!! Prevention Is Better Than Cure !!

Tuesday, January 8, 2008

Diarrhea : 1

Any adult individual usually drinks about 2L of fluid in a day and swallows around 1L litre of saliva. He also secretes 2 L of gastric juice and 4L of biliary, pancreatic and small intestine secretions.
So the total fluid entering the gastrointestinal tract is around 9L.
Out of this 9L of fluid entering the gastrointestinal tract around 8 L of fluid is reabsorbed in small intestine - 4-5 L in jejunum ( initial portion of small intestine) and around 3-4L in ilium ( end portion of small intestine) .
So the total fluid entering in large bowel is approximately 1L. Out of which about 800 mL is again reabsorbed during passage in large bowel towards the rectum and evacuation.
Overall the usual amount of fluid excreted in feces is approximately 200 mL/ day.

Defecation:
Fecal matter and fluid entering the rectum causes acute distention of rectum. This distention causes internal anal sphincter to relax. Defecation can now occur if external anal sphincter relaxes simultaneously. But if this is not socially acceptable time for the individual then external anal sphincter can prevent the defecation till socially acceptable time.
With socially acceptable time concomitant relaxation of both internal as well external anal sphincters permits evacuation of feces,which can be augmented by voluntary increase in intra abdominal pressure by the individual.

Normal Feces:
Normal individual usually evacuate approximately 200 gm of the stool per day. Water content of this stool is approximately 60-85 % of stool weight.
Normal bowel frequency can range anything from 3 times a day to 3 times a week.
Normal consistency of the stool is solid, well formed.
Factors which influence weight, consistency and frequency of stool are fiber content of the diet, gender, ingested medications if any, possibly exercise and stress.
The weight of stool in women is less than that of man.

Diarrhea:
Diarrhea means increase in stool weight more than 200 gm/day.
Along with increase in weight there also may be increase in frequency and change in consistency of the feces. Stools usually becomes more liquid rather than well formed solid.
Acute Diarrhea: Diarrhea which lasts less than 7 to 14 days.
Chronic Diarrhea : Diarrhea which lasts more than 2 to 3 weeks.

Pseudodiarrhea:
Another word for pseudo diarrhea is Hyper defecation. The term is self explanatory in itself. There is increase in frequency of defecation without increase in stool weight above normal.
This may happen in certain conditions such as Irritable Bowel Syndrome ( IBS) , local rectal causes such as Proctitis or some endocrine conditions such as Hyperthyroidism .

Incontinence :
This is involuntary release of rectal contents. This can occur if the stool is more liquid. This is mainly because of abnormal function of anorectal and pelvic muscles.