Osmotic diarrhea is a pathological intestinal disorder, which is accompanied by an increased number of bowel movements and a change in the structure of feces. The osmotic type differs from other varieties in that it is characterized by a permanent violation of the functioning of the gastrointestinal tract.
Varieties of diarrhea
In medical practice, four types of diarrheal disorders are distinguished:
- Secretory diarrhea.
- Osmotic.
- Mixed.
- Invasive
Having an idea of the origin and pathogenesis of intestinal disorder, it is possible to identify the cause of the osmotic type of diarrhea and eliminate it, and not treat the symptoms without a positive result.
An invasive form of diarrhea is accompanied by an active lesion of the colon by pathogenic microorganisms. In this case, the signs of the disease pass after taking antibacterial drugs.
The appearance of secretory diarrhea is due to toxic damage to the body by the products of the vital activity of bacteria. In this case, the treatment consists in replenishing the balance of electrolytes and affecting the pathogen.
Consider the definition of osmotic diarrhea. It is characterized as a continuous disorder in the work of the gastrointestinal tract, accompanied by a violation of the digestive processes and motility of the colon. The intestine becomes unable to fully perform its functions, which leads to the accumulation of water and sodium in it, thinning the stool and irritating the mucous membrane. Quite often, symptoms of osmotic diarrhea occur against various pathological processes in the digestive system, such as diseases of the intestines, gall bladder, and pancreas in a chronic form.
Causes
There are quite a few factors that can affect the appearance of osmotic diarrhea. In most cases, it occurs as a result of an infectious lesion of the body, for example, with enterovirus or rotavirus. However, diarrhea may appear against the background of other conditions:
1. Chronic pancreatitis often leads to stool disorders. Moreover, in this case, prolonged constipation is replaced by no less prolonged diarrhea. The osmotic type of diarrhea is a concomitant symptom of pancreatitis and occurs as a result of a lack of enzymes and bile acids. Eaten food is poorly digested and quickly enters the intestines in the form of coarse fibers. Deficiency of pancreatic enzymes is also observed with cancer of the pancreas and gall bladder, as well as with obstructive jaundice.
2. Another cause of osmotic diarrhea is hereditary fermentopathy. Children often suffer from intolerance to foods such as lactose and gluten. Such pathologies are accompanied by colic, anxiety, soreness in the abdomen and upset stool. Diagnosis, as a rule, is not difficult. Disaccharide deficiency occurs as a result of a violation of the production of lactose and sucrose. Without disaccharides, these substances are not absorbed by the small intestine. Carbohydrates that do not undergo a cleavage process are excreted through the large intestine and cause osmotic diarrhea.
3. Another type of fermentopathy is hypolactasia. In this case, diarrhea occurs after consuming fermented milk and dairy products. After a couple of hours, the patient begins to feel flatulence, rumbling, pain. Feces become fluid, voluminous and foamy. Such a condition is dangerous with the likelihood of developing water-electrolyte imbalance. The only way to treat hypolactasia is to follow a special diet.
4. Another cause of diarrhea is surgery performed on one of the intestines, for example, anastomoses or resections. After such an intervention, there is a high risk of impaired osmosis. This is due to the shortening of the contact interval between the digested products and the intestinal wall undergoing resection. Nutrients do not have enough time to fully absorb. Against this background, polyphecal syndrome develops, when with feces, food remains that do not have time to digest are released.
5. Long-term use of laxatives in excess of the prescribed dosages can also cause the development of pathology.
Symptoms
The following symptoms are characteristic of osmotic diarrhea:
- Increased excreted stool mass and increased toilet visits.
- Soreness in the large intestine.
- Discomfort arising against the background of bloating.
- Liquefaction of feces, their watery contents. In pathology caused by bacterial damage, the excreted masses acquire a greenish color.
- Body temperature rises as the body responds to an irritant.
- Dehydration due to prolonged diarrhea, accompanied by thirst, dry skin and mucous membranes.
If the symptoms of osmotic diarrhea do not go away for a long time, and the patient feels a worsening condition, you should consult a doctor.
Diagnostics
At the initial stage of the examination of the patient, the doctor conducts a physical examination. In addition, a detailed history is collected with a clarification of the contents of feces and a proctological examination is performed. In the presence of blood impurities in the feces, as well as in the detection of anal fissure, fistulous passage or paraproctitis, we can talk about Crohn's disease.
