DEFINITION The definition of chronic diarrhoea varies in the different references. The generally accepted definition is the frequent passage of stools (> 3 times per day) that are loose in consistency for a minimum duration of 4 weeks or more. The minimum duration of 4 weeks is set in order to exclude common infective causes of diarrhoea. The commonly accepted reference value for diarrhoea for the amount of stools passed per day is more than 200 g. it is important to note that it is just a rough guide as pathology in the distal colon may not increase the stool weight above 200 g / day. [clinical approach and management of CD] [evaluation of chronic diarrhoea] [guideline for the investigation of chronic diarrhoea, 2nd ed] It is important to determine whether or not the patient has faecal incontinence. If faecal incontinence is present, refer the patient to the surgery department. [clinical approach and management of CD] INCIDENCE There are no figures available for the incidence of chronic diarrhoea in the South African population. International figures suggest that the incidence is between 3 and 5 percent. [evaluation of chronic diarrhoea] CLASSIFICATION [what is the ebst approach for chronic diarrhoea] [evaluation of chronic diarrhoea] [guideline for the investigation of chronic diarrhoea, 2nd ed] PATHOLOGICAL FUNCTIONAL Urgency and cramping Urgency and cramping Nocturnal bowel movements – pathognomonic of pathological No awakening at night due to bowel movements Continuous diarrhoea Intermittent diarrhoea Significant weight loss Normal physical examination Fever Bleeding per rectum Greater stool volumes Smaller stool volumes Abnormal laboratory results No gross abnormalities on laboratory results New onset Known diarrhoea or sy... ... middle of paper ... ...e entails treating the symptoms and treating the cause. [clinical approach and management of CD] Empiric therapy is for chronic diarrhoea is warranted when one has a specific diagnosis in mind. It may only be given if the patient can be followed-up. [evaluation of chronic diarrhoea] NUTRITION The link between gastrointestinal disorders, especially pathological chronic diarrhoea, is strong. In cases of severe malnutrition chronic diarrhoea may persist due to impaired immune function and poor mucosal recovery. Thus it is of the utmost importance to address the nutrition as a part of the holistic management of the patient. Specialised nutritional support via enteral or parenteral routes may be required to boost caloric and / or micronutrient intake. It is important to refer the patient to a dietician as early as possible. [nutritional consequences of chronic diarrhoea]
The SMART goal for the patient’s diagnosis of diarrhea is that the patient will defecate formed, soft stool every 1 to 3 days and will express relief of cramping with little or no diarrhea. The intervention to meet this smart goal is the administration of fidaxomicin, a narrow spectrum antibiotic, to treat the infection of Clostridium difficile (Sears, 2013). Another nursing intervention for the treatment of diarrhea is assessing the patient for sodium and potassium loss, as well as explaining the prevention methods to avoid the spread of excessive diarrhea (Mitchell, 2014). The nurse must also provide proper skin integrity care to the peritoneal are and make the environment safe and easy for access to the bathroom. The SMART goal for the patient’s diagnosis of acute pain is that the patient will state relief of pain in abdominal area after treatment with opioids in a 24hr period. The nursing intervention for acute pain is the administration of opioids as well as positioning to keep patient in as much comfort as possible and take pressure off of the abdominal area. The nurse must also assess the patient’s vital signs and pain level
According to the article The mechanism and efficacy of probiotics in the prevention of Clostridium difficile-associated diarrhea there is a great concern about increasing incidence of C. difficile infection due to use of broad spectrum antibiotics. Clindamycin, third generation of cephalosporins and flouroquinolones are considered high risk antibiotics. It is believed that normal gastrointestinal flora has potential effect in inhibition C.difficile growth and toxin A,B release which offen associated with sever diarrhea resulting in patient’s mortality and other comorbidities. After first episode, there is a high chance for relapses due to reduction serum IgG antibodies to toxin A and colonic IgA secretion cells.
...tic patients with jaundice.” The authors concluded that their study demonstrated that supplemental enteral feedings provided no additional benefit to patients being treated for cirrhosis. Additionally, the authors argued that the risk of associated complications (e.g. infection, encephalopathy, bleeding) outweighed any benefit patients may receive through supplemental enteral feedings.
4. When to see a doctor. Most cases of watery stools improve within a few days to two weeks, especially if the baby remains well and active. However, in children with diarrhea, a serious complication is dehydra...
