Acute diarrhea pathophysiology

Acute Diarrhea Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

The exact pathogenesis of [disease name] is not fully understood.

OR

It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].

OR

[Pathogen name] is usually transmitted via the [transmission route] route to the human host.

OR

Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.

OR

[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].

OR

The progression to [disease name] usually involves the [molecular pathway].

OR

The pathophysiology of [disease/malignancy] depends on the histological subtype.

Pathophysiology

Pathogenesis

• The exact pathogenesis of acute diarrhea is different for infectious and non-infectious causes.

Osmotic diarrhea

• Stool osmotic gap in cases of osmotic diarrhea is characterized by osmotic gap >125 mOsm/kg and fasting leads to cessation of diarrhea. 
• This may occur due to increased osmolarity due to nonabsorbable carbohydrates within the intestinal lumen, such as lactulose which induces a secretory state.
• Diarrhea induced by enterotoxins generate a secretory state by increasing secretion of anions.

Secretory diarrhea

• It is understood that diarrhea is the result of alteration of the absorptive role of the gut to a secretory one.
• In secretory diarrheas, stool osmotic gap is <50 mOsm/kg and fasting does not lead to diarrhea cessation.
• Bacterial infection of the intestine leads to activation of epithelial ion channels with increased secretion of anions.
• Invasion of the epithelium by various pathogens lead to exotoxin production and enhancement of enterocyte secretion by cytotoxins or intracellular signalling.
• Cytokines activate release of inflammatory mediators such as platelet activating factor and prostaglandins which stimulate secretion.

Genetics

• [Disease name] is transmitted in [mode of genetic transmission] pattern.
• Genes involved in the pathogenesis of [disease name] include [gene1], [gene2], and [gene3].
• The development of [disease name] is the result of multiple genetic mutations.

Gross Pathology

• On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].

Microscopic Pathology

• On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].