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Diarrhea is a frequent occurrence in gastrointestinal diseases
.

Diarrhea is a frequent occurrence in gastrointestinal diseases
.

To treat diarrhea, we must first understand the classification, pathogenic factors and clinical symptoms of diarrhea, so as to better choose treatment methods and drugs
.

To treat diarrhea, we must first understand the classification, pathogenic factors and clinical symptoms of diarrhea, so as to better choose treatment methods and drugs
.

01Classification of diarrhea

01Classification of diarrhea01 Classification ofdiarrhea

Diarrhea can be divided into six types according to the pathogenic factors: infectious diarrhea, inflammatory diarrhea, digestive diarrhea, irritant or traveler's diarrhea, dysbacteriosis diarrhea and functional diarrhea
.

Diarrhea can be divided into six types according to the pathogenic factors: infectious diarrhea, inflammatory diarrhea, digestive diarrhea, irritant or traveler's diarrhea, dysbacteriosis diarrhea and functional diarrhea
.

Infection Digestion

02Causes of Diarrhea

02Causes of Diarrhea02 Causes ofDiarrhea

First, infectious diarrhea

First, infectious diarrhea

Mostly by bacteria (Vibrio parahaemolyticus, Salmonella, Staphylococcus aureus, Escherichia coli, Shigella), fungi (Candida enterica), viruses (rotavirus, Coxsackie virus), parasites (ameba , schistosomiasis, dinoflagellate pear) infection or collective food poisoning
.

Mostly by bacteria (Vibrio parahaemolyticus, Salmonella, Staphylococcus aureus, Escherichia coli, Shigella), fungi (Candida enterica), viruses (rotavirus, Coxsackie virus), parasites (ameba , schistosomiasis, dinoflagellate pear) infection or collective food poisoning
.

Second, inflammatory diarrhea

Second, inflammatory diarrhea

Caused by rectal or colon ulcers, tumors, or inflammation
.

Caused by rectal or colon ulcers, tumors, or inflammation
.

Third, digestive diarrhea

Third, peptic diarrhea digestion

Caused by indigestion, malabsorption, or overeating
.

Caused by indigestion, malabsorption, or overeating
.

Fourth, irritable or traveler's diarrhea

Fourth, irritable or traveler's diarrhea

It is often caused by various external stimuli, such as cold, unaccustomed to the soil and water, over-eating seafood, greasy or spicy food and so on
.

It is often caused by various external stimuli, such as cold, unaccustomed to the soil and water, over-eating seafood, greasy or spicy food and so on
.

Fifth, dysbacterial diarrhea

Fifth, dysbacterial diarrhea

It is usually caused by long-term oral administration of broad-spectrum antibiotics and adrenocortical hormones due to the imbalance in the growth and quantity or proportion of normal intestinal bacteria
.

It is usually caused by long-term oral administration of broad-spectrum antibiotics and adrenocortical hormones due to the imbalance in the growth and quantity or proportion of normal intestinal bacteria
.

antibiotic

Sixth, functional diarrhea

Sixth, functional diarrhea

Caused by mental factors, such as tension, excitement, fright or colon allergies
.

Caused by mental factors, such as tension, excitement, fright or colon allergies
.

03Clinical  symptoms of diarrhea

03Clinical  symptoms of diarrhea03Clinical  symptoms of diarrhea

1.
Acute diarrhea is more common in intestinal infection, food poisoning, hemorrhagic necrotizing enteritis, acute localized enteritis, intestinal purpura,
etc.

1.
Acute diarrhea is more common in intestinal infection, food poisoning, hemorrhagic necrotizing enteritis, acute localized enteritis, intestinal purpura,
etc.

Acute diarrhea is divided into two subtypes:

Acute diarrhea is divided into two subtypes:

Dysentery-like diarrhea: There may be mucosal damage, frequent discharge of purulent and bloody stools, accompanied by abdominal pain and tenesmus
.

Dysentery-like diarrhea: There may be mucosal damage, frequent discharge of purulent and bloody stools, accompanied by abdominal pain and tenesmus
.

Watery diarrhea: without red blood cells, pus cells, without abdominal pain and tenesmus
.

Watery diarrhea: without red blood cells, pus cells, without abdominal pain and tenesmus
.

