Types of Diarrhoea ICDS Supervisor Exam|ICDS Supervisor Kerala PSC

 Types of Diarrhoea ICDS Supervisor Exam|ICDS Supervisor Kerala PSC

In this post  Types of Diarrhoea, one of the Infections spread by food and water is explained.  The pathogens of Diarrhoea are explained in detail in the previous post. Other Infections spread by water are Typhoid, Paratyphoid fever, Poliomyelitis, Hepatitis A and Hepatitis E. Those will be explained in next post. Immunization and Vaccines are important topics for ICDS Supervisor Exam. 

Types of Diarrhoea: Infections spread by food and water

There are three types of diarrhoea:

• acute watery diarrhoea;
• dysentery; and
• persistent diarrhoea.

1. Acute watery diarrhoea

• Starts acutely

• Lasts < 14 days and in most cases < 7 days

• Stools passed are frequent, loose or watery without visible blood

• The patient may vomit and have a fever

• Acute watery diarrhoea causes dehydration

• When food intake is reduced it contributes to undernutrition

• When a death occurs it is usually due to acute dehydration

• Most important causes of acute watery diarrhoea in young  children in developing countries are: rotavirus, enterotoxigenic Escherichia coli, Shigella, C. jejuni and cryptosporidium

• In some areas Vibrio cholerae 01, salmonella  andd enteropathogenic E. coli are also important causes

2.Dysentery

• Diarrhoea with visible blood in the faeces 

• Can cause anorexia and rapid weight loss, and the invasive bacteria can cause damage to the intestinal mucosa

• Other complications may occur, for example, haemolytic uraemic syndrome, which may cause renal failure

• The most important cause of acute dysentery is Shigella; other causes are C. jejuni, and infrequently enteroinvasive E. coli or Salmonella; Entamoeba histolytica can cause serious dysentery in young adults, but rarely in young children.

3.Persistent diarrhoea

• Begins acutely, but is of unusually long duration (at least 14 days).

• May begin either as watery diarrhoea or as dysentery.

• Marked weight loss is frequent.

• Diarrhoeal stool volume may also be great, with a risk of dehydration.

• There is no single microbial cause for persistent diarrhoea.

• Enteroadherent E. coli, cryptosporidium, and giardiasis sometimes play a greater role than other agents.

• Persistent diarrhoea should not be confused with chronic diarrhoea, which refers to recurrent or longlasting diarrhoea due to noninfectious causes, such as sensitivity to gluten or inherited metabolic disorders.

Age groups affected by Diarrhoea

Most diarrhoeal episodes occur during the first two years of life. Incidence is highest at ages 6–11months, a time period often associated with weaning. 

This pattern reflects the combined effects of declining levels of maternally acquired antibodies, the lack of active immunity in the

infant, the introduction of food that may be contaminated with faecal bacteria, and direct contact with human or animal fæces when the infant starts to crawl. 

Most enteric pathogens stimulate at least partial immunity against repeated infection or illness, which helps to explain the declining incidence of disease in older children and adults. 

However, some elderly adults may become increasingly susceptible to advancing years if they become physically frail.

Diagnosis of Diarrhoea

The diagnosis of infective diarrhoea is dependent upon the identification of the causative pathogen from the faeces by culture, antigen detection or by light microscopy (in the case of parasites). 

For viruses, antigen detection, culture and microscopy are most often used. 

Bacterial bowel pathogens are closely related and the only reliable diagnosis is made by culture and identification of the individual pathogens.

 However, routine determination of the aetiology of diarrhoea in a laboratory is not practical, and the clinical aspects of illness do not usually permit a specific aetiological diagnosis, although clinical features can act as a rough guide. 

The treatment of diarrhoea must, therefore, be based on the major features of the disease and an understanding of the underlying pathogenetic mechanisms

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