Please enable JavaScript.
Coggle requires JavaScript to display documents.
DIARRHOEA - ACUTE (Assessment (Onset, duration, frequency, severity., Red…
DIARRHOEA - ACUTE
Assessment
Onset, duration, frequency, severity.
Red flags - blood in stool, weight loss, recent hospital admission or antibiotic, dehydration, nocturnal symptoms.
Underlying causes - quantity & chart stools. Features of suspected infection fver, vomiting, travel abroad, stress/anxiety. exposure to animals, eating out. Changes to medication. Abdominal pain - IBD, IBS, colitis. Changes to diet. Any abdomial or GI surgery.
Observations - BP, temp, pulse, rr, O2 sats. Abdominal exam, PR exam.
Admission
The person is vomiting and unable to retain oral fluids, or
They have features of severe dehydration or shock
Older age (people 60 years of age or older are more at risk of complications).
Home circumstances and level of support.
Fever.
Bloody diarrhoea.
Abdominal pain and tenderness.
Increased risk of poor outcome, Coexisting medical conditions — immunodeficiency, lack of stomach acid, inflammatory bowel disease, valvular heart disease,
diabetes mellitus, renal impairment, rheumatoid disease, systemic lupus erythematosus.
Drugs — immunosuppressants or systemic steroids, proton pump inhibitors, angiotensin-converting enzyme inhibitors, diuretics.
Management
Send stool sample if indicated - suspected .diff, recent antibiotic therapy, blood or pus in stool or recent foreign travel. Self care advice on fluids if suspected viral.
Consider bloods if ongoing diarrhoea.
Defnition
Diarrhoea is a symptom, of which there are many causes.
Many different definitions of diarrhoea have been suggested, but the World Health Organization defines diarrhoea
as 'the passage of three or more loose or liquid stools per day (or more frequent passage than is normal for the individual)' [WHO, 2017].
Acute diarrhoea is defined as lasting for less than 14 days.
Persistent diarrhoea is defined as lasting more than 14 days.
Chronic diarrhoea is defined as lasting for more than 4 weeks .
Referral
Refer adults using a suspected cancer pathway referral (for an appointment within 2 weeks) for colorectal cancer if:They are aged 40 and over with unexplained weight loss and abdominal pain, or
They are aged 50 and over with unexplained rectal bleeding, or
They are aged 60 and over with iron deficiency anaemia or changes in their bowel habit, or tests show occult blood in their faeces.
Refer if the diagnosis remains uncertain after a primary care assessment