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Diarrhoea
Diarrhoea is the passage of 3 or more loose or liquid stools per day, or more frequently than is
normal for the individual. It is usually a symptom of gastrointestinal infection, which can be
caused by a variety of bacterial, viral and parasitic organisms.
What causes diarrhea?
The most common cause of diarrhea is a virus that infects your bowel (“viral gastroenteritis”).
Other possible causes of diarrhea can include:
 Infection by bacteria.
 Infections by other organisms and pre-formed toxins
 Eating foods that upset the digestive system.
 Allergies and intolerances to certain foods (Celiac disease or lactose intolerance).
 Medications.
 Radiation therapy.
 Malabsorption of food (poor absorption).
What are the symptoms of diarrhea?

When you have diarrhea, you may experience all of these symptoms or only a few. The main
symptom of diarrhea is loose or watery stool.
Other symptoms of mild diarrhea can include:
 Bloating or cramps in the abdomen.
 A strong and urgent need to have a bowel movement.
 Nausea (upset stomach).
If you have severe diarrhea, you may experience symptoms like:
 Fever.
 Weight loss.
 Dehydration.
 Severe pain.
 Vomiting.
 Blood.
Types of Diarrhoea
There are actually several different ways to classify diarrhea. These types of diarrhea include:
 Acute diarrhea: The most common, acute diarrhea is loose watery diarrhea that lasts one
to two days. This type doesn’t need treatment and it usually goes away after a few days.
 Persistent diarrhea: This type of diarrhea generally persists for several weeks – two to
four weeks
 Chronic diarrhea: Diarrhea that lasts for more than four weeks or comes and goes
regularly over a long period of time is called chronic diarrhea.
How do you diagnose diarrhea?
More serious cases of diarrhea may require medical attention. In these situations, there are a few
diagnostic tests that your provider may order. These tests can include:
 Discussing a detailed family history, as well as physical and medical conditions, your
travel history, and any sick contacts you may have.
 Doing a stool test on a collected stool sample to check for blood, bacterial infections,
parasite and inflammatory markers.
 Doing a breath test to check for lactose or fructose intolerance, and bacterial overgrowth.
Management
 Antibiotics: Your healthcare provider might prescribe an antibiotic or other medication

to treat an infection or parasite that’s causing the diarrhea.
 Medication for a specific condition: Diarrhea can be a sign of several other medical
conditions, including irritable bowel syndrome (IBS), inflammatory bowel disease (IBD)
such as Crohn’s disease and ulcerative colitis, microscopic colitis, or bacterial
overgrowth. Once the cause of the diarrhea is identified, diarrhea can usually be
managed.
 Probiotics: Groupings of good bacteria, probiotics are sometimes used to re-establish a
healthy biome to combat diarrhea.
Nursing Rx
 Drinking plenty of water and other electrolyte balanced fluids (like diluted and pulp-free
fruit juices.
 Changing your diet. Instead of picking greasy, fatty or fried foods, go for the BRAT diet:
o B: Bananas.
o R: Rice (white rice).
o A: Applesauce.
o T: Toast (white bread).
 Cutting back on caffeine. Foods and drinks that have caffeine can have a mild laxative
effect, which can make your diarrhea worse. Foods and drinks with caffeine include
coffee, diet sodas, strong tea/green tea, and even chocolate.
 Avoiding foods and drinks that give you gas.
Prevention
 Avoiding infections with good hygiene habits:

 Getting your vaccinations: Rotavirus, one of the causes of diarrhea, can be prevented
with the rotavirus vaccine
 Storing food properly:
 Watching what you drink when you travel:
Dysentery
Dysentery is a gastrointestinal disease. Its causes include bacterial or parasitic infections.
Symptoms include diarrhea, fever, nausea, vomiting, weight loss and stomach cramps.
What is dysentery?
Dysentery is a gastrointestinal disease. It causes severe diarrhea that contains blood or mucus.
Types
 Amoebic dysentery (amoebiasis): The parasite Entamoeba histolytica (E. histolytica) is

one of the main causes of amoebic dysentery. Other parasites that cause amoebic
dysentery include Balantidium coli (B. coli) and strongyloidiasis.
 Bacillary dysentery: A bacterial infection causes bacillary dysentery. Some of the most
common bacteria that cause bacillary dysentery
include Shigella, Salmonella, Campylobacter and Escherichia coli (E. coli). Bacillary
dysentery is the most common type of dysentery.
What are the causes of dysentery?

Transmission can occur during:
 Food preparation by someone who doesn’t wash their hands or has poor hygiene.
 Drinking contaminated water.
 Sexual contact, especially involving the anus.
Bacillary dysentery occurs when foreign bacteria enter your body and the infection becomes
severe. Some of the most common bacteria that cause bacillary dysentery include:
 Shigella, which leads to shigellosis.

