DIARRHOEA AND CONSTIPATION

Diarrhoea

Diarrhoea is defined as the passage of frequent ,loose,watery stools 3 or more times a day. Diarrhoea may be accompanied by vomiting. In children, the commonest cause is viral. There is therefore usually no need to take in antibiotics,as it may worsen or prolong the condition except in special cases. Other diseases such as malaria, pneumonia,ear infections and urinary tract infections,may be associated with diarrhoea.

TYPES OF DIARRHEA

*Acute Diarrhoea is defined as the abrupt onset of 3 or more loose stools per day and lasts no longer than 14 days.

*Chronic or persistent diarrhea is defined as an episode that lasts longer than 14 days.

CAUSES

*Infections

– Viral ; example is the rotavirus,norovirus, opportunistic infections with HIV.

– Bacteria: example is the Salmonella spp, Shigella,Campylobacter, E coli,Vibrio cholerae.

– Protozoa: example Entamoeba histolytica

*Drug induced diarrhoea: Example is Penicillins.Laxatives, Opioids withdrawal, NSAIDs etc.

*Food allergies such as Cow’s milk protein allergy, Soy protein allergy,multiple food allergies, Olestra etc.

*Inflammatory dysfunction: example Ulcerative colitis, Crohn’s disease.

*Malignancy : example colon cancer etc

SYMPTOMS

The clinical presentation and course of diarrhea therefore depend on its cause and on the host. Below are some symptoms of diarrhoea.

*Frequent watery stools

*Blood or mucus in the stool

*Associated vomiting

*Reduced urination

* Fever

SIGNS

*Anaemia

*Weight loss

*Sunken eyes

*Altered conscious

*Signs of dehydration

*Anorexia

*Rectal mass

*Enlarged thyroid

PREVENTIVE MEASURES

Acute onset diarrhoea is self limiting. However an acute onset can have a prolonged course. Below are preventive measures one can take in order to reduce diarrhoea occurances;

*Vaccines

*Keeping our surroundings clean

*Improve personal hygiene example; hand washing after visiting the loo.

*Maintaining adequate nutrition.

*Avoid eating at filthy environments.

*Eat properly cooked or warm foods.

* Avoid drinking contaminated water.

CONSTIPATION

Constipation refers to bowel movements that are infrequent or stools that are hard and difficult to pass. Constipation is one of the most common digestive complaints patients bring to Community Pharmacies. It is a symptom rather than a disease and, despite its frequency, often remains unrecognized until the patient develops sequelae, such as anorectal disorders.

CAUSES

*Lack of roughages in diet

*Ignoring the urge to defaecate example due to immobility.

*Irritable bowel syndrome.

*Dehydration and starvation

*Lack of exercise

*Hypercalcemia ( increased levels of calcium in the body)

*Drugs induced constipation such as herbal preparations, atropine, codeine, morphine etc.

*Medical condition

SYMPTOMS

*Inability to move bowels

* Passing hard stools

*Straining to pass stools

*Infrequent passing of stools

*Feeling of incomplete evacuation of the bowel.

*Inability to pass flatus.

SIGNS

* Generalized abdominal tenderness

*Frequent high pitched bowel sounds.

*Low back pain.

MANAGEMENT

*Engaging in regular exercises

*Taking in high fibre meals

*Increase the intake of roughages by eating more fruits and vegetables.

* Adequate fluids intake.

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