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CHEM PATH:DIARRHEA - Coggle Diagram
CHEM PATH:DIARRHEA
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Osmotic
Lactose Intolerance-dissaccharide(galactose+glucose) , lack of lactase >unabsorbed sugars >lactose osmotic active>can pull fluid=diarrhoea/bloating
Anything that is not absorbed(partially digested) that is osmotic active in gut lumen>pull H20 by osmosis to maintain intraluminal osmolality , since small intestines can't maintain osmotic gradient
Unabsorbed laxative(lactulose,MgSO4, impaired digestion(lactase deficiency),impaired absorption
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Secretory vs Osmotic
Osmotic diarrhea improves after administering IV Fluids, stopping oral intake.Secretory diarrhea persists
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Osmolar gap>100=osmotic diarrhea , Osmolar gap<100=secretory diarrhea
Secretory
All infective diarrhea are secretory(cholera-choleratoxin acts in enterocyte>activates adenylyl cyclase>↑cAMP>Opens CFTR channels>↑Cl>Na& H20 follow) , irritant laxatives', rotavirus, malabsorption of bile salts &vasoactive intestinal peptide(stimulate secretion by epithelial cells)
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Acute:no longer than 14 days , Chronic:longer than 14 days
Lactose intolerance
Diagnosis
self test(exclude lactose from diet), Lactose tolerance test(pt given 50g of lactose),Hydrogen breath test(lactose ends up in colon>broken down by bacteria>H+ produced),stool reducing substances on thin layer chorography(tests sugars-tells you what is unabsorbed)
Treatment
Avoid dairy
Take lactase orally with dairy