Diarrhoea & constipation

Diarrhoea

Diarrhoea is an increase in frequency or decrease in consistency (liquid or semisolid) of stool. It can either be acute or chronic in nature.

• Acute diarrhoea is mostly infectious in origin and self-limiting. It can be treated by oral and Intravenous fluids. However, in some cases use of antibiotics and antiparasitic agents is suggested.
• Long standing diarrhoea can be caused due to diseases of small and large intestine and pancreatic insufficiency.

Diarrhoea due to small intestine problems

• Celiac disease
• Tropical sprue
• Giardiasis and other parasitic infections
• Whipple disease
• Tuberculosis in small bowel
• Crohn’s disease in small bowel
• Immune deficiencies
• Bacterial overgrowth in small intestine

Diarrhoea due to large intestine problems

• Microscopic colitis
• Colonic malignancies
• Lymphoma
• Ulcerative colitis
• Crohn’s disease
• Radiation colitis
• Chronic pancreatitis
• Cystic fibrosis
• Ischemic colitis
• Pancreatic disorders
• Endocrine disorders causing excessive secretion

Diagnosis

Diagnosis requires a thorough evaluation and tests. This includes stool evaluation, blood tests, and other tests such as colonoscopy, endoscopy, and biopsies.

Treatment

Therapy is based on management of specific etiology.

Constipation

Constipation is the decrease in frequency of stool (less than one stool in 3 days) or change in the form of normal stool frequency.

Causes

Common reasons include:

• Slowness of bowel movement
• Hypercalcemia
• Anal fissure
• Hypokalemia
• Hypothyroidism
• Diabetes mellitus etc.
• Side-effects of few medications
• Colon obstruction due to large polyp or malignancy

Evaluation

Diagnosis requires a thorough evaluation and tests. This includes blood tests, and other tests such as colonoscopy, anal manometry and cross-sectional imaging.

Treatment

Therapy is based on management of specific etiology.