Diarrhoea & constipation

Diarrhoea

  • Diarrhoea is an increase in frequency or decrease in consistency (liquid or semisolid) of stool
  • Diarrhoea can be acute (less than 28 days) or chronic
  • Acute diarrhea are mostly infectious in origin and are self limiting and are treated by oral and Intravenous fluids, and use of antibiotics and ant parasitic agents in selected cases
  • Long standing diarrhoea are caused by diseases of small and large intestine and pancreatic insufficiency

Small intestinal causes of diarrhea

  • Celiac disease
  • Troipcal sprue
  • Giardiaisis and other parasitic infections
  • Whipple disease
  • Small bowel tuberculosis
  • Small bowel Crohn’s disease
  • Chronic variable immunodeficiency and other immune deficiencies
  • Small intestinal bacterial overgrowth

Large bowel causes of diarrhea

  • Ulcerative colitis
  • Crohn’s disease
  • Microscopic colitis
  • Colonic malignancies
  • Lymphoma
  • Radiation colitis
  • Ischemic colitis
  • Pancreatic disorders
  • Chronic pancreatitis
  • Cystic fibrosis
  • Other causes include excessive secretion due to various endocrinological causes

Diagnosis

  • Diagnosis requires evaluation of stool, blood tests, endoscopy, colonoscopy and biopsies. Therapy is targeted at specific etiology.

Constipation

Constipation is decrease in frequency of stool (less than one stool in 3 days) or change form normal stool frequency for a particular individual

Common causes of constipation are

  • Slowness of bowel movement
  • Hypothyroidism
  • Diabetes mellitus
  • Hypercalcemia
  • Hypokalemia
  • Side effect of certain medications
  • Obstructing lesion in colon such as large polyp or malignancy
  • Anal fissure

Evaluation

  • Evaluation requires blood testing, and colonoscopy and cross sectional imaging and anal manometry

Treatment

  • Treatment is targeted at specific etiology

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