[Diarrhea. III. Diarrhea as a sequela of inhibited ion absorption --diarrhea as a sequela of abnormal mucosal permeability--relation between diarrhea and steatorrhea].
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Celiac Disease↗
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Virus detection in monkeys with diarrhea: the association of adenoviruses with diarrhea and the possible role of rotaviruses.
To explore the role of viruses in the etiology of diarrhea in colony-reared monkeys, direct electron microscopy, the fluorescent virus precipitin test and cell culture inoculation were used to examine the stools of monkeys with and without diarrhea. The animals were predominantly rhesus with a few macaques of other species, and included infants, juveniles and adults. Adenoviruses were isolated from a higher proportion of specimens from rhesus monkeys with diarrhea (73% of specimens from infants and 78% of specimens from juveniles and adults) than from control monkeys without diarrhea (22% of specimens from infants and 26% of specimens from juveniles and adults). SV 20 was the most frequently isolated simian adenovirus type; SV 17 and SV 32 also were recovered. Noncultivable adenoviruses detectable only by electron microscopy were not seen. Although adenovirus excretion was associated with diarrhea, the causal role of adenoviruses was difficult to assess. When serial specimens from animals with chronic or intermittent episodes of diarrhea were examined, sequential infections with different viruses were found to be common. Rotaviruses were detected by electron microscopy and isolated in cell cultures from two infant rhesus monkeys with diarrhea. However, the low detection rate, together with negative serologic data on 40% of infant monkeys with diarrhea, suggested that rotaviruses were not the major cause of gastroenteritis in the monkeys under study.
Adenoviridae↗
Symposium on diarrhea. 2. Clinical diagnosis of the causes of diarrhea.
Elucidation of the cause of diarrhea is facilitated by considering which of three principal determinants are of relevance in a particular case. These determinants relate to the onset (whether diarrhea is acute or chronic), to infection or an absence ofinfection and to the presence in the stool of blood or mucus, or both. Diagnosis is also facilitated by taking an accurate and full history, conducting a physical examination, performing sigmoidoscopy and, with proper care, attempting a therapeutic diagnosis. Findings from investigations should then enable one to arrive at a diagnosis. The diagnosis can be reached in an orderly fashion by classifying the types of diarrhea into eight categories: with respect to the acute or chronic onset a case of diarrhea may be noninfectious, without blood or mucus in the stool; noninfectious, with blood or mucus, or both; infectious, without blood or mucus; and infectious, with blood or mucus in the stool.
Acute Disease↗
Detection of neonatal calf diarrhea virus, infant reovirus-like diarrhea virus, and a coronavirus using the fluorescent virus precipitin test.
Thirty-four calf and five infant fecal specimens were tested for the neonatal calf diarrhea virus (NCDV) and for the reovirus-like infantile diarrhea agent; respectively. The procedures used were the fluorescent virus precipitin test and immune electron microscopy. Fourteen of the calf stools contained detectable NCDV, and four of the five infant stools contained the reovirus-like human agent. Infectious NCDV was detected in four of the 34 calf fecal specimens when Madin-Darby bovine kidney cell cultures that had been inoculated with supernatant fluids from stool suspensions were stained with fluorescent antibody. The 20 calf stools that did not have detectable virus were examined for the bovine corona diarrhea virus. Coronavirus was found in two of these specimens.
Animals↗
Symposium on diarrhea. 3. Investigation of chronic diarrhea.
The practical approach to the investigation of diarrhea must be logical and based on anatomic considerations. The site of the underlying disorder may be determined by the clinical picture, and the logic of investigation will be influenced by the history. Important specific investigation in a case of colonic diarrhea include a careful rectal examination, stool inspection, sigmoidoscopy, rectal biopsy and barium enema study. Colonoscopy has been used, but its role has yet to be defined. In a case of small-bowel steatorrhea or diarrhea quantitative chemical estimation of the daily output of stool fat is useful, and to this investigation is added a small-bowel radiograph series and, if the radiographic findings are abnormal, small-bowel biopsy. Other investigations for small-bowel disease may include the breath test with carbon-14-labelled glycocholic acid, the lactose tolerance test, duodenal aspiration for giardiasis, analysis of serum immunoglobulins and, on occasion, isolation of vasoactive intestinal polypeptide hormone (which may aid the diagnosis of functioning tumours of the pancreas or small bowel). Investigations for pancreatic steatorrhea include abdominal radiography, performance of the secretin test and testing of the response to pancreatic replacement therapy. In some patients it may be useful to use endoscopic retrograde cholangiopancreatography to differentiate pancreatic carcinoma and chronic pancreatitis.