2.
Chronic diarrhea: characterized by slow onset, seen in amoebic dysentery, tuberculosis, schistosomiasis, tumors,
etc.

2.
Chronic diarrhea: characterized by slow onset, seen in amoebic dysentery, tuberculosis, schistosomiasis, tumors,
etc.

3.
Whole batches of diners in collective canteens with the same symptoms are collective food poisoning, epidemic diarrhea or the prevalence of infectious diseases
.

3.
Whole batches of diners in collective canteens with the same symptoms are collective food poisoning, epidemic diarrhea or the prevalence of infectious diseases
.

4.
Small intestinal inflammatory diarrhea: abdominal pain does not relieve after diarrhea
.

4.
Small intestinal inflammatory diarrhea: abdominal pain does not relieve after diarrhea
.

5.
Colitis diarrhea: Most of the abdominal pain after diarrhea can be relieved
.

5.
Colitis diarrhea: Most of the abdominal pain after diarrhea can be relieved
.

04  Fecal properties provide reference for clinical diagnosis

04  Fecal characteristics provide reference for clinical diagnosis04 Fecal  characteristics provide reference diagnosis for clinical diagnosis

①The stool is thin and watery and the amount is large, which is intestinal inflammatory diarrhea;

①The stool is thin and watery and the amount is large, which is intestinal inflammatory diarrhea;

②Pus and blood stools or mucus stools are mostly bacillary dysentery;

②Pus and blood stools or mucus stools are mostly bacillary dysentery;

③ Dark red jam-like stools are seen in amebiasis;

③ Dark red jam-like stools are seen in amebiasis;

④Blood water or watery stools from washing meat are seen in halophilic food poisoning and acute hemorrhagic necrotizing enteritis;

④Blood water or watery stools from washing meat are seen in halophilic food poisoning and acute hemorrhagic necrotizing enteritis;

⑤ Yellow water samples are found in Salmonella or Staphylococcus aureus food poisoning;

⑤ Yellow water samples are found in Salmonella or Staphylococcus aureus food poisoning;

⑥ Rice swill samples are found in cholera or paracholera;

⑥ Rice swill samples are found in cholera or paracholera;

⑦ steatorrhea and clay-colored stools are seen in intestinal obstruction and malabsorption syndrome;

⑦ steatorrhea and clay-colored stools are seen in intestinal obstruction and malabsorption syndrome;

⑧Yellow-green mixed with milk valve is more common in children with indigestion
.

⑧Yellow-green mixed with milk valve is more common in children with indigestion
.
child

⑨ The irritable diarrhea is mostly watery stools with fecal particles, rapid diarrhea, and at the same time there are bowel sounds and severe abdominal pain
.

⑨ The irritable diarrhea is mostly watery stools with fecal particles, rapid diarrhea, and at the same time there are bowel sounds and severe abdominal pain
.

After understanding the classification, etiology and clinical symptoms of diarrhea, let's talk about the drug treatment of diarrhea
.

After understanding the classification, etiology and clinical symptoms of diarrhea, let's talk about the drug treatment of diarrhea
.

05Drug  therapy for diarrhea

05Drug  therapy for diarrhea05Drug  therapy for diarrhea

First, infectious diarrhea

First, infectious diarrhea

1.
Over-the-counter medication

1.
Over-the-counter medication

Berberine hydrochloride tablets (berberine hydrochloride tablets) should be the first choice for mild acute diarrhea caused by dysentery and Escherichia coli infection;

Berberine hydrochloride tablets (berberine hydrochloride tablets) should be the first choice for mild acute diarrhea caused by dysentery and Escherichia coli infection;

Oral medicinal charcoal, medicinal charcoal can absorb intestinal gas, bacteria and toxins, pay attention to take it before meals
.

Oral medicinal charcoal, medicinal charcoal can absorb intestinal gas, bacteria and toxins, pay attention to take it before meals
.

Tannin reduces inflammation and protects the intestinal mucosa.
Take it on an empty stomach
.

Tannin reduces inflammation and protects the intestinal mucosa.
Take it on an empty stomach
.

2.
Prescription drug treatment

2.
Prescription drug treatment

For acute diarrhea caused by bacterial infection, oral levofloxacin, ofloxacin, ciprofloxacin and norfloxacin should be used (norfloxacin is contraindicated in children under the age of 18 ) .

