Gastrointestinal diseases, in this section
we'll be diving into. The intestine begin with
the small bowel first and move in to the large bowel.
And all the diseases that are associated
with this journey. Diarrhea is where we begin. And
obviously this is going to be high volume output
but then it is important that you are able to
properly categorize your diarrhea, so that
you will be able to find out as to what exactly is
causing the diarrhea. That way you're not wasting
time and more importantly you prevent certain
complications taking place in your patient.
For example, physiologically when there is diarrhea,
you're worried about losing bicarbs so therefore
your patient is in a state of metabolic acidosis.
And also when you lose stool excessively,
there is every possibility that the patient might
also be hypokalemic. The potassium levels could be
anywhere. Do not forget, in this particular course
of metabolic acidosis. The mechanisms of diarrhea
include the following. Osmotic. Remember we are in
the intestine now. So you should be thinking about
osmotic agents that then remain within the
intestine which is then going to pull water in.
Or diffusion of water into the intestinal lumen
thus bringing about large, large voluminous amounts
of diarrhea. Example, lactose intolerance. Secretory.
There is some kind of tumor perhaps in which literally
it is going to be secreting fluid into the lumen of
the intestine resulting in a secretory type of diarrhea.
Example for this would be something like a VIPoma or
maybe perhaps carcinoid tumor. Altered motility.
Exudative. Example here would be something like
your ischemic bowel disease. Of the two types of
ischemic bowel disease that you're quite comfortable
with, it should be ulcerative colitis. That's more
exudative. And anorectal dysfunction/injury may then
result in involuntary lost of stool. Incontinence,
is a huge topic on your step.