Diarrhea Types: Osmotic and Secretory
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Questions and Answers

What is traditionally defined as an increase in daily stool weight in diarrhea?

  • > 300 g/day
  • > 200 g/day (correct)
  • > 400 g/day
  • > 100 g/day

    • Chronic diarrhea accounts for 10% of the population.

    False

    What are the three primary functions of the small bowel?

    motility, digestion, absorption

    In normal stool fluids processing, the large bowel absorbs approximately _______________ L/d.

    <p>1-2</p> Signup and view all the answers

    Match the following nutrient/vitamin absorption sites:

    <p>Carbohydrates = Duodenum/Jejunum Vitamin B12 = Ileum Fats = Small intestine Iron = Duodenum</p> Signup and view all the answers

    What is the cause of Osmotic Diarrhea?

    <p>Ingestion of poorly absorbed osmotically active substance</p> Signup and view all the answers

    Inflammatory Diarrhea is caused by exogenous secretagogues.

    <p>True</p> Signup and view all the answers

    What is the main reason for Diarrhea caused by motility disturbances?

    <p>Abnormal intestinal motility</p> Signup and view all the answers

    Osmotic Diarrhea is caused by the ingestion of ______________ osmotically active substances.

    <p>poorly absorbed</p> Signup and view all the answers

    Match the following types of diarrhea with their causes:

    <p>Osmotic Diarrhea = Ingestion of poorly absorbed osmotically active substance Secretory Diarrhea = Exogenous secretagogues Inflammatory Diarrhea = Structural damage to the intestinal mucosa Diarrhea - motility disturbances = Abnormal intestinal motility</p> Signup and view all the answers

    Study Notes

    Normal Stool Processing

    • The GI system processes 8-9 L/day of stool fluids, with 1-2 L/day ingested and 7 L/day created
    • The small bowel reabsorbs 6-7 L/day, and the large bowel absorbs 1-2 L/day
    • This results in 100-200 g/day of stool created
    • A decrease in absorption or increase in secretion by as little as 1% can lead to diarrhea

    Nutrient/Vitamin Absorption

    • Carbohydrates/simple sugars are absorbed in the duodenum/jejunum
    • Vitamin B12 and short-chain fatty acids are absorbed in the ileum
    • Fats, bile salts, and vitamin K are absorbed in the colon
    • Amino acids, iron, fat-soluble vitamins (A, D, E, K), calcium, magnesium, and other vitamins and minerals are also absorbed in the GI system

    Chronic Diarrhea

    • Affects 5% of the population
    • Most frequent etiologies include:
      • Functional disorders (e.g., irritable bowel syndrome)
      • Inflammatory bowel disease (IBD)
      • Malabsorptive syndromes
      • Chronic infection

    Small Bowel Function

    • Motility
    • Digestion
    • Absorption
    • Immune defense

    Pathophysiology of Chronic Diarrhea

    • Types of chronic diarrhea:
      • Osmotic diarrhea
      • Secretory diarrhea
      • Inflammatory diarrhea
      • Motility disturbances

    Osmotic Diarrhea

    • Causes:
      • Ingestion of poorly absorbed osmotically active substances (non-electrolytes)
      • Carbohydrate malabsorption (e.g., disaccharidase deficiency, glucose-galactose malabsorption, fructose malabsorption)
    • Mechanism: retention of unabsorbed ions in the intestinal lumen, leading to water retention to maintain intraluminal osmolality

    Secretory Diarrhea

    • Causes:
      • Exogenous secretagogues (e.g., cholera toxin)
      • Endogenous secretagogues (e.g., neuroendocrine tumor)
      • Absence of ion transporter (e.g., congenital chloridorrhea)
    • Mechanism: increased net flux of ions into the intestinal lumen, leading to secretion of anions (chloride or bicarbonate) and inhibition of sodium absorption

    Inflammatory Diarrhea

    • Causes:
      • Inflammatory bowel disease (IBD)
      • Ischemic colitis
      • Diverticulitis
      • Radiation colitis
      • Infectious causes (e.g., invasive bacterial, parasitic, or viral infections)
    • Mechanism: structural damage to the intestinal mucosa, impairing absorption and stimulating secretion

    Diarrhea - Motility Disturbances

    • Causes:
      • Abnormal intestinal motility (e.g., hyperthyroidism, dumping syndrome, postvagotomy diarrhea, postsympathectomy diarrhea, diabetic autonomic neuropathy)
    • Mechanism: decreased contact between digested food products and the intestinal mucosa, leading to diarrhea

    Clinical Classification of Chronic Diarrhea

    • Organic vs. functional
    • Fatty
    • Watery
    • Inflammatory

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    Description

    This quiz covers the causes and characteristics of osmotic and secretory diarrhea, including the role of poorly absorbed substances, ions, and carbohydrates in the development of these conditions.

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