METHODS OF ACQUIRING KNOWLEDGE IN NURSING.pptx by navdeep kaur
Diarrhoea - Julie Cornish
1. Diarrhoea
• What does the patient mean by diarrhoea?
• Normal bowel habit
• Frequency over 24h
• Consistency – colour, steatorrhoea, offensive
smell
• Blood/mucus mixed in
• Associated wt loss or other symptoms:
– N&V
– Abdo pain
12. IBS
• Defn: at least 12 weeks of preceding 12
months of abdominal pain or discomfort +
at least two of the following:
• relief by defaecation
• onset with change of frequency of stool
• onset with change in form of stool
13. IBS
• typically 20-30’s
• female 2:1 male
• estimated 10-20% incidence in UK
• causes not defined
– visceral hypersensitivity
– disturbed colonic motility
– post infective bowel dysfunction
15. coeliac
• immune response to gliaden in gluten
• causes villous atrophy in small bowel
• develop intestinal malabsorption
• children – diarrhoea, fatigue and failure to
thrive
16. Coeliac disease in adults
• unexplained iron-deficiency anemia
• fatigue
• bone or joint pain
• arthritis
• osteoporosis
• depression or anxiety
• peripheral parasthesia
• seizures
• missed menstrual periods
• infertility or recurrent miscarriage
• mouth ulcers
• dermatitis herpetiformis
19. classification
• Marsh classification for coeliac disease
– Marsh stage 0: normal mucosa
– Marsh stage 1: increased number of intra-epithelial
lymphocytes, usually exceeding 20 per 100
enterocytes
– Marsh stage 2: proliferation of the crypts of
Lieberkuhn
– Marsh stage 3: partial or complete villous atrophy
– Marsh stage 4: hypoplasia of the small bowel
architecture
24. Rectal bleeding - questions
• Duration of symptoms – yrs, months
• Previous episodes or treatment
• Is the blood:
– mixed in with stool
– separate – found on toilet paper/splashes in
toilet bowl
• Fresh or altered blood - ? Lower vs upper
GI bleed