Lower GI Study Guide
Diarrhea – passage of at least 3 loose or liquid stools per day. May be acute, 14 days or less, or
persistent lasting longer than 14 days. Chronic = 30 days or more
Primary cause – ingesting infectious organisms. Some infections can be deadly most are mild
and last less than 24 hours.
Other causes – decreased fluid absorption, increased fluid secretion, motility disturbances, or a
combination of these.
A persons age, gastric acidity, intestinal microflora, and immune status influence the
susceptibility to pathogenic organisms. Older adults are most likely to have life threatening
diarrhea. Since stomach acid kills ingested pathogens, taking drugs to decrease stomach acid
(PPI’s) INCREASES the chance that pathogens will survive.
Secretory diarrhea – common result of bacterial or viral infections. It occurs when ingested
pathogens survive in the GI tract long enough to absorb into the enterocytes. The resulting
chain reaction changes cell permeability and causes the oversecretion of water and Sodium and
chloride ions in the bowel.
CDIFF – causes the most serious antibiotic-associated diarrhea and is a common cause of
hospital-acquired GI Illness in the US.
Watery diarrhea, fever, anorexia, nausea, abdominal pain.
Caused by prolonged use of antibiotics followed by exposure to feces-contaminated
surfaces are extremely hard to kill.
SOAP and water only.
People who are immunocompromised (HIV) because of disease or immunosuppressive drugs
are susceptible to GI tract infection. Immunocompromised patients receiving jejunal enteral
nutrition (EN) are especially prone to CDI and other foodborne infections. Jejunostomy and
nasointestinal feedings, which bypass the stomachs acid environment, do not contain poorly
digestible fiber that normal colonic bacteria needed for survival.
Leukocytes, blood and mucous may be present in the stool, depending on the cause. Severe
diarrhea may cause life threatening dehydration, electrolyte problems, and acid base
imbalances (metabolic acidosis). CDI can progress to deVere colitis and intestinal perforation.
Diagnostic Studies for diarrhea:
Stool cultures – usually only pts who are very ill, have a fever, bloody diarrhea, or diarrhea
lasting longer than 3 days, or were exposed during an outbreak.
Travelers diarrhea should be evaluated for parasitic infections.
Stools are examined for blood, mucus, WBC’s, and parasites.
Cultures reliably identify infectious organisms.
Multiple pathogen stool tests can detect common viral, parasitic, and bacterial organisms from
a single stool sample.
Drug Therapy –
Diarrhea – passage of at least 3 loose or liquid stools per day. May be acute, 14 days or less, or
persistent lasting longer than 14 days. Chronic = 30 days or more
Primary cause – ingesting infectious organisms. Some infections can be deadly most are mild
and last less than 24 hours.
Other causes – decreased fluid absorption, increased fluid secretion, motility disturbances, or a
combination of these.
A persons age, gastric acidity, intestinal microflora, and immune status influence the
susceptibility to pathogenic organisms. Older adults are most likely to have life threatening
diarrhea. Since stomach acid kills ingested pathogens, taking drugs to decrease stomach acid
(PPI’s) INCREASES the chance that pathogens will survive.
Secretory diarrhea – common result of bacterial or viral infections. It occurs when ingested
pathogens survive in the GI tract long enough to absorb into the enterocytes. The resulting
chain reaction changes cell permeability and causes the oversecretion of water and Sodium and
chloride ions in the bowel.
CDIFF – causes the most serious antibiotic-associated diarrhea and is a common cause of
hospital-acquired GI Illness in the US.
Watery diarrhea, fever, anorexia, nausea, abdominal pain.
Caused by prolonged use of antibiotics followed by exposure to feces-contaminated
surfaces are extremely hard to kill.
SOAP and water only.
People who are immunocompromised (HIV) because of disease or immunosuppressive drugs
are susceptible to GI tract infection. Immunocompromised patients receiving jejunal enteral
nutrition (EN) are especially prone to CDI and other foodborne infections. Jejunostomy and
nasointestinal feedings, which bypass the stomachs acid environment, do not contain poorly
digestible fiber that normal colonic bacteria needed for survival.
Leukocytes, blood and mucous may be present in the stool, depending on the cause. Severe
diarrhea may cause life threatening dehydration, electrolyte problems, and acid base
imbalances (metabolic acidosis). CDI can progress to deVere colitis and intestinal perforation.
Diagnostic Studies for diarrhea:
Stool cultures – usually only pts who are very ill, have a fever, bloody diarrhea, or diarrhea
lasting longer than 3 days, or were exposed during an outbreak.
Travelers diarrhea should be evaluated for parasitic infections.
Stools are examined for blood, mucus, WBC’s, and parasites.
Cultures reliably identify infectious organisms.
Multiple pathogen stool tests can detect common viral, parasitic, and bacterial organisms from
a single stool sample.
Drug Therapy –
