Diarrhoea

Definition

Increase in the amount of water in stool.

Dysentery is severe diarrhoea with blood.

Epidemiology

Really common.

Differential Diagnosis

Differential MINDSI: Malabsorption Infective Neoplastic Drugs

• Gastroenteritis - there are a whole bunch of infective causes of diarrhoea.
• IBD/Cancer
• Motility disorder - IBS there are some rare ones but hyperthyroidism can cause problems with motility
• Malabsoprtion - coeliac disease, lactose intolerance

Clinical and Associated Features

• Gastroenteritis - diarrhoea (bloody in dysentery), fever, malaise, dehyrdration, loss of appetite, nausea, vomiting, weight loss
• IBD/Cancer - alternating constipation and diarrhoea, blood in stools, weight loss, tiredness
• IBS - diagnosis of exclusion, episodes of diarrhoea, nausea and general abdominal discomfort
• Hyperthyroidism - there are about a million
• Coeliac disease - diarrhoea, failure to thrive, steatorrhoea (floaty, smelly, fatty stools), abdominal distention, abdominal pain, nausea, vomiting, apthous ulcers, mineral deficiencies (iron, folate, vitamin K, vitamin D, calcium), rashes (dermatitis herpetiform), peripheral neuropathy, oedema
• Lactose intolerance - diarrhoea and nausea after eating dairy products. Vomiting, abdominal pain, bloating.