Aklan State University

School of Arts and Sciences

Bachelor of Science in Nursing
Banga, Aklan

Name: Lourenz S. Bontia Date: January 23, 2016

Diarrhea
Definition:
Diarrhea is the abnormal passage of loose or liquid stools more than three times daily
and/or a volume of stool greater than 200 g/day. Patients may use the term diarrhea in different
ways. Diarrhea lasting for more than 4 weeks is generally considered chronic, likely to be of
noninfectious aetiology and warrants further investigation.i

Signs and Symptoms:

In addition to the increased frequency and fluid content of stools, the patient usually has
abdominal cramps, distention, intestinal rumbling (ie, borborygmus), anorexia, and thirst. Painful
spasmodic contractions of the anus and ineffectual straining (ie, tenesmus) may occur with
defecation. Other symptoms depend on the cause and severity of the diarrhea but are related to
dehydration and to fluid and electrolyte imbalances. Watery stools are characteristic of small
bowel disease, whereas loose, semisolid stools are associated more often with disorders of the
colon. Voluminous, greasy stools suggest intestinal malabsorption, and the presence of mucus
and pus in the stools suggests inflammatory enteritis or colitis. Oil droplets on the toilet water
are almost always diagnostic of pancreatic insufficiency. Nocturnal diarrhea may be a
manifestation of diabetic neuropathy.ii

Pathophysiology:

The epithelium of the digestive tube is protected from insult by a number of mechanisms
constituting the gastrointestinal barrier, but like many barriers, it can be breached. Disruption of
the epithelium of the intestine due to microbial or viral pathogens is a very common cause of
diarrhea in all species. Destruction of the epithelium results not only in exudation of serum and
blood into the lumen but often is associated with widespread destruction of absorptive
epithelium. In such cases, absorption of water occurs very inefficiently and diarrhea results.

The immune response to inflammatory conditions in the bowel contributes substantively

to development of diarrhea. Activation of white blood cells leads them to secrete inflammatory
mediators and cytokines which can stimulate secretion, in effect imposing a secretory
component on top of an inflammatory diarrhea. Reactive oxygen species from leukocytes can
damage or kill intestinal epithelial cells, which are replaced with immature cells that typically are
deficient in the brush border enyzmes and transporters necessary for absorption of nutrients
and water. In this way, components of an osmotic (malabsorption) diarrhea are added to the
problem.iii

Recommended Diet:iv

Foods to avoid Foods to eat

Nuts Bananas

Seeds Rice (white)

Whole-grain products Applesauce

Spicy foods Toast

Caffeinated foods Yogurt

v
Meal Plan:

Meal Food Choices

Breakfast 1 cup of mashed bananas
Slice of lightly toasted white bread
Lunch Applesauce
Baked white potato
Poached chicken
Snacks Blueberries
Dinner Clear soup
Bowl of white rice
Yogurt
i Kendall, Giles (2005). Medicine and surgery A concise textbook. 350 Main Street, Malden,
Massachusetts 02148-5020, USA: Blackwell Publishing Ltd.

ii Bare, S. C. (2003). Brunner and Suddarths Textbook of Medical-Surgical Nursing. Lippincott

Williams and Wilkins; 10th Revised edition.

iii Bowen, R. (2006, 27 July). Pathophysiology of Diarrhea. Retrieved February 2, 2016, from
http://arbl.cvmbs.colostate.edu/hbooks/pathphys/digestion/smallgut/diarrhea.html

iv Moore, E. (2013, 21 October). Foods to Eat to Stop Diarrhea. Retrieved February 2, 2016, from
LIVESTRONG.COM: http://www.livestrong.com/article/258348-foods-to-eat-to-stop-diarrhea/

v Lynn, D. (2014, January 30). A Menu Plan for Diarrhea Problems. Retrieved February 2, 2016,
from LIVESTRONG.COM: http://www.livestrong.com/article/512187-a-menu-plan-for-diarrhea-
problems/