According to Rohike and Stollman (2012), fecal microbiotic transplantation (FMT) first was used in 1958, as a treatment option for patients with antibiotic-associated diarrhea. However, the procedure was rarely performed or used in medical practice in the United States and in other countries. Because of increasing incidences and severity of CDI, FMT has gain acceptance as a quick and inexpensive treatment option (Brandt, 2012) for recurrent CDI. FMT involves the instillation of fecal material from a healthy individual into the intestinal track of a patient with recurrent CDI. Fecal material can be administered via endoscopy and colon...
Patient says “The constant use of the bathroom for bowel movement has drastically decreased her sex drive, altered her social life, and is causing tension in her marriage
IBS is a functional GI disorder, meaning it cannot be explained by any specific structural or biochemical abnormality. The disorder is subdivided into three different types, which are named on the basis of the predominant symptom – IBS-D (diarrhea-predominant), IBS-C (constipation-predominant), IBS-M (mixed diarrhea and constipation). Clinical presentation varies considerably with regard to the quality of the predominant feature and the overall severity of symptoms. Formal diagnosis is based on the most recent Rome III criteria, which require that a patient experience recurrent abdominal discomfort of at least 3 days per month over the previous 3 months, with a total symptom duration of at least 6 months, in...
If symptoms are mild then they may not require specific treatment as the symptoms can clear up by itself. Certain foods may trigger diarrhoea and bloating. They should be given lifestyle and dietary advice. They should be advised to drink plenty of fluids and eat small amounts of food throughout the day. Patients should avoid high fibre foods such as bran, beans and nuts. They may also limit their intake of milk products if they are lactose intolerant. Finally they should avoi...
A person who has IBS can lead a normal life. One would think that with continual diarrhea that a person with IBS would lose weight, be malnourished, or that they would develop more serious digestive problems. However, these are very rare. Only in a very small number of cases does IBS become so disabling that it can interfere with a person’s normal activities. But some people withdraw from activities because the diarrhea or constipation bothers them. In such cases, doctors may recommend mental health counseling.
Di Lorenzo C. Approach to the child with constipation and encopresis. In: Rudolph CD, Rudolph MR (eds). Rudolph’s Pediatrics. United States of America: McGraw-Hill; 2002:1368-1370. 2.
When asked about his typical elimination pattern, the patient stated that he voids several times daily, and typically has one bowel movement per day. The patient denied any concerns nor expressed any problems regarding his usual pattern of bowel/bladder elimination. He also denied any symptoms such as pain, bleed, unusual appearance or pattern. Furthermore, he has previously experienced dysuria and hesitancy by record. No treatment regarding elimination is implied at this time. There were no labs drawn in respects to the patient’s fluid or electrolyte status.
MUST is a five-step screening tool designed for healthcare professionals to identify adult patients who at risk of, or are malnourished. It includes guidelines on how to develop an effective treatment plan. The Malnutrition Advisory Group (MAG) in 2000 adapted and extended their community screening tool to include care homes and hospitals, in response to national concerns. (Department of Health, 2001). In 2003 MUST was designed by MAG and the British Association for Parenteral and Enteral Nutrition (BAPEN). It was piloted across many care settings, to target patients who may be at risk of malnutrition.
In order to adequately discuss Cholera's impact on Zambia, Africa I will be providing an overview of the disease, discussing it's etiology, epidemiology, pathogenesis, and finally its prevention and treatment.
The disease, cholera, is an infection of the intestines, caused by the bacterium Vibrio cholerae. As stated in Microbes and Infections of the Gut, the bacterium is “a Gram-negative, comma- shaped, highly motile organism with a single terminal flagellum” (105). Cholera is characterized by the most significant symptom that presents with the disease, diarrhea, and victims can lose up to twenty liters of body fluids in a day. Cholera can be a serious disease, due to the serious dehydration that can occur, but it is only fatal if treatment is not administered as soon as possible. This research paper includes information on the causes of cholera, symptoms, ways of treatment, studies of treatments, complications that may occur, the tests and diagnosis for cholera, and finally, the ways the cholera bacterium may be transmitted.
Gastroenteritis, sometimes referred to as infectious diarrhoea is a common disease that affects millions of people annually. It is a disease caused by viruses, bacteria or parasites that enter the human body and spread, which induce symptoms such as vomiting, diarrhoea, abdominal pain and nausea. Although it is a common occurrence in society and is usually not harmful, cases of gastroenteritis in less developed countries may have more fatal repercussions due to their inability to access ample means of treatment. Over time, as more research was conducted into the disease, scientific developments were made to aid those affected by gastroenteritis and reduce the number of fatalities by educating people regarding preventative methods.