For acute diarrhea caused by bacterial infection, oral levofloxacin, ofloxacin, ciprofloxacin and norfloxacin should be used (norfloxacin is contraindicated in children under the age of 18 ) .

Second, digestive diarrhea 

Second, digestive diarrhea 

Digestive diarrhea can be treated with over-the-counter medications
.

Digestive diarrhea can be treated with over-the-counter medications
.

Pancreatin should be taken for dyspepsia diarrhea caused by pancreatic insufficiency
.

Pancreatin should be taken for dyspepsia diarrhea caused by pancreatic insufficiency
.

Pancreatin and sodium bicarbonate can be taken for food intake
.

Pancreatin and sodium bicarbonate can be taken for food intake
.

Oral pepsin is suitable for those with indigestion caused by protein intake
.

Oral pepsin is suitable for those with indigestion caused by protein intake
.

For those accompanied by abdominal distension, lactase raw tablets or dimethicone tablets can be used
.

For those accompanied by abdominal distension, lactase raw tablets or dimethicone tablets can be used
.

Third, irritable diarrhea 

Third, irritable diarrhea 

1.
Over-the-counter drugs

1.
Over-the-counter drugs

Double octahedral montmorillonite: It can be used for diarrhea caused by chemical stimulation.
Its pharmacological effect is to cover the digestive tract, strengthen the mucus barrier after combining with mucosal proteins, and prevent the damage of acid, virus, bacteria and toxin to the digestive tract mucosa.
Lactase raw or probiotics (such as bifid triple viable bacteria capsules, etc.
)
.

Double octahedral montmorillonite: It can be used for diarrhea caused by chemical stimulation.
Its pharmacological effect is to cover the digestive tract, strengthen the mucus barrier after combining with mucosal proteins, and prevent the damage of acid, virus, bacteria and toxin to the digestive tract mucosa.
Lactase raw or probiotics (such as bifid triple viable bacteria capsules, etc.
)
.

Irritant diarrhea should pay attention to keeping the abdomen warm and control the diet (eat less cold, greasy, spicy and irritating food)
.

Irritant diarrhea should pay attention to keeping the abdomen warm and control the diet (eat less cold, greasy, spicy and irritating food)
.

2.
Prescription drugs

2.
Prescription drugs

Irritant diarrhea can take nifedipine tablets, orally, 10-20mg at a time , 2 times a day .
The pharmacological effect is to promote intestinal absorption of water and inhibit gastrointestinal movement and contraction .
Note that this method should not be used in patients who are taking nifedipine or other antihypertensive drugs .

Irritant diarrhea can take nifedipine tablets, orally, 10-20mg at a time , 2 times a day .
The pharmacological effect is to promote intestinal absorption of water and inhibit gastrointestinal movement and contraction .
Note that this method should not be used in patients who are taking nifedipine or other antihypertensive drugs .

Fourth, intestinal flora dysbiosis diarrhea  

Fourth, intestinal flora dysbiosis diarrhea  

It can be treated with probiotics
.

It can be treated with probiotics
.

Bifidobacterium triple viable bacteria preparation, its pharmacological effect is to combine with intestinal mucosa epithelial cells, occupy the surface of intestinal mucosa with other anaerobic bacteria, form a biological barrier, and prevent the invasion of pathogenic bacteria
.

Bifidobacterium triple viable bacteria preparation, its pharmacological effect is to combine with intestinal mucosa epithelial cells, occupy the surface of intestinal mucosa with other anaerobic bacteria, form a biological barrier, and prevent the invasion of pathogenic bacteria
.

Lactobacillus acidophilus tablets, its pharmacological effect is to inhibit the growth of spoilage bacteria in the intestine, prevent the fermentation of protein in the intestine, thereby reducing abdominal distension and diarrhea
.

Lactobacillus acidophilus tablets, its pharmacological effect is to inhibit the growth of spoilage bacteria in the intestine, prevent the fermentation of protein in the intestine, thereby reducing abdominal distension and diarrhea
.

Fifth, viral diarrhea  

Fifth, viral diarrhea  

The application of antibiotics or probiotics is basically ineffective, and antiviral drugs such as acyclovir and famciclovir can be used
.

The application of antibiotics or probiotics is basically ineffective, and antiviral drugs such as acyclovir and famciclovir can be used
.

