OIA2004 CONSTIPATION & DIARRHOEA

Diarrhoea

Faecal output >200g/day with loose or watery stools.

Acute Diarrhoea

Sudden onset, lasting 3 days to 2 weeks, usually self-limiting.

Chronic Diarrhoea

Persists for >3 weeks, often linked to underlying conditions.

Osmotic Diarrhoea

Caused by poorly absorbed solutes drawing water into the intestines.

Secretory Diarrhoea

Caused by increased intestinal secretion, often due to bacterial toxins.

Constipation

Fewer than 3 bowel movements per week or difficulty passing stools.

Idiopathic Constipation

No identifiable cause, often linked to diet and lifestyle.

Proximal Small Intestine

Absorbs iron, calcium, folate, fats, proteins, and carbohydrates.

Distal Small Intestine

Absorbs vitamin B12 and bile salts.

Colon

Responsible for water and electrolyte absorption.

Infectious Causes

Viruses (e.g., rotavirus), bacteria (e.g., Salmonella, E. coli, C. difficile), and parasites.

Medication-Induced Diarrhoea

Caused by laxatives, antibiotics, and statins.

Metabolic Causes

Hyperthyroidism, lactose intolerance.

Psychological Causes

Anxiety, stress.

Gastrointestinal Disorders

Irritable bowel syndrome (IBS), inflammatory bowel disease (IBD).

Stool Examination

Checks for bacteria, parasites, and blood.

Laboratory Tests

Includes full blood count (FBC), iron, folate, and B12 levels.

Imaging Studies

Colonoscopy, sigmoidoscopy, barium X-ray for chronic cases.

Rehydration Therapy

Oral rehydration solutions (ORS) to restore fluids and electrolytes.

Dietary Management

BRAT diet (Bananas, Rice, Applesauce, Toast).

Antimotility Agents

Loperamide, diphenoxylate slow gut motility.

Adsorbents

Activated charcoal binds toxins in the gut.

Probiotics

Lactobacillus, Saccharomyces boulardii restore gut microbiota.

Antibiotics

Used for bacterial infections like C. difficile.

Enkephalinase Inhibitors

Racecadotril reduces intestinal fluid secretion.

Signs of Dehydration

Sunken eyes, dry mouth, reduced urine output.

Severe Symptoms

Fever, blood in stool, weight loss.

Diarrhoea in Infants

Requires immediate medical attention.

Dietary Factors

Low fiber intake, inadequate water intake.

Medication-Induced Constipation

Opioids, anticholinergics, calcium supplements.

Endocrine & Metabolic Causes

Hypothyroidism, hypercalcemia.

Neurological Causes

Spinal cord injuries, multiple sclerosis.

Psychological Factors

Depression, eating disorders.

Gastrointestinal Disorders

Haemorrhoids, IBS.

Physical Examination

Abdominal distension, rectal exam.

Laboratory Investigations

Blood tests, imaging (X-ray, colonoscopy).

Non-Pharmacological Management

Exercise, increased fiber, increased water intake.

Laxative Therapy

Bulking Agents: Psyllium, ispaghula husk.

Stool Softeners: Liquid paraffin.

Osmotic Laxatives: Lactulose, polyethylene glycol.

Stimulant Laxatives: Bisacodyl, senna.

Prokinetic Agents: Tegaserod, prucalopride, linaclotide.

Haemorrhoids

Caused by straining during defecation.

Faecal Impaction

Severe blockage requiring manual removal or enemas.