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
...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.
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...
...Crohn's Disease: Comparative Effectiveness” [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2014 Feb. (Comparative Effectiveness Reviews, No. 131.) Introduction. Available from: http://www.ncbi.nlm.nih.gov/books/NBK192950/
An article published in Lancet in 1989 by Bennet and Brinkman, reported the first use of FMT for treatment of Irritable Bowel Disorder. Bennet was diagnosed with UC himself and performed a trial of self-transplanted donor stool by retention enema. He would take the stool and reconstitute it with saline in order to be administered through an enema. Three months later colon biopsies showed improvement in inflammation and he remained symptom free for six months (Clinical and Experimental Gastroenterology, 2015). There
Uncontrolled diarrhea, that is, increased number of stools, increased stool water, and/or decreased form that is not contained by the diaper- until diarrhea
Sephton (2009) discusses an overview of severe ulcerative colitis, along with assessments, medical management, and nursing care. Ulcerative colitis is an inflammation in the mucosal layer of the colon. Ulcerative colitis has characteristics of watery diarrhea with blood, mucus, or pus. Treatment usually depends on the extent and severity of the disease. Mild to moderate ulcerative colitis is treated with 5-aminosalicylic acid. Corticosteroids can be used for patients who relapse or do not respond well to the 5-aminosalicylic acid treatment. Azathioprine or 6-mercaptopurine are immunosuppressive drugs that are used when the disease becomes steroid dependent. For patients with severe ulcerative colitis, intravenous corticosteroids during a hospital stay are used.
Interventions: Measure intake and output to make sure patient is voiding efficiently. Running warm water over perineal area to stimulate urination (Lowdermilk, Perry, Cashion & Alden,
A 57-year-old female presents to her physician with changes in her bowel habits for the past few weeks. The patient reveals that she usually has soft bowel movements once a day. However, she has started passing pellet-like stools that alternate with loose stools. Her current symptoms are associated with sense of bloating and abdominal fullness. The patient denies seeing blood in her stool, weight loss, low-grade fever, a family history of colorectal cancer, or previous colon cancer screening. Abdominal examination reveals normal bowel sounds, no tenderness to palpation, and no evidence of a mass. Rectal examination is normal, and stool is negative for occult blood. Which of the following is the most appropriate next step in the management of
Such diet involves frequent meals (at least five times a day). In addition, the diet during the Crohn’s disease includes less amount of fat and carbohydrate food, but more proteins (up to one hundred and fifty grams per day). The amount of fat in the diet should be reduced to the lowest possible dose (seventeen grams per day). The amount of carbohydrate food should also be reduced to a minimum (two hundreds and fifty grams per day). There is a norm according to the use of the salt – it is not more than eight grams per day. If a person suffers from the Crohn’s disease, it is important to put into his/her menu more foods, which contain potassium and calcium. Calcium will not allow the bones become brittle and reduce inflammation. People who suffer from Crohn’s disease may drink up to two liters per day – that is more than enough. The diet does not include the dishes and foods that provoke fermentation in the intestine and stomach.
A randomized trial of ondansetron for the treatment of irritable bowel syndrome with diarrhea, was a two-centre, double-blind, placebo controlled crossover study of ondansetron 4 mg/tablet versus placebo. The inclusion criteria of the study were age 18–75 years, IBS-D patients meeting the Rome III criteria, women of childbearing age should agree to have contraception during the study, no evidence of inflammatory bowel disease/microscopic colitis and able to give informed consent. The exclusion criteria were pregnancy or br...
Could you imagine not feeling good, day to day? Could you imagine not being able to eat what you want to eat because it will cause your stomach to flare up? Or even to keep running back and forth to the bathroom? Living with Crohn’s disease has those effects on the people who are living with it. According to Medicine Net, “Crohn's disease is a chronic inflammatory disease, primarily involving the small and large intestine, but which can affect other parts of the digestive system as well. Abdominal pain, diarrhea, vomiting, fever, and weight loss are common symptoms”. People that live with Crohn’s are living with a daily struggle. It’s important that they’re familiar with this disease, which includes knowing the cause, symptoms, complications and treatments.
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.
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.