Diarrhoeal diseases

Definition

Diarrhea is a disease in which there is an increased frequency as well as liquefaction and thus a higher weight of the bowel movement. By definition, diarrhoea is defined as having more than three bowel movements per day, a stool quantity of more than 250 grams or a water content of more than three quarters. Most diarrheal diseases are infectious and heal on their own after a few days.

Pathogens from the environment, for example, can get into the gastrointestinal tract and cause illness there. However, an imbalance in the natural intestinal population caused by other factors (e.g. by antibiotics) can also trigger a diarrheal disease. Important in the therapy of diarrhoea is a sufficient amount of drinking water as well as the absorption of blood salts (electrolytes), which are lost in diarrhoea through defecation.

Which diarrheal diseases are there ?

In diarrheal diseases one can distinguish between different mechanisms of disease development. For example, there is the great variety of infectious diarrheal diseases, which include both viral and bacterial diarrhea. In the case of bacterial diarrhoea diseases, the symptoms can be caused by various bacterial colonizations such as Campylobacter, Salmonella, Cholera, Yersinia and E. coli.

Bacterial infectious diarrhoea also includes diarrhoea caused by an imbalance in the intestinal flora, for example when antibiotics are administered. In this case, the pathogen Clostridium difficile typically spreads in the digestive tract and thus leads to diarrhea. Typical viral pathogens are the noro- and rotavirus, but other viruses such as the adenovirus can also lead to enteritis, i.e. inflammation of the digestive tract and thus to diarrhoea.

More rarely, infectious diarrhoea is also caused by parasites, fungi or worm diseases. You want to know when a diarrhea disease becomes contagious? A further group of diarrhoeal diseases are intolerance reactions.

Here, certain substances cannot be absorbed from the intestine; instead, they draw a lot of water into the intestine and thus trigger a diarrheal disease. This can happen, for example, with lactose intolerance or gluten intolerance. Please note that there is a difference between a proven gluten intolerance (coeliac disease) as an autoimmune disease with breakdown of the small intestinal mucosa and gluten sensitivity.

Damage to the intestine as a result of surgery or medication and radiation can also cause diarrhoea. There are also chronic inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis, which also cause diarrhea. Typical viral pathogens are the noro- and rotavirus, but other viruses such as the adenovirus can also cause enteritis, i.e. inflammation of the digestive tract and thus diarrhoea.

Here, certain substances cannot be absorbed from the intestine; instead, they draw a lot of water into the intestine and thus cause diarrhea. This can happen, for example, with lactose intolerance or gluten intolerance. Please note that there is a difference between a proven gluten intolerance (coeliac disease) as an autoimmune disease with breakdown of the small intestinal mucosa and gluten sensitivity.

Damage to the intestine as a result of surgery or medication and radiation can also cause diarrhoea. There are also chronic inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis, which also cause diarrhea.Crohn’s disease is a chronic inflammatory bowel disease that usually first manifests itself at the end of the small bowel segment. Later it can spread throughout the entire digestive tract from the mouth to the rectum.

Typically, the disease begins in young adulthood. Usually diarrhea and abdominal pain together with weight loss appear first. No concrete risk factors for the development of Crohn’s disease are known, but the probability of developing the disease increases when other family members are affected.

Smoking can also be a risk factor for the development of Crohn’s disease. During the course of the disease, more and more parts of the intestine can be affected by the inflammatory disease. This can lead to damage to the intestinal wall, which can subsequently result in fistulas (atypical connections between two hollow organs).

In addition, due to the chronic inflammation in Crohn’s disease, the nutrients from the intestine can no longer be absorbed so well, which can cause not only weight loss but also growth disorders in childhood and deficiency symptoms such as anemia. In addition, other parts of the body such as joints, eyes, liver and skin can also be affected by inflammatory changes in Crohn’s disease. The blood and bowel movements can be examined for characteristic signs of Crohn’s disease.

Often an MRI and/or colonoscopy is performed during the course of the disease to determine which parts of the intestine are affected. Since Crohn’s disease is a chronic bowel disease, it usually requires long-term treatment. For this purpose, drugs are used that have an anti-inflammatory effect and regulate the body’s immune response.

Similar to Crohn’s disease, ulcerative colitis initially manifests itself through abdominal pain, weight loss and diarrhea. However, in ulcerative colitis only the colon is affected by the chronic inflammation. Genetic causes also play a role in ulcerative colitis, and drugs can also play a role in the development of the diarrhea.

In addition to the digestive tract, other parts of the body can be affected in ulcerative colitis, including the liver and bile ducts, as well as joints, skin and eyes. The activity of inflammation markers in the blood and stool plays an important role in diagnostics, and various antibodies can also be tested. In ulcerative colitis, too, imaging (often MRI) and colonoscopy, during which tissue samples can be obtained, are crucial for diagnosis.

Therapy initially consists of drug treatment, in which drugs are used to downregulate the response of the immune system. In contrast to Crohn’s disease, ulcerative colitis can be cured by surgical treatment, but this requires the removal of the entire colon. The use of surgical therapy must be decided on a case-by-case basis, since the quality of life can be improved more by medication or surgery, depending on the situation of the affected person. The use of surgical therapy has to be decided on a case-by-case basis, since, depending on the situation of the affected person, the quality of life can be improved more by medication or more by surgery.