379755
Acute Diarrhoea
- Causes
- COMMON: infective, Drugs, Food
poisoning, Pseudomembranous
colitis, colitis(inflammatory)
Annotations:
- PSEUDOMEMBRANOUS COLLITIS; ~up to 50% mortality ~antibiotic associated ~diagnose by finding Clostridium difficile toxins in stool ~20% ascending colon only ~treatment: METRONIDAZOLE/VANCOMYCIN Relapse occurs up to 20% and treated with oral vancomycin
- UNCOMMON: inflammatory bowels disease,
ischaemic colitis, diverticular change
- RARE: colon cancer
- COMMON: infective, Drugs, Food
poisoning, Pseudomembranous
colitis, colitis(inflammatory)
- occur in less than 48 to 72
hours (2 to 3 days)
- History
- 1)travel, contacts, food (sexual history) 2) recent
medication: C.difficle toxin (2days - 1mnth)
- 1)travel, contacts, food (sexual history) 2) recent
medication: C.difficle toxin (2days - 1mnth)
- Examinations
- 1)state of hydration 2)volume depleted(even
in young) with tachycardia and postural
hypertension. 3)infective cause, may present
in severe collitis .4) abdominal examinations
5)sigmoidoscopy and rectal biopsy
Annotations:
- Abdominial examinations may reveal non-specific tenderness. Sig and rectal b mayb useful but does not distinguis btwn various cases
- SIGNS OF CHRONIC:
1)clubbing, 2)koilonychia
3)leukonychia 4)mouth ulcers
5)weight loss
- 1)state of hydration 2)volume depleted(even
in young) with tachycardia and postural
hypertension. 3)infective cause, may present
in severe collitis .4) abdominal examinations
5)sigmoidoscopy and rectal biopsy
- investigations
- a) blood test: 1)FBC; anaemia or thrombocytosis suspect its chronic.
Low albumin tells severity but non-specific. 2)stool culture presence of
toxin c.difficile 3) plain abdominal x-ray(show acute collitis
Annotations:
- C. difficile bacteria are found 5% in normal individual. diagnosis therefore requires appropriate SYMPTOMS rather than the organisms alone!
- a) blood test: 1)FBC; anaemia or thrombocytosis suspect its chronic.
Low albumin tells severity but non-specific. 2)stool culture presence of
toxin c.difficile 3) plain abdominal x-ray(show acute collitis
- Management
- 1)rehydration- resting the gut and rehydrate
2)treat underlying cause: antibiotics or steroids
is used with known pathogen
- 1)rehydration- resting the gut and rehydrate
2)treat underlying cause: antibiotics or steroids
is used with known pathogen
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