What Is Sialorrhea?

Diarrhea is a common symptom, commonly known as "diarrhea", which means that the frequency of defecation significantly exceeds the frequency of weekday habits, thin stools, increased water content, daily defecation volume exceeds 200g, or undigested food or pus, blood, mucus . Diarrhea is often accompanied by urgency to defecate, anal discomfort, and incontinence. Normally, about 9L of liquid enters the gastrointestinal tract every day, and the water in the feces is only about 100-200ml through the absorption of water by the intestine. If the amount of fluid entering the colon exceeds the absorption capacity of the colon or (and) the absorption capacity of the colon decreases, it will result in an increase in the amount of water excreted in the stool and diarrhea. According to the clinical course, diarrhea is divided into acute and chronic types. The onset of acute diarrhea is rapid, and the course of disease is within 2 to 3 weeks, most of which are caused by infection. Chronic diarrhea refers to recurrent diarrhea with a course of more than two months or an interval of 2 to 4 weeks. The cause is more complicated and can be caused by infectious or non-infectious factors.

Basic Information

nickname: Diarrhea
English name: diarrhea
Visiting department: Gastroenterology

Common causes: Bacterial virus infection, food poisoning, cold, etc., intestinal inflammation, etc.
Common symptoms: Increased bowel movements during diarrhea, altered traits, and increased total

Causes of diarrhea

Acute diarrhea

(1) Infection Includes viruses (rotavirus, norovirus, coxsackie virus, echo, etc.), bacteria (coli, salmonella, shigella, dysentery, vibrio cholerae) or parasites ( Intestinal infections caused by amolytic histoplasma, flagellate piriformis).

(2) Poisoning Food poisoning such as eating undercooked lentils, mushroom poisoning, pufferfish poisoning, heavy metal poisoning, pesticide poisoning, etc.

(3) Drugs Laxatives, cholinergic drugs, digitalis drugs, etc.

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

2. Chronic diarrhea

The cause of chronic diarrhea is more complicated than acute. The lesions of the intestinal mucosa, excessive reproduction of bacteria in the small intestine, defective intestinal transport function, insufficient digestive capacity, intestinal movement disorders, and certain endocrine diseases and extra-intestinal tumors may cause chronic diarrhea. occur. Diseases that can cause chronic diarrhea include:

(1) Intestinal infectious diseases chronic amoebic dysentery; chronic bacterial diseases; intestinal tuberculosis; piriformis and schistosomiasis; intestinal candidiasis.

(2) Non-infectious intestinal inflammation Inflammatory bowel disease (Crohn's disease and ulcerative colitis); Radiation enteritis; Ischemic colitis; diverticulitis; Uremic enteritis.

(3) Tumors colorectal cancer; adenoma of the colon (polyp); malignant lymphoma of the small intestine; amine precursor uptake decarboxycytoma, gastrinoma, carcinoid, intestinal vasoactive intestinal peptide tumor, etc.

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

(5) Intestinal motility diseases such as irritable bowel syndrome

(6) Stomach and hepatobiliary and pancreatic diseases Major resection of the stomach-gastrojejunostomy; Atrophic gastritis; Chronic hepatitis; Cirrhosis; Chronic pancreatitis; Chronic cholecystitis.

(7) Systemic diseases Hyperthyroidism; Diabetes; Chronic adrenal insufficiency; Systemic lupus erythematosus; Niacin deficiency; Food and drug allergies.

Clinical manifestations of diarrhea

Acute diarrhea

The onset is acute and the course of disease is within 2 to 3 weeks. It can be divided into watery diarrhea and dysentery-like diarrhea. The former does not contain blood or pus, but it can be severe without abdominal pain and mild abdominal pain. Colic in the abdomen. Infectious diarrhea is often accompanied by abdominal pain, nausea, vomiting, and fever. Small bowel infections are often watery diarrhea, and large bowel infections often include bloody stools.

