Discuss the clinical and pathologic findings in the GI tract of a patient with diarrhoea.
Viral, bacterial, and parasitic illnesses account for about 80% of acute diarrhoea cases. The remaining is caused by drugs with an osmotic force, that increase the release of intestinal fluid, that include carbohydrates that are difficult or impossible to digest (such as sorbitol), or, less frequently, by faecal impaction or pelvic inflammation (e.g., acute appendicitis, or intestinal ischemia).
Infectious Diarrhea From Food and Water The majority of infectious diarrheas are spread from person to person or through water, food, or fecal-oral contact. Patients with infectious diarrhoea frequently have nausea, vomiting, and cramping in addition to fever and watery, malabsorptive, or bloody diarrhoea (dysentery).
Noroviruses are to blame for the majority of nonbacterial acute gastroenteritis outbreaks in the United States and other nations. Although rotavirus primarily affects young children, it can also affect adults, especially the elderly, who may get non-seasonal severe diarrhoea. The death of villus enterocytes, the stimulation of fluid secretion by NSP4 rotatoxin, and viral activation of the enteric nervous system are some of the mechanisms behind diarrhoea.
Salmonella, Campylobacter jejuni, E. coli, and Shigella are the most frequent food-borne bacterial pathogens in the United States.
The distal small bowel and colon are the primary sites of invasion for these bacteria, where they grow intracellularly and harm the epithelium. Inflammatory mediators that stimulate intestinal secretion, reduced absorption due to injured epithelium, and protein exudation into the lumen all contribute to diarrhoea. The "Shiga toxin," which is produced by Shigella species and enterohemorrhagic E. coli and is cytotoxic to intestinal epithelial cells, causes inflammation, cell damage, and diarrhoea with blood and pus.
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