Diarrhea

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In medicine, diarrhea, also spelled diarrhoea (see spelling differences), refers to frequent loose or liquid bowel movements.

Although for many people diarrhea is merely unpleasant, diarrhea that is both acute and severe is a common cause of death in developing countries and a major cause of infant death worldwide. It is often due to gastroenteritis.

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Causes

This disease can have symptoms such as the runs, infection, allergy, food intolerance, foodborne illness and/or extreme excesses of Vitamin C and/or magnesium and may be accompanied by abdominal pain, nausea and vomiting. Temporary diarrhea can also result from the ingestion of laxative medications or large quantities of certain foods like prunes with laxative properties. There are other conditions which involve some but not all of the symptoms of diarrhea, and so the formal medical definition of diarrhea involves defecation of more than 200 grams per dayTemplate:Fact (although formal weighing of stools to determine a diagnosis is rarely actually carried out).

Diarrhea occurs when insufficient fluid is absorbed by the colon. As part of normal digestion, food is mixed with large amounts of water. The water is supplied, as needed, by the stomach and small intestine. The colon recovers this water, leaving the remaining material as a semisolid stool. If the colon is damaged or inflamed, however, absorption is inhibited, and watery stools result.

Diarrhea is most commonly caused by viral infections or bacterial toxins. In sanitary living conditions and with ample food and water available, an otherwise healthy patient typically recovers from the common viral infections in a few days and at most a week. However, for ill or malnourished individuals diarrhea can lead to severe dehydration and can become life-threatening without treatment.

Diarrhea can also be a symptom of more serious diseases, such as dysentery, Montezuma's Revenge, cholera, or botulism, and can also be indicative of a chronic syndrome such as Crohn's disease. Though appendicitis patients do not generally have diarrhea, it is a common symptom of a ruptured appendix. It is also an effect of severe radiation sickness.

Diarrhea can also be caused by dairy intake in those who are lactose intolerant.

Symptomatic treatment for diarrhea involves the patient consuming adequate amounts of water to replace that loss, preferably mixed with electrolytes to provide essential salts and some amount of nutrients. For many people, further treatment is unnecessary. The following types of diarrhea indicate medical supervision is required:

• Diarrhea in infants;
• Moderate or severe diarrhea in young children;
• Diarrhea associated with blood;
• Diarrhea that continues for more than two weeks;
• Diarrhea that is associated with more general illness such as non-cramping abdominal pain, fever, weight loss, etc;
• Diarrhea in travelers, since they are more likely to have exotic infections such as parasites;
• Diarrhea in food handlers, because of the potential to infect others;
• Diarrhea in institutions such as hospitals, child care centers, or geriatric and convalescent homes.

A severity score is used to aid diagnosis.^[1]

Types of diarrhea

There are at least four types of diarrhea: secretory diarrhea, osmotic diarrhea, motility-related diarrhea, and inflammatory diarrhea.

Secretory diarrhea

Secretory diarrhea means that there is an increase in the active secretion, or there is an inhibition of absorption. There is little to no structural damage. The most common cause of this type of diarrhea is a cholera toxin that stimulates the secretion of anions, especially chloride ions. Therefore, to maintain a charge balance in the lumen, sodium is carried with it, along with water.

Osmotic diarrhea

Osmotic diarrhea occurs when there is a loss of water due to a heavy osmotic load. This can occur when there is maldigestion (e.g., pancreatic disease or Coeliac disease), where the nutrients are left in the lumen, which pulls water into the lumen.

Motility-related diarrhea

Motility-related diarrhea occurs when the motility of the gastrointestinal tract is abnormally high. If the food moves too quickly, there is not enough time for sufficient nutrients and water to be absorbed. This can be due to a vagotomy or diabetic neuropathy, or a complication of menstruation.

Inflammatory diarrhea

Inflammatory diarrhea occurs when there is damage to the mucosal lining or brush border, which leads to a passive loss of protein-rich fluids, and a decreased ability to absorb these lost fluids. Features of all three of the other types of diarrhea can be found in this type of diarrhea. It can be caused by bacterial infections, viral infections, parasitic infections, or autoimmune problems such as inflammatory bowel disease.

Infectious diarrhea

Main article{{#if:|s}}: Infectious diarrhea{{#if:

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