Question

Your athlete sees a physician to find out why she is having cramps and diarrhea. After doing some tests the doctor tells her it is because of a bacterial infection. The athlete comes to you because she wants to take an anti-diarrheal medication.

What are the types of diarrhea?

What are two main types of drugs to treat diarrhea?

What do you tell her regarding her request?

What actions would you recommend for her?

Answer 1

Diarrhoea is defined as the loose, watery stools that occur very frequently than usual. It is the condition of having at least three loose, liquid, or watery bowel movements each day.

Diarrohea is very common, happening in most people a few times each year. Diarrhoea is usually caused by a virus, or sometimes, contaminated food. Less frequently, it can be a sign of another disorder, such as inflammatory bowel disease or irritable bowel syndrome.

Types of diarrohea -

1.) Short duration watery diarrohea ( which last 2 days to 2 weeks and have fluids )

2.) Short duration bloody diarrohea (which can lasts 2 days to 2 weeks and have have blood)

3.) Persistent diarrohea which lasts 14 days or longer

4.) Secretory diarrhoea - Secretory diarrhea means that there is an increase in the active secretion, or there is an inhibition of absorption. There is little to no structural damage.

5.) Osmotic diarrhoea - Osmotic diarrhea occurs when too much water is drawn into the bowels. If a person drinks solutions with excessive sugar or excessive salt, these can draw water from the body into the bowel and cause osmotic diarrhea.

6.) Exudative diarrohea - Exudative diarrhea occurs with the presence of blood and pus in the stool. This occurs with inflammatory bowel diseases and other infections.

7.) Inflammatory diarrohea - Inflammatory diarrhea occurs when there is damage to the mucosal lining or brush border, which leads to a passive loss of protein-rich fluids and a decreased ability to absorb these lost fluids.

8.) Dysentery diarrohea - If there is blood visible in the stools, it is also known as dysentery.

*Acute diarrohea - Acute diarrhea is defined as an abnormally frequent discharge of semisolid or fluid fecal matter from the bowel, lasting less than 14 days.

## Main drugs to treat diarrohea - ( Anti motility medication and bulk forming agents )

In many cases of diarrhea, replacing lost fluid and salts is the only treatment needed. This is usually by mouth - oral rehydration therapy or, in severe cases, intravenously.

* Antidiarrheal agents can be classified into four different groups: -

• antimotility

• antisecretory

• adsorbent

• anti-infectious.

* Antimotility medicines are used to treat acute diarrhoea. They include codeine phosphate, loperamide, and kaolin and morphine mixture.

- Racecadotril an antisecretory medication may be used to treat diarrhea in children and adults.

- Bile acid sequestrants such as cholestyraminecan be effective in chronic diarrhea due to bile acid malabsorption.

- Diosmectite, a natural aluminomagnesium silicate clay, is effective in alleviating symptoms of acute diarrhea.

- Bismuth compounds (Pepto-Bismol) decreased the number of bowel movements in those with travelers' diarrhea, they do not decrease the length of illness.

** I will tell her that diarrohea and abdominal cramps are due to bacterial infection according to tests. She might have bacterial gastroenteritis which happens when bacteria causes an infection in the gut. This causes inflammation in stomach and intestines. Patient may also experience symptoms like vomiting, severe abdominal cramps, and diarrohea. Bacterial gastroenteritis can result from poor hygiene. Infection can also occur after close contact with animals or consuming food or water contaminated with bacteria (or the toxic substances bacteria produce).

** Management for her condition -

Treatment is meant to keep hydrated and avoid complications. It’s important not to lose too much salt, such as sodium and potassium.

If she have a serious case of bacterial gastroenteritis, she may be admitted to the hospital and given fluids and salts intravenously. Antibiotics are usually reserved for the most severe cases.

• Drink fluids regularly throughout the day, especially after bouts of diarrhea.

• Eat little and often, and include some salty foods.

• Consume foods or drinks with potassium, such as fruit juice and bananas.

• Avoid eating dairy, fruit, or high-fiber foods to keep diarrhea from getting worse.

- Over-the-counter medicines that neutralize your stomach acid can help fight these infections. Medicines that treat symptoms like diarrhea, nausea, and abdominal pains can help ease the stress and pain of the infection.

- ORS - Oral rehydration therapy (ORT) remains central to case management. oral replacement fluids are glucose-electrolyte solutions known collectively as oral rehydration solutions (ORS). ORT has been a life saving therapy for many patients with severe diarrhoea. The scientific principle and rationale for this therapy is based on active carrier mediated sodium-glucose cotransport.

- There are four main approaches to the treatment of infectious diarrhoea.

• Supportive therapy—fluid and electrolyte replacement.

• Antidiarrhoeal symptomatic treatment to reduce stool frequency and any other symptoms such as abdominal pain.

• Antisecretory drug therapy aimed at reducing faecal losses.

• Specific therapy such as antimicrobial chemotherapy to reduce duration and severity of the illness.

In this patient, fluid therapy and anti- diarrhoea and anti secretory drugs and antibiotics should be given for treating the condition of the patient.