Causes of diarrhea in enteral nutrition Lumen Intestinal mucosa Excess volume Edema Osmotic load Disaccharidases or Formulas transport mechanisms Medication Atrophy Contamination Bacteria
Causes of diarrhea in enteral nutrition
Pathophysiological mechanisms Decreased intestinal surface area and/or intestinal absorption E: surgical removal; malabsorption syndrome
Pathophysiological mechanisms • Decreased intestinal surface area and/or intestinal absorption E: surgical removal; malabsorption syndrome
Pathophysiological mechanisms Rapid transit of intestinal contents(shortened transit time) increase in intestinal motility(intestinal hurry) contents reduce volume contact time->increase liquidity, stool small bowel mucosa E: irritable bowel syndrome [Functional diarrhea laxatives abuse post vagotomy diarrhea post gastrectomy dumbing syndrome
Pathophysiological mechanisms • Rapid transit of intestinal contents (shortened transit time) E: irritable bowel syndrome [Functional diarrhea] laxatives abuse post vagotomy diarrhea post gastrectomy dumbing syndrome stool volume liquidity contact time→ increase small bowel mucosa contents increase in intestinal motility (intestinal hurry) reduce
Calculation of osmotic gap 290 Unmeasured osmoles INcO □c 200 匚aK+ 匚Na+ E 100 0 Secretory diarrhea Osmotic diarrhea Osmotic gap 290 290 2X(Na+]+〖K+])=102X(Na+]+[K+])=230
Calculation of osmotic gap
Etiology Acute Diarrhea infection Food poisoning Systematic diseases(influenza, sepsis, measle, etc) Miscellanous
Etiology Acute Diarrhea • infection • Food poisoning • Systematic diseases (influenza, sepsis, measle, etc) • Miscellanous