DIARRHOEA & CONSTIPATION DIARRHOEA & CONSTIPATION

Diarrhoea

Diarrhoea is an increase in frequency or decrease in consistency (liquid or semisolid) of stoolDiarrhoea can be acute (less than 28 days) or chronicAcute 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 casesLong 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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