Diarrhoea

Diarrhoea is a gastrointestinal condition recognized by the frequent passage of loose and watery stools that can lead to excess water loss, malabsorption of nutrients, and electrolyte imbalances. Usually, diarrhoea is not a life-threatening disease, but prolonged symptoms may require medical attention to treat serious underlying reasons. 

1.0Types of Diarrhoea

1. Acute Diarrhoea: Diarrhoea that lasts for less than 2 weeks. It is commonly caused by infections, either viral, bacterial, or parasitic.
2. Chronic Diarrhoea: Diarrhoea that lasts more than 4 weeks. It is caused by underlying diseases such as inflammatory bowel disease (IBD), malabsorption syndromes, or chronic infections.
3. Osmotic Diarrhoea: Caused by undigested substances that draw water into the intestine, such as lactose intolerance.
4. Secretory Diarrhoea: Caused by toxins or inflammation that increase fluid secretion in the intestines; some examples include cholera and certain bacterial infections. 
5. Inflammatory Diarrhoea: Caused by inflammation of the intestines; for example, by Inflammatory bowel disease or infections with blood or pus in the stools.

2.0Causes of Diarrhoea: 

Causes of Diarrhoea can be many, some of them are as follows: 

Infectious Causes: 

• Bacterial infections: The most common cause of diarrhoea is a bacterial infection with common bacterial pathogens, including Salmonella, Escherichia coli (E. coli), Shigella, and Vibrio cholerae. 
• Viral Infections: Viruses also play an important role in the spreading of gastrointestinal diseases like diarrhoea. Viruses such as norovirus and enteric adenovirus are some examples of such viruses. 
• Parasitic Infections: Protozoans such as Giardia and Entamoeba histolytica are the ones that can lead to diarrhoea. 

Non-Infectious Causes: 

• Increased Intestinal Activity: Conditions like inflammation in the gut can lead to increased peristaltic movements. This increased movement causes faster transit of nutritional content to the intestine, leaving a short time for better absorption of nutrients and electrolytes from the food. As a result, more water reaches the colon (part of the large intestine), which causes diarrhoea. 
• Impaired Absorption: Certain gastrointestinal conditions such as inflammatory bowel disease (IBD) or celiac disease, inflammation, or damage to the intestinal lining decrease the absorption capacity of the gastrointestinal system, leading to conditions like Diarrhoea.
• Bile Salt Malabsorption: When bile salts are not absorbed properly, either because of liver dysfunction or diseases such as Crohn's disease, they remain in the intestine, especially in the colon. Bile salts are irritants to the colon, which increases fluid secretion and motility, leading to diarrhoea.

3.0Symptoms of Diarrhoea: 

• Frequent loose stools
• Abdominal cramps and bloating
• Nausea or vomiting
• Dehydration symptoms (for example, dry mouth, dark urine, dizziness).
• Fever (in certain infections)
• Blood or mucus in stools (in cases of bacterial or inflammatory causes).

4.0Prevention and Treatment of Diarrhoea:

Diarrhoea Treatment: 

1. Rehydration:

• The best treatment for diarrhoea is rehydration to prevent dehydration.
• Salt and glucose-containing ORS can regain the lost electrolytes.

2. Diarrhoea Medicines:

• Anti-diarrhoeal medications: These decrease the frequency of stool with symptoms. Some commonly used drugs are:
• Loperamide is an anti-motility agent that slows intestinal movement.
• Bismuth subsalicylate inhibits inflammation and fluid secretion.
• Antibiotics: It's prescribed, only for specific bacterial infections or the causative pathogens like Shigella or Salmonella.
• Probiotics: Assist in the restoration of normal gut flora, especially after antibiotic use or in cases of viral diarrhoea.

3. Dietary Management:

• BRAT Diet (Bananas, Rice, Applesauce, Toast) to help reduce irritation in the intestines.
• Avoid fatty, spicy foods or dairy products during recovery.

Diarrhoea Prevention: 

• Hand Hygiene: Most of the pathogenic bacteria, viruses, and protozoans are spread via unhygienic hands. Frequent hand washing to prevent infections from these bacteria and viruses.
• Safe drinking water: Water sources should be clean to avoid waterborne pathogens such as cholera.
• Proper Food Handling: Avoid undercooked meats and unwashed fruits and vegetables.
• Vaccination: Some of the types of diarrhoea are vaccinable; for instance, there is the rotavirus vaccine.
• Managing Stress: For those with Irritable Bowel Syndrome(IBS) or stress-induced diarrhoea, practising stress-reduction techniques such as meditation can help prevent symptoms.

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