bacterial diarrhea 2010 white background

bacterial diarrhea 2010 white background - Clinical...

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Unformatted text preview: Clinical Correlation: Enteric Infections Bacterial Diarrhea Chris E. Forsmark, M.D. Division of Gastroenterology, Hepatology, and Nutrition Infectious Diarrhea • 3-5 billion episodes yearly • Major cause of worldwide morbidity and mortality • 5 million deaths yearly, 80% < 1 year of age • Major cause of work/school absenteeism • Major economic burden, especially in developing countries • Bacteria cause 5.2 million cases of diarrhea in US yearly (80% foodborne) Organisms • Bacteria – E. Coli, Salmonella, Shigella, Campylobacter, Vibrio, Yersinia, Clostridium difficle, S. aureus, B. cereus, C. botulinum • Viruses – Norovirus, Rotavirus, CMV • Parasites – Giardia, Amoeba, Ascaris, etc These organisms cause diarrhea through a wide variety of mechanisms Pathophysiology – Osmotic – Secretory – Exudation – Abnormal motility Osmotic Diarrhea • Interferes with absorption of water • Solutes are ingested (fasting stops diarrhea) – Magnesium sulfate or citrate or magnesium containing antacids – Sorbitol – Malabsorption of food • Lactase deficiency • Celiac sprue • Variety of infectious organisms (particularly viruses) Definition: Increased amounts of poorly absorbed, osmotically active solutes in gut lumen Secretory Diarrhea • Excess secretion of electrolytes and water across mucosal surface • Usually coupled with inhibition of absorption • Clinical features – stools very watery – stool volume large – fasting does not stop diarrhea Secretory Diarrhea Bacterial or viral enterotoxins • Vibrio cholerae • Noncholeraic vibrios • Enterotoxigenic E. coli • B. cereus • S. aureus • Others: Rotavirus, Norovirus Non-infectious causes Exudative Diarrhea • Intestinal or colonic mucosa inflamed and ulcerated – Leakage of fluid, blood, pus – Impairment of absorption – Increased secretion (prostaglandins) • The extent and location of bowel involved determines – Severity of diarrhea – Systemic signs and symptoms (abdominal pain, fever, leukocytosis, etc) – Tenesmus, urgency Exudative Diarrhea...
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This note was uploaded on 07/02/2011 for the course MMC 6500 taught by Professor Gulig during the Spring '11 term at University of Florida.

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bacterial diarrhea 2010 white background - Clinical...

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