Microscopic examination reveals the presence of mast cells, protozoa and worm eggs in the contents of feces. When conducting sigmoidoscopy, it is possible to diagnose dysentery, ulcerative or pseudomembranous colitis. Laboratory diagnostic methods are based on macro- and microscopic examination of a stool sample.
If the diagnosis shows the absence of an inflammatory process, we can conclude that diarrhea was the result of impaired absorption. Acute diarrhea can be caused by enteroviruses, therefore, a blood test is performed for the presence of these microorganisms.
When diagnosing osmotic diarrhea, it is necessary to find out if there is a connection between this symptom and an infectious or inflammatory disease. To this end, various studies of feces are carried out, including bacteriological, microscopic and sigmoidoscopy. To exclude inflammation as a factor in the occurrence of diarrhea, a pathogenetic mechanism is determined. In some cases, for proper diagnosis, diet is prescribed for some time.
Treatment of osmotic diarrhea
Treatment of the disease involves two directions: elimination of symptoms and therapy of the cause of the pathology. At the initial stage, the patient is rehydrated. If the patient’s condition is not characterized as severe, you can establish a drinking regime, thereby compensating for the lost volume. Rehydration involves frequent drinking of water in small quantities every 10-15 minutes. In more complex cases, the patient should be monitored in an inpatient setting. There, the patient will be given droppers with glucose, saline and Ringer's solution.
Antibiotics
After eliminating dehydration, antibacterial drugs are prescribed. When an intestinal infection is detected, Bactrim, Biseptol and other drugs from the sulfonamide group are prescribed. Another popular drug for the treatment of intestinal infectious diseases is Nifuroxazide. This drug is an antimicrobial agent that has an antiseptic effect. The disadvantage of antibiotic therapy is the inhibition of not only pathogenic microflora, but also healthy bacteria in the intestine.
Probiotics
Against the background of antibiotic therapy or after its completion, the administration of probiotics is also prescribed. These drugs restore the balance of intestinal microflora and contribute to its normal functioning. Such medicines include Linex, Acipol, Biogaya, Enterozhermina, Lactofiltrum, etc. These drugs will help to avoid diarrhea caused by taking antibiotics, while not causing any harm to the body.
Medications to slow down peristalsis
In the future, symptomatic treatment begins, consisting in taking medications that can slow intestinal motility. The following drugs are most often prescribed for osmotic diarrhea, stopping it:
1. Loperamide. Peristalsis slows down as a result of drug binding to receptors of the colon mucosa and inhibition of acetylcholine production. The drug is in the form of capsules for oral administration. The most commonly prescribed regimen is to take one capsule after each pathogenic bowel movement. A very popular analogue of Loperamide is Imodium.
2. "Codeine phosphate." It is prescribed for the treatment of various syndromes, including cough, pain and diarrhea. The drug is taken in short courses and small dosages. The treatment regimen for Codeine Phosphate should be determined by your healthcare provider.
Medical nutrition
None of the proposed methods of therapy will give a positive result in the presence of signs of osmotic diarrhea, unless the patient begins to follow special medical nutrition. It is a gentle, dietary diet that will help restore normal bowel and stomach function.
Recommendations
When drawing up the right diet, the following recommendations should be considered:
- Soups should be vegetarian.
- Groats must be boiled in water.
- Instead of bread, you should use crackers.
- Tea should be drunk without added sugar.
- You can eat baked apples.
- Meat can only be low-fat varieties and in strictly limited quantities.
It is necessary to follow a diet for several weeks, even after intestinal motility has been fully restored.
Complications and consequences
If timely measures are not taken to treat osmotic diarrhea, the following complications may develop:
- Mild, moderate, and severe dehydration. This condition is calculated based on the percentage of patient weight loss. In the first stage of dehydration, body weight loss is about three percent, in the second it reaches 4-6 percent, and in the third more than seven percent. In addition, a significant loss of fluid and electrolytes can provoke the development of kidney failure and other pathologies of these organs.
- Septic or hypovolemic shock.
- Metabolic acidosis.
- Hypokalemia.
- Incessant diarrhea.
- Convulsive syndrome, accompanied by loss of consciousness and falling into a coma.
- Intestinal bleeding.
In order to avoid the unpleasant consequences of osmotic diarrhea, it is necessary to consult a specialist in a timely manner and carry out both symptomatic and aimed at eliminating the causes of the pathology.