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group_1_presentation_3_-_global_burden_of_disease_diarrhoeal_disease [2017/04/07 19:50] wardhaw |
group_1_presentation_3_-_global_burden_of_disease_diarrhoeal_disease [2018/01/25 15:18] (current) |
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| ====Diarrheal Disease==== | ====Diarrheal Disease==== | ||
| - | Diarrhea is characterized by an increase in the volume of stool or frequency of defecation. It is typically one of the most common symptom of gastrointestinal disease, but it may also reflect disorders outside the digestive system. There are four main mechanisms through which the disease manifests itself. | + | Diarrhea is characterized by an increase in the volume of stool or frequency of defecation. It is typically one of the most common symptom of gastrointestinal disease, but it may also reflect disorders outside the digestive system. There are four main mechanisms through which the disease manifests itself (Bailen, n.d.). |
| ===1. Osmotic Diarrhea=== | ===1. Osmotic Diarrhea=== | ||
| - | When excessive amounts of insoluble solutes are retained in the intestinal lumen, water is not reabsorbed and diarrhea will occur. Electrolyte absorption (K, Ca, Na) is unaffected by the presence of the solutes, thus stool water contains very little unabsorbed sodium and potassium. Osmotic diarrhea occurs due to two main reasons: | + | When excessive amounts of insoluble solutes are retained in the intestinal lumen, water is not reabsorbed and diarrhea will occur. Electrolyte absorption (K, Ca, Na) is unaffected by the presence of the solutes, thus stool water contains very little unabsorbed sodium and potassium (Bowen, 2006). Osmotic diarrhea occurs due to two main reasons: |
| *Ingestion of poorly absorbed substance - the molecule is typically a carbohydrate or divalent ion. Examples include: mannitol, sorbitol, epson salt, etc | *Ingestion of poorly absorbed substance - the molecule is typically a carbohydrate or divalent ion. Examples include: mannitol, sorbitol, epson salt, etc | ||
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| ===2. Secretory Diarrhea=== | ===2. Secretory Diarrhea=== | ||
| - | Secretory Diarrhea is caused by abnormal ion transport in the intestinal epithelial cells, which results in a decrease of the absorption of electrolytes. Typically, large amounts of water is secreted in the small intestine, where it will be reabsorbed before it reaches the large intestine. When the electrolyte balance is overthrown, diarrhea occurs in which large amounts of water is able to reach the large intestine and be excreted. | + | Secretory Diarrhea is caused by abnormal ion transport in the intestinal epithelial cells, which results in a decrease of the absorption of electrolytes. Typically, large amounts of water is secreted in the small intestine, where it will be reabsorbed before it reaches the large intestine. When the electrolyte balance is overthrown, diarrhea occurs in which large amounts of water is able to reach the large intestine and be excreted (Bailen, n.d.; Bowen, 2006). |
| Exposure to toxins and several types of bacteria (ie. E.coli and V. cholerae) induces the prolonged opening of calcium ion channels in the intestine, which is responsible for mediating the secretion of water. The prolonged opening causes off-balance of the ion concentration between the lumen and interstitial space. In addition to bacteria, the following agents are also able to induce secretory diarrhea: | Exposure to toxins and several types of bacteria (ie. E.coli and V. cholerae) induces the prolonged opening of calcium ion channels in the intestine, which is responsible for mediating the secretion of water. The prolonged opening causes off-balance of the ion concentration between the lumen and interstitial space. In addition to bacteria, the following agents are also able to induce secretory diarrhea: | ||
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| ===3. Inflammatory Diarrhea === | ===3. Inflammatory Diarrhea === | ||
| - | Inflammatory Diarrhea occurs when the gastrointestinal barrier of the intestines, composed of epithelial cells with tight junctions, is breached by bacterial or viral pathogens. The destruction of the epithelium results in excretion of serum and blood into the lumen, in addition to disrupting the absorption processes. Due to the large influx of serum and blood into the lumen, the immune system releases white blood cells which stimulate the release of cytokines and inflammatory mediators, which further contributes to the lack of reabsorption. Some common pathogens include: | + | Inflammatory Diarrhea occurs when the gastrointestinal barrier of the intestines, composed of epithelial cells with tight junctions, is breached by bacterial or viral pathogens. The destruction of the epithelium results in excretion of serum and blood into the lumen, in addition to disrupting the absorption processes. Due to the large influx of serum and blood into the lumen, the immune system releases white blood cells which stimulate the release of cytokines and inflammatory mediators, which further contributes to the lack of reabsorption (Bowen, 2006). Some common pathogens include: |
| *Bacteria: Salmonella, E. coli, Campylobacter | *Bacteria: Salmonella, E. coli, Campylobacter | ||
| *Viruses: rotaviruses, coronaviruses, parvoviruses (canine and feline), norovirus | *Viruses: rotaviruses, coronaviruses, parvoviruses (canine and feline), norovirus | ||
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| ===4. Deranged Motility Diarrhea=== | ===4. Deranged Motility Diarrhea=== | ||
| - | Deranged Motility Diarrhea occurs when the intestinal contents are accelerated through the intestine, bypassing the mucosal epithelium and decreasing the contact time at the absorptive cells. Slow motility may also results in diarrhea, as the intestinal stasis can contribute to increased bacterial growth. | + | Deranged Motility Diarrhea occurs when the intestinal contents are accelerated through the intestine, bypassing the mucosal epithelium and decreasing the contact time at the absorptive cells. Slow motility may also results in diarrhea, as the intestinal stasis can contribute to increased bacterial growth (Bowen, 2006). |
| ====== Diagnosing CAD ====== | ====== Diagnosing CAD ====== | ||
