PATOPHYSIOLOGY AND CLINICAL MANIFESTATION OF

OSMOTIC DIARRHEA, SECRETORY DIARRHEA, AND

DYSMOTILTY DIARRHEA
SECRETORY DIARRHEA
Peningkatan
cGMP, cAMP,
calcium intra
celullar
microbial
enterotoxins
endogenous
endocrine
inflammatory
cytokines
Stool volume
Response to fasting
Stool osmolality
Ion gap
Nelson textbook of pediatrics 19th edition, 2011
OSMOTIC DIARRHEA
Peningkatan
Tekanan
osmotic intara
lumen
intestinal
damage (such
as in enteric
infection),
reduced
functional
absorptive
surface (such
as in celiac
disease)
defective
digestive enzyme
or nutrient carrier
(such as in lactase
deficiency)
decreased
intestinal
transit time
(such as in
functional
diarrhea
nutrient
overload
exceeding the
digestive
capacity
Stool volume
Response to fasting
Stool osmolality
Ion gap
Nelson textbook of pediatrics 19th edition, 2011
DYSMOTILITY DIARRHEA
hypermotility
drugs (e.g.,
prostaglandin
s, prokinetic
agents)
Hyperthyroidis
m, carcinoid
syndrome
diarrhea
Hirschsprung
disease
chronic
idiopathic
intestinal
pseudo-
obstruction
Hypomotility /
statis
secondary
bacterial
overgrowth
Nelson textbook of pediatrics 19th edition, 2011
Harrisons principles of internal medicine 18th edition, 2012
CLINICAL MANIFESTATION
CLINICAL MANIFESTATION
Diare
Osmotic
Stool volume : moderately increased
Fasting diarrhea stop
Stool osmolality normal-increased
Secretory
Stool volume : very large
Fasting continue
Stool osmolality normal