Approach to the Patient with Diarrhea

Powell, Don W.

doi:10.1002/9781444300758.ch18

Cited by 13 publications

(9 citation statements)

References 430 publications

(637 reference statements)

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“…presence of constipation or diarrhea. 13,[29][30][31] Voluntary suppression of defecation delays gastric emptying in normal subjects, 32 and this "cologastric brake" is believed to be involved in the pathogenesis of upper abdominal symptoms in constipated patients. After ingestion or intragastric administration of equal amounts of liquid, antral volumes determined by ultrasonography show a wide intersubject variability.…”

Section: Figurementioning

confidence: 99%

Measurement of gastric emptying by standardized real-time ultrasonography in healthy subjects and diabetic patients.

Darwiche

Almér

Björgell

et al. 1999

Journal of Ultrasound in Medicine

112

106

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The aim of this study was to simplify and standardize a reproducible, well-tolerated and clinically applicable method for the assessment of gastric emptying rate by real-time ultrasonography. A total of 33 subjects were examined, including 19 healthy subjects and 14 patients with insulin-dependent diabetes mellitus and clinically suspected delayed gastric emptying. Measurements of the gastric antrum were taken in the supine position and in relation to internal landmarks to obtain a standardized cross-sectional image producing the area of a selected slice of the antrum. Diabetic patients were examined on the condition that the fasting blood glucose level was 3.5 to 9.0 mmol/l. Gastric emptying rate was estimated and expressed as the percentage reduction in antral cross-sectional area from 15 to 90 min after the ingestion of a standardized semisolid breakfast meal (300 g rice pudding, 330 kcal). Interobserver and intraobserver measurement errors were assessed, as was the significance of age and sex on gastric emptying. In comparison to healthy subjects, diabetic patients showed significantly wider median values of the 90 min postprandial antral area, but only a mild tendency toward greater dilation of the gastric antrum prior to and 15 min after meal ingestion. The median value of gastric emptying rate in these diabetic patients was estimated at 29%, which was less than half of that in the healthy subjects (63%). Statistically the difference was highly significant. Interpersonal variability of gastric emptying rate and antral areas was large for both groups. Measurements of gastric emptying rate gave highly reproducible results on separate days and from different observers (interobserver systematic measurement error 0.3% and random measurement error 10.9%; intraobserver systematic measurement error 3.6% and random measurement error 9.5%). No difference in gastric emptying rate was found related to age or sex. We conclude that the use of standardized real-time ultrasonography to determine gastric antral cross-sectional area in a single section of the stomach is a valid method for estimating gastric emptying rate.

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Section: Figurementioning

confidence: 99%

Measurement of gastric emptying by standardized real-time ultrasonography in healthy subjects and diabetic patients.

Darwiche

Almér

Björgell

et al. 1999

Journal of Ultrasound in Medicine

112

106

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“…49 In the stool, average sodium concentration is 40 mEq/L, and potassium, 90 mEq/L. 50 Water and solute losses increase in sweating, vomiting, or diarrhea and hyperpnea. Urinary losses vary during treatment of hyponatremia.…”

Section: Inaccuracies Of Predictive Formulasmentioning

confidence: 99%

Principles of Management of Severe Hyponatremia

Tzamaloukas

Malhotra

Rosen

et al. 2013

JAHA

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“…1° Chronic diarrhoea is defined as diarrhoea for at least three to six weeks. 11 Drug therapy is one of the most common causes of diarrhoea in the elderly (Table 1 ). I 2 Diarrhoea is more often dose-related than due to idiosyncratic drug reactions.…”

Section: Definitionsmentioning

confidence: 99%

Drug‐Associated Diarrhoea and Constipation in Older People 1. Diarrhoea

Ratnaike

Milton

Nigro

2000

The Australian Journal of Hospital Pharmacy

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Diarrhoea and constipation are common side effects of many drugs. In the elderly, such drug‐related iatrogenic conditions compound the increased prevalence of acute and chronic illness. In older persons, an awareness of diarrhoea and constipation as complications of drug therapy and the use of preventative measures wherever practical may significantly increase the quality of life of the patient. It is important to understand the mechanisms whereby medications may cause diarrhoea and constipation and to periodically review drug use in the elderly. The first part of this review explains the mechanisms involved in drug‐induced diarrhoea and gives examples of drugs commonly involved.

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Approach to the Patient with Diarrhea

Cited by 13 publications

References 430 publications

Measurement of gastric emptying by standardized real-time ultrasonography in healthy subjects and diabetic patients.

Measurement of gastric emptying by standardized real-time ultrasonography in healthy subjects and diabetic patients.

Principles of Management of Severe Hyponatremia

Drug‐Associated Diarrhoea and Constipation in Older People 1. Diarrhoea

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