Diarrhea

Diarrhea according to its duration is classified as acute diarrhea (duration less than 4 weeks) or chronic (when it lasts more than 4 weeks). Let's know how it occurs, what its symptoms are and how to prevent it.

How is it produced?

The most frequent causes of acute diarrhea are infectious, that is, caused by viruses, bacteria, parasites or fungi. It is what is known as acute gastroenteritis. Non-infectious causes include drug use (for example antibiotics), food offenses, chemotherapy, radiation therapy, food intolerances and some digestive diseases (such as appendicitis).

The causes of chronic diarrhea are very numerous and include many digestive diseases such as Crohn's disease and celiac disease, pancreatic diseases, autoimmune diseases, neurological diseases, diseases of the thyroid gland (hyperthyroidism) and abuse of laxatives, among others.

Symptoms

Diarrhea is a symptom easily identifiable by anyone. There is an increase in the number of stools and, depending on the causative disease, it may be accompanied by fever, vomiting, abdominal pain, perirectal burning, feeling tenesmus, swelling, meteorism or emission of blood, mucus or pus along with the stool.

In acute diarrhea the picture is of abrupt onset and usually lasts between 3-7 days. Special attention must be paid to the so-called risk patients in whom medical care and surveillance must be closer, such as the elderly, infants, children, the chronically ill and the immunosuppressed.

The most common complication of diarrhea is dehydration caused by excessive loss of fluids and electrolytes that can lead to a state called shock (circulatory collapse due to lack of fluids) that requires urgent treatment with fluids and progressive electrolyte replacement.

Diagnosis

Acute diarrhea does not require tests other than symptoms and medical history. In the cases that the doctor considers pertinent, a stool culture may be indicated

(stool culture) to rule out certain infections, a blood test, and an abdominal X-ray.

A physical examination of the patient should also be performed to determine if there are signs of dehydration or any alarming symptoms.

In chronic diarrhea, the study of its cause requires other complementary examinations. Diagnosis must include a detailed medical history, physical examination of the patient, laboratory tests and other complementary examinations aimed at understanding the underlying disease.

The following tests may be required:

• General analysis (including blood count, thyroid hormones, blood electrolytes and markers of inflammatory diseases).
• Stool culture for the study of infectious agents in feces.
• , gastroscopy and taking biopsies (intestinal tissue samples) that allow the study by direct vision of the digestive tract.
• Barium enema and abdominal ultrasound.
• Tests to rule out intolerance to certain products (such as fructose, lactose and sorbitol) and a malabsorption test.
• Rectal manometry to rule out malfunction of the rectal sphincter (muscle), especially in cases of significant anal incontinence.

Treatment

In acute diarrhea, treatment is aimed at providing adequate fluid and electrolyte intake. Rehydration is based on the restitution of the amount of water, glucose and electrolytes that are lost due to diarrhea and is the first measure to take once diagnosed. There are different oral rehydration formulas for sale in pharmacies. In cases of severe dehydration, hospitalization and intravenous administration of fluids may be required.

In mild cases, oral rehydration with fluids (serum, sports drinks that are rich in electrolytes) is sufficient, drinking in small quantities, continuously. It is advisable not to take solid foods for approximately 12 hours and when you improve, start a soft diet. Foods prohibited during diarrhea include: stews, fried, cold cuts and fats, veget fiber

al, sweets, milk, coffee and orange juice.

In some types of acute infectious diarrhea (bacteria, parasites) antibiotic treatment is indicated.

In cases of chronic diarrhea, treatment will depend on the underlying disease that causes it. antibiotics, special diets and nutritional supplements, corticosteroids, immunosuppressants, and even surgical treatment may be required (especially if there are complications). In addition, during episodes of diarrhea, adequate rehydration must be carried out.

Prevention

Most of the acute diarrhea of ​​infectious causes are transmitted by the lack of hygiene. For its prevention, proper handling of food is recommended, hand washing after using the bathroom and only drinking properly bottled water in areas where there is a risk of infection.

It includes a complete Preventive Medicine Program aimed at taking care of your health (consultation, exploration and tests carried out by a specialist who will offer you an assessment of your state of health and recommendations for taking care of yourself.

Intensive Medicine Specialist