Biopsy, Needle↗
Symposium on diarrhea. 1. Definition and mechanisms of diarrhea.
Diarrhea, an increase in frequency of evacuation and in water content of the stool, is the result of three categories of mechanism--solute malabsorption, secretion of fluid and motility disturbance. Before diarrhea is considered an abnormal condition, any alteration in stool frequency and content must be related to an individual person's normal bowel habit and to norms for the population, but more than three bowel movements or the passage of liquid stools exceeding 300 g daily should, in general, be considered abnormal. A useful way of understanding the mechanism of diarrhea is to become familiar with the normal functions of the bowel in regard to water and electrolyte absorption and motility, and then to relate these functions to solute malabsorption, fluid secretion and motility disturbance.
Diarrhea↗
Symposium on diarrhea. 5. Postoperative diarrhea.
Under normal circumstances many physiologic mechanisms prevent diarrhea. The most important are the normal processes of gastric emptying, digestion and absorption, the functioning of the ileocecal valve and elimination of bacteria from the small bowel. A surgical procedure may disrupt any of these mechanisms or may unmask a previously asymptomatic disorder that now requires appropriate treatment. Treatment of diarrhea related to surgery may be directed toward the diarrhea itself with such agents as tranquilizers and opiates but if these are not soon effective any disrupted functions must be analysed and specific measures taken to correct or compensate for these disruptions. The most useful measures in appropriate cases are the prevention of the dumping syndrome and the administration of pancreatic enzymes, cholestyramine, hydrophilic stool thickeners and broad-spectrum antibiotics. These measures may be ineffective or inadequate and surgical revision may be necessary.
Diarrhea↗
Symposium on diarrhea. 4. Diarrhea in the irritable colon syndrome.
The irritable colon syndrome comprises two predominant symptom patterns -- "spastic colon" with pain and constipation, and painless "nervous diarrhea". The two patterns frequently overlap. Low intake of dietary fibre is common to patients in both groups. Diagnosis of the irritable colon as a cause of diarrhea requires the characteristic symptom pattern and exclusion of organic disease. Management is based on common sense, careful reassurance of the patient, detailed explanation of the symptom pattern and explicit dietary advice. Increasing fibre in the diet is of prime importance in most patients.
Colonic Diseases, Functional↗
Symposium on diarrhea. 6. Infectious diarrhea.
Diarrhea may be primarily infectious in origin. Causes can be conveniently classified according to the etiologic agent, which may be viral, chlamydial, bacterial, protozoal, helminthic or fungal. The most common type of infectious diarrhea in Canada is viral. Bacterial infection, particularly staphylococcal and salmonellal, also is relatively common.
Anti-Infective Agents↗
Rearing regimen producing piglet diarrhea (rotavirus) and its relevance to acute infantile diarrhea.
Piglets were weaned when 1 day old and thus were denied further access to the antibodies supplied by their dam's milk. They were placed in a nursery in which contamination by the ubiquitous rotavirus steadily increased with continuous use causing a progressive increase in the incidence of vomiting, diarrhea, and death among the piglets. A similar syndrome involving an antigenically related rotavirus and analogous management practices occurs in human infants.
Animals↗
[Infectious diarrhea. Prevention and treatment. Microbiological basis of infectious diarrhea].
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Adult↗
Fecal steroids in diarrhea. II. Travellers' diarrhea.
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Adult↗
[Studies on diarrhea of young calves. 1. Quantitative analysis of the gastrointestinal flora in clinically healthy calves and in calves with diarrhea].
Quantitative composition of gastro-intestinal-flora was determined in 23 clinically healthy calves and the course of germ spreading was followed up. In comparison with these healthy animals in 25 diarrhoea affected calves at the age of 4 to 17 days there could be observed signigicant differences only in few parts of the gastro-intestinal-tract concerning the quantitative composition of germ flora. Only in 3 animals enterotoxin producing E coli strains could be detected.
Animals↗
[Study on diarrhea in young calves. 2. Pathomorphological studies in clinically healthy calves and in calves with diarrhea].
