diarrhea is a common symptom, commonly known as "diarrhea", which means that the frequency of defecation obviously exceeds the usual frequency, the fecal matter is thin, the water is increased, the daily defecation volume exceeds 2g, or it contains undigested food, pus and mucus. Diarrhea is often accompanied by symptoms such as urgency of defecation, anal discomfort and incontinence. Normal people have about 9L of liquid entering the gastrointestinal tract every day, and the water in the feces is only about 1 ~ 2 ml through the absorption of water by the intestine. If the amount of liquid entering the colon exceeds the absorption capacity of the colon or (and) the absorption capacity of the colon decreases, it will lead to an increase in the amount of water discharged from the feces, resulting in diarrhea. Clinically, according to the duration of the disease, diarrhea can be divided into acute and chronic types. Acute diarrhea is acute, and the course of disease is within 2 ~ 3 weeks, mostly caused by infection. Chronic diarrhea refers to recurrent diarrhea with a course of more than two months or an intermittent period of 2-4 weeks. The causes are more complicated and can be caused by infectious or non-infectious factors.

alias

diarrhea

Diarrhea

Clinic

Gastroenterology

Common causes

Bacterial virus infection, food poisoning, catching cold, intestinal inflammation, etc.

Common symptoms

When diarrhea occurs, the frequency of defecation increases and the character changes. Total increase

rapid

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diagnosis and treatment of clinical manifestations

etiology

1. Acute diarrhea

(1) Infection includes viruses (rotavirus, Norwalk virus, Coxsackie virus, echo virus, etc.) and bacteria (Escherichia coli, Salmonella, Shigella, Shigella dysenteriae and Vibrio cholerae).

(2) Poisoning food poisoning such as eating uncooked lentils, toadstool poisoning, puffer fish poisoning, heavy metal poisoning, pesticide poisoning, etc.

(3) laxatives, cholinergic drugs, digitalis drugs, etc.

(4) Other diseases: acute attack of ulcerative colitis, acute necrotizing enteritis, food allergy, etc.

2. Chronic diarrhea

The cause of chronic diarrhea is more complicated than acute diarrhea. Intestinal mucosal lesions, excessive bacterial reproduction in the small intestine, intestinal transport dysfunction, insufficient digestive ability, intestinal motility disorder, some endocrine diseases and extraintestinal tumors may all lead to chronic diarrhea. Diseases that can cause chronic diarrhea include:

(1) Intestinal infectious diseases ① Chronic amebic dysentery; ② Chronic bacterial diseases; ③ Intestinal tuberculosis; ④ pyriform flagelliasis and schistosomiasis; ⑤ Intestinal candidiasis.

(2) non-infectious intestinal inflammation ① inflammatory bowel disease (Crohn's disease and ulcerative colitis); ② Radiation enteritis; ③ Ischemic colitis; ④ diverticulitis; ⑤ Uremic enteritis.

(3) tumor ① colorectal cancer; ② adenomatosis of colon (polyp); ③ Malignant lymphoma of small intestine; ④ Amine precursor uptake decarboxylation cell tumor, gastrinoma, carcinoid tumor, intestinal vasoactive intestinal peptide tumor, etc.

(4) Small intestinal malabsorption ① Primary small intestinal malabsorption; ② Secondary intestinal malabsorption.

(5) Intestinal motility diseases such as irritable bowel syndrome

(6) Stomach and hepatobiliary and pancreatic diseases ① subtotal gastrectomy-gastrojejunostomy; ② Atrophic gastritis; ③ Chronic hepatitis; ④ Cirrhosis; ⑤ Chronic pancreatitis; ⑥ Chronic cholecystitis.

(7) Systemic diseases ① hyperthyroidism; ② Diabetes; ③ Chronic hypoadrenocortical function; ④ Systemic lupus erythematosus; ⑤ Nicotinic acid deficiency; ⑥ Food and drug allergy.

Clinical manifestations

1. Acute diarrhea

has an acute onset with a course of 2-3 weeks, which can be divided into watery diarrhea and dysentery-like diarrhea. The former does not contain blood or pus, but it is not accompanied by acute diarrhea and then severe abdominal pain. The latter has purulent bloody stool, often accompanied by acute diarrhea and abdominal cramps. Infectious diarrhea is often accompanied by abdominal pain, nausea, vomiting and fever, small intestine infection is often watery diarrhea, and large intestine infection often contains bloody stool.

2. Chronic diarrhea

Frequent defecation, defecation more than 3 times a day, thin or shapeless stool, fecal water content greater than 85%, sometimes accompanied by mucus and purulent blood, lasting more than two months, or recurrent diarrhea with intermittent period of 2 ~ 4 weeks. Patients with lesions located in rectum and/or sigmoid colon often have acute bowel movement and then severe bowel movements, and sometimes only a small amount of gas and mucus are discharged. The pink color is dark, mostly sticky and frozen, which can be mixed with blood. The abdomen is not suitable for both sides of the abdomen or the lower abdomen. Diarrhea caused by small intestinal lesions is characterized by abdominal discomfort mostly located around the umbilicus, which is aggravated after meals or before defecation. There is no urgency in the bowels, and the feces are shapeless, liquid, light in color and large in quantity. In patients with chronic pancreatitis and intestinal malabsorption, oil droplets, foam, food residue and foul smell can be seen in feces. Diarrhea caused by schistosomiasis, chronic dysentery, rectal cancer, ulcerative colitis, etc., often with pus and blood in feces. Irritable bowel syndrome and intestinal tuberculosis often alternate diarrhea and constipation. It may be accompanied by abdominal pain, fever, emaciation, abdominal mass and other symptoms due to different causes.