2. Chronic diarrhea

Increased stool frequency, defecation more than 3 times a day, stools are thin or not formed, fecal water content is greater than 85%, sometimes accompanied by mucus, pus and blood, lasting more than two months, or intermittent recurrence within 2 to 4 weeks diarrhea. Patients with lesions in the rectum and (or) sigmoid colon often have acute and severe symptoms, with a small amount of defecation, sometimes only a small amount of gas and mucus, dark pink, mostly sticky, mixed with blood, abdominal discomfort on both sides of the abdomen or lower abdomen . Small bowel disease caused by diarrhea is characterized by abdominal discomfort mostly located around the umbilicus, and intensified after meals or before the stool, after the anxiety, heavy stools, can not be formed, can be liquid, lighter, and more. Chronic pancreatitis and small intestinal malabsorption, oil droplets, foamy, food residues, and foul odor are seen in the stool. Diarrhea caused by schistosomiasis, chronic dysentery, rectal cancer, ulcerative colitis and other diseases. Feces often carry pus and blood. Irritable bowel syndrome and intestinal tuberculosis often have alternating diarrhea and constipation. Depending on the cause, it may be accompanied by abdominal pain, fever, weight loss, and abdominal mass.

Diarrhea check

1. Blood routine and biochemical examination

Learn about anemia, increased white blood cell count, diabetes, and electrolyte and acid-base balance.

2. stool test

The most important step in diagnosing the cause of acute and chronic diarrhea during fresh stool examination is to find red and white blood cells, phagocytic cells, protozoa, worm eggs, fat droplets, and undigested food. The occult blood test can detect bleeding. Fecal culture can detect pathogenic microorganisms.

3.X- ray inspection

X-ray barium examination and plain abdominal film can show gastrointestinal disease, intestinal dynamics and so on.

4. Selective angiography and CT examination

It is especially valuable for the diagnosis of digestive system tumors such as liver cancer and pancreatic cancer.

5. Endoscopy and biopsy

Endoscopy has important diagnostic value for intestinal tumors and inflammatory lesions. Mucosal biopsy can help detect early malignancies, precancerous lesions, and certain parasites.

6. Small intestine absorption function test

The absorption function of the small intestine can be understood by methods such as faecal fat measurement, bile salt absorption test, vitamin B ₁₂ absorption test, and d-xylitol absorption test.

7. Determination of gastrointestinal hormones and chemicals in serum and urine

It has important diagnostic value for the judgment of various gastrointestinal neuroendocrine tumors.

Diarrhea diagnosis

The key to the diagnosis of diarrhea is the diagnosis of the primary disease or cause. It needs to be based on the onset and duration of the disease, the age of onset, the population affected, the number of diarrhea and the nature of the stool, accompanying symptoms and signs, routine tests, especially stool tests.

Acute diarrhea should be based on medical history, onset season, and accompanying systemic symptoms. First, identify whether it is infectious diarrhea caused by viruses, bacteria, parasites, etc., or diarrhea caused by food poisoning, drugs, or other diseases. The identification of pathogenic bacteria depends on fecal culture, and some parasites, such as Giardia, require intestinal mucosal biopsy.

Chronic diarrhea can be diagnosed through medical history, physical examination, digital anal examination, routine stool culture and worm eggs and parasites, stool fat measurement, digestive endoscopy and biopsy. First, it should be clear whether diarrhea originates from the small intestine or the colon.

For small intestinal diarrhea, a barium meal examination, enteroscopy, and other laboratory tests should be performed to determine whether it is organic or functional. In the case of colonic diarrhea, a colonoscopy should be performed to observe the presence of tumors, ulcerative colitis, and Crohn's disease.

Diarrhea Treatment

Etiology and symptomatic treatment are important. Before the cause is unclear, painkillers and antidiarrheal drugs should be used with caution, so as not to cover up the symptoms and cause misdiagnosis and delay the illness.

Cause treatment

(1) Anti-infective treatment According to different causes, the corresponding antibiotics are selected.

(2) Others If dairy products are not suitable for lactose intolerance, celiac disease in adults should be fasted to wheat products. Chronic pancreatitis can be supplemented with a variety of digestive enzymes. Drug-related diarrhea should be discontinued immediately.

Symptomatic treatment

(1) General treatment Correct water, electrolyte, acid-base balance disorders and nutritional imbalances. Supplement fluids as appropriate, supplement vitamins, amino acids, fat emulsions and other nutrients.

(2) Mucosal protective agent Dioctahedral montmorillonite, sucralfate, etc.

(3) Microecological preparations such as bifidobacteria can regulate the intestinal flora.

(4) Antidiarrheal agent Select the appropriate antidiarrheal agent according to the specific situation.

(5) Other 654-2, bromoproline, atropine, etc. have antispasmodic effect, but be used with caution in glaucoma, prostatic hypertrophy, and patients with severe inflammatory bowel disease.