Pathological-anatomical and histological investigations were performed in 49 calves aged from 1 to 18 days, 26 of them being affected by diarrhoea, 23 being without clinical signs. In both the groups above all rhinitis, gastritis and typhlocolitis could be observed, thus the affection could be characterized as rhinogastrocolitis. Significant differences only existed between diarrhoea affected and clinical incospicuous calves concerning the macroscopic signs of the colon, periportal infiltrates of the liver and thymus in involution. The peak of inflammatory reaction is in general reached at the 7. to 10. day of life. In concordance with bacteriological findings the results refer to an affection not due to coli infection. Virus etiology may not be excluded and has to be examined in further studies.
Animals↗
[Pathology and pathogenesis of coli dysentery and coli diarrhea in suckling piglets. 1. Studies on the pathomorphology of the gastrointestinal tract in coli dysentery as well as coli diarrhea in the suckling piglet].
The following findings were obtained from histomorphological examination of 45 piglets with coli-bacillosis (with serotypical Escherichia coli detected) and ten piglets with coli-diarrhoea (with non-serotypical E. coli detected): Diarrhoea accompanying either disease was not attributable to catarrhal or haemorrhagic gastro-enteritis. The mucous membrane of the gastro-insestinal tract remained histomorphologically intact in either disease. No change was recorded particularly from villous or surface epithelia and glandular epithelium, and the villous structure was not basically altered. Different degrees of hyper aemia of the gastro-intestinal mucous membrane and moderate oedematisation of the villous stroma were irregular findings. Adhesion of enteropathogenic E. coli to mucous membrane surface was observed but rarely and did not exhibit any visible relationship with the incidence in E. coli of L-antigen K88. In coli-bacillosis and coli-diarrhoea both the diarrhoea and morphological situation of the gastro-bacillosis tract were in conformity with the cholera-type "intestinal noninflammatory secretory diarrhoea" as caused by enterotoxins. Other issues relating to pathology and diagnosis are also discussed.
Animals↗
[Diarrhea. I. Anatomic-functional apparatus--osmotic diarrhea].
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Diarrhea↗
[Diarrhea. II. Secretory diarrhea].
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Diarrhea↗
Acute undifferentiated neonatal diarrhea in beef calves. I. Occurence and distribution of infectious agents.
Beef calves in a 48-cow herd were studied during one calving season from birth to ten days of age to determine the presence or absence of potentially enteropathogenic bacteria, viruses, and/or chlamydia in both normal and diarrheic calves. Calves were born and raised outside in large pens unless the ambient temperature was below minus 10 degrees F when calving was done inside. Fecal swabs, fecal aliquots, and nasal swabs were taken from each calf at 32, 128 plus or minus 3, and 248 plus or minus 3 hours of age and as soon after the onset of diarrhea as possible. Diarrhea was defined as that condition in which the feces contained less than 10% dry matter. Enteropathogenic Escherichia coli in feces were identified using the ligated gut loop procedure in calves and by feeding broth cultures to colostrum fed lambs seven to 16 hours old. Potentially enteropathogenic viruses were detected using a variety of methods which included tissue culture, fluorescent antibody, hemadsorption, and electron microscope techniques. Of the 40 calves studied, 32 (80%) developed diarrhea before ten days of age. Twenty-two strains of Escherichia coli which caused dilation of calf ligated intestinal loops were isolated from 11 scouring calves and from one normal calf. Nine out of ten strains of Escherichia coli which dilated ligated loops also caused diarrhea when fed to colostrum-fed lambs seven to 16 hours old. Using antibody technique a Reo-like virus was detected in the feces of 15 calves before, during, and after the onset of diarrhea. Four calves excreted both loop dilating strains of E. coli and Reo-like virus in the feces before ten days of age; in all cases the loop dilating E. coli were isolated from the feces prior to the demonstration of Reo-like virus. A Corona-like virus was also demonstrated in three of the 15 calves infected with Reo-like virus and a noncytopathogenic strain of bovine virus diarrhea virus was isolated from two of the 15 calves infected with Reo-like virus. A loop dilating strain of Citrobacter was isolated from one diarrheic calf. There was no consistent pattern of onset or duration of diarrhea in calves which excreted different infectious agents. Salmonella species, infectious bovine rhinotracheitis virus, parvovirus, adenoviruses, parainfluenza-3 virus, and Chlamydia species could not be demonstrated in any of the calves or their dams. No potentially enteropathogenic agents could be demonstrated in 11 of the 32 calves which scoured. These findings emphasize the complexity of the infectious aspect of the neonatal diarrhea syndrome and illustrate the difficulty in making an etiological diagnosis in field outbreaks of the calf scours complex.
Acute Disease↗