacillus cereus,Clostridium perfringens
      - Drugs - Laxatives, magnesium-containing antacids, caffeine, antineoplastic drugs, many antibiotics, colchicine, quinine/quinidine, prostaglandin analogs, excipients (eg, lactose) in elixirs
  - - - Inflammatory bowel disease - Ulcerative colitis, Crohn disease
      - Surgery - Intestinal or gastric bypass or resection
      - Malabsorption syndromes - Celiac disease, pancreatic insufficiency ,Carbohydrate intolerance (particularly lactose intolerance)
      - Tumors - Colon carcinoma, lymphoma, villous adenoma of the colon
      - Endocrine tumors - Vipoma, gastrinoma, carcinoid, mastocytosis, medullary carcinoma
- - - - excessive amount of solute in intestinal lumen
        
        water retention in lumen
        
        osmotic diarrhea
        
        COLON : fermentation of undigested food
        
        Gas production
  - - - accelerate transit time
        
        Decrease absorption
        
        malabsorption
        
        Diarrhea
  - - - increase hydrostatic pressure
        
        decrease osmotic pressure
        
        increase permeability of small blood vessels in the lamina propria
        
        migration of fluid into intestinal lumen
        
        increase vagus activity, increase gut wall peristalsis
        
        Osmotic diarrhea.
    - - specialized columnar cells replaced by non-specialized cuboidal cells
        
        Decrease production of digestive enzyme
        
        less absorption -decrease glucose intake , decrease ATP production
        
        Malabsorption syndrome (undigested food) draws in water through osmosis
  - - - inhibiting epithelial Na+/K+-ATPase
        
        increase permeability
        
        increase intestinal water secretion > absorption capacity
        
        increase electrolyte transport
        
        decrease water reabsorption before reaching large intestine
        
        Secretory diarrhea
    - - inflammation (minimal/ severe)
        
        activation of WBC & cytokines
        
        secrete inflammatory mediators
        
        decreased secetion of chloride ion. stimulate secretion
        
        enterocyte damage and death
        
        Bloody diarrhea/ infectious diarrhea