 Salmonella, which causes salmonella.
 Campylobacter, which causes campylobacteriosis.
 Escherichia coli, which leads to E. coli infection.
Amoebiasis occurs when a particular parasite enters your body.
What are the symptoms of dysentery?

Amoebic dysentery
Most people who have amoebic dysentery don’t have any symptoms.
Mild symptoms of amoebic dysentery may include:
 Diarrhea.
 High fever.
 Nausea and vomiting.
 Weight loss.
 Upset stomach.
Bacillary dysentery
Symptoms of bacillary dysentery may include:
 Diarrhea containing blood or mucus.

 High fever.
 Nausea and vomiting.
 Painful stomach cramps (abdominal pain).
Cholera
Cholera is an acute diarrheal illness caused by infection of the intestine with Vibrio
cholerae bacteria.
What are the symptoms of cholera?
A cholera infection can be mild, with no symptoms. But about 10% of infected people develop
severe symptoms, 12 hours to five days after ingesting the bacteria. These symptoms include:
 Diarrhea, or extremely watery poop.

 Intense thirst.
 Lower amounts of urine (pee).
 Muscle cramps.
 Restlessness or irritability.
 Vomiting.
 Weakness.
How is cholera treated?
The most important part of cholera treatment is preventing or reversing dehydration. Anyone
with cholera should immediately replace the fluids and salts they’ve lost. A healthcare provider
may prescribe:
 Oral rehydration solution (ORS): You may have to drink large amounts of a
prepackaged mix of sugar, salts and water.
 Intravenous fluids: For a severe case of dehydration, a healthcare provider may use a
needle to pump fluids directly into your veins.
Other treatments may include:
 Antibiotics.
 Zinc in children younger than 5.
V. cholera bacteria usually disappear from the body within two weeks
Comparison Note
What problems can cholera cause?
Diarrhea and vomiting from cholera can make your body lose large amounts of important
substances:
 Electrolytes.
 Fluids.
 Sodium.
 Potassium.
When your body doesn’t have enough of those things, you get dehydrated and may develop:
 Dry mucous membranes (such as in the eyes, nose and mouth).
 Fast heart rate.
 Hypokalemia (low potassium levels in the blood).
 Hypotension (low blood pressure).
 Loss of the natural stretchiness in skin.
Untreated, severe dehydration from cholera can lead to:
 Kidney failure.
 Shock.
 Coma.
 Death.
What’s the difference between dysentery and cholera?

Dysentery and cholera are gastrointestinal diseases. The difference between them is that they
have different causes.
There are two main types of dysentery: amoebiasis and bacillary dysentery. Parasites cause
amoebiasis, including E. histolytica. Bacteria cause bacillary dysentery,
including Shigella, Salmonella, Campylobacter and E. coli.
The bacteria Vibrio cholera (V. cholera) causes cholera.
What’s the difference between Diarrhoea and cholera?

How diagnosis Cholera?
 Stool culture — a definitive diagnosis of cholera is based on isolation of the organism
from clinical samples, which also permits a determination of the antibiotic susceptibility
profile. V. cholerae can be isolated from stool using selective media such as thiosulfate
citrate bile sucrose agar or taurocholate tellurite gelatin agar.
 Rapid tests and other tools
●Antigen detection − several rapid antigen detection-based tests are commercially
available for diagnosis of cholera. These include immunochromatographic lateral flow
devices (dipsticks), such as Crystal VC, which detect the presence of the O1 or O139 antigen
in watery diarrheal stools, and Cholkit, which detects only the O1 antigen.
●Molecular tests − Molecular testing for V. cholerae (eg, PCR), including tests that use
dried fecal spots, is also feasible; however, thus far practical use of molecular tests has been
limited to epidemiologic research and surveillance.
●Darkfield microscopy − Darkfield microscopy of rice-water stools (at 400x
magnification) can also be used to evaluate for the presence of highly motile Vibrios, whose
shooting star-like motion can be inhibited by the subsequent addition of specific
antibodies.Darkfield microscopy is quite specific for V. cholerae but lacks sufficient
sensitivity to be used reliably for diagnosis.

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Diarrhoea

Other possible causes of diarrhea can include:

What are the symptoms of diarrhea?

 Antibiotics: Your healthcare provider might prescribe an antibiotic or other medication

 Avoiding infections with good hygiene habits:

 Amoebic dysentery (amoebiasis): The parasite Entamoeba histolytica (E. histolytica) is

What are the causes of dysentery?

 Shigella, which leads to shigellosis.

Amoebiasis occurs when a particular parasite enters your body.

What are the symptoms of dysentery?

Symptoms of bacillary dysentery may include:

 Diarrhea containing blood or mucus.

What are the symptoms of cholera?

 Diarrhea, or extremely watery poop.

How is cholera treated?

Other treatments may include:

What’s the difference between dysentery and cholera?

The bacteria Vibrio cholera (V. cholera) causes cholera.

What’s the difference between Diarrhoea and cholera?

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