Sixth, for diarrhea patients with severe abdominal pain or repeated vomiting, when severe pain occurs, oral antispasmodics such as racemic anisodamine tablets or belladonna tablets can be administered
.

Sixth, for diarrhea patients with severe abdominal pain or repeated vomiting, when severe pain occurs, oral antispasmodics such as racemic anisodamine tablets or belladonna tablets can be administered
.

Seventh, for non-infectious acute and chronic diarrhea, loperamide and diphenoxylate can be used
.

Seventh, for non-infectious acute and chronic diarrhea, loperamide and diphenoxylate can be used
.

The pharmacological effect is to inhibit the contraction of intestinal smooth muscle, reduce peristalsis, prolong the residence time of food in the small intestine, promote the absorption of water, electrolytes and glucose, and reduce the frequency of defecation
.

The pharmacological effect is to inhibit the contraction of intestinal smooth muscle, reduce peristalsis, prolong the residence time of food in the small intestine, promote the absorption of water, electrolytes and glucose, and reduce the frequency of defecation
.

Diphenoxylate

Diphenoxylate

It is a synthetic morphine analog with antidiarrheal effect, with weak opioid effect, but no analgesic effect
.
Clinical application of compound diphenoxylate tablets, which is a compound preparation of diphenoxylate and atropine, directly acts on intestinal smooth muscle, reduces intestinal peristalsis, delays the passage of intestinal contents, is conducive to the absorption of intestinal water, and has a spasmodic effect
.

It is a synthetic morphine analog with antidiarrheal effect, with weak opioid effect, but no analgesic effect
.
Clinical application of compound diphenoxylate tablets, which is a compound preparation of diphenoxylate and atropine, directly acts on intestinal smooth muscle, reduces intestinal peristalsis, delays the passage of intestinal contents, is conducive to the absorption of intestinal water, and has a spasmodic effect
.

Medication Tips

Medication Tips Medication Tips

1.
Diarrhea is caused by a variety of pathogenic factors.
Antidiarrheal drugs are only symptomatic treatment, and the diagnosis and treatment of the cause are more important
.

1.
Diarrhea is caused by a variety of pathogenic factors.
Antidiarrheal drugs are only symptomatic treatment, and the diagnosis and treatment of the cause are more important
.

2.
Berberine hydrochloride tablets (berberine tablets) should not be taken at the same time as tannin
.

2.
Berberine hydrochloride tablets (berberine tablets) should not be taken at the same time as tannin
.

3.
Taking a large amount of tannin protein may cause constipation, and it is not suitable to take it with iron
.

3.
Taking a large amount of tannin protein may cause constipation, and it is not suitable to take it with iron
.

4.
Microecological preparations are mainly used for diarrhea caused by intestinal flora imbalance, or irritating diarrhea caused by cold and various stimuli, but are invalid for early application of infectious diarrhea caused by bacteria or viruses; Anti-infectives and anti-viral drugs are taken as adjuncts later to help restore the balance of intestinal flora
.

4.
Microecological preparations are mainly used for diarrhea caused by intestinal flora imbalance, or irritating diarrhea caused by cold and various stimuli, but are invalid for early application of infectious diarrhea caused by bacteria or viruses; Anti-infectives and anti-viral drugs are taken as adjuncts later to help restore the balance of intestinal flora
.

5.
Most of the ecological preparations are preparations containing active ingredients, and should not be used together with antibiotics, medicinal charcoal, berberine hydrochloride tablets and tannin protein at the same time, so as not to reduce the potency of active preparations
.
If it is necessary to use it together, it should be at least 3 hours apart
.

5.
Most of the ecological preparations are preparations containing active ingredients, and should not be used together with antibiotics, medicinal charcoal, berberine hydrochloride tablets and tannin protein at the same time, so as not to reduce the potency of active preparations
.
If it is necessary to use it together, it should be at least 3 hours apart
.

6.
Medicinal charcoal can affect the nutritional absorption of children.
Children under 3 years old are forbidden to have long-term diarrhea or abdominal distension; it is also not suitable to take it with vitamins, antibiotics, alkaloids, lactase and various digestive enzymes, because medicinal charcoal can Adsorption of these drugs affects the efficacy
.

6.
Medicinal charcoal can affect the nutritional absorption of children.
Children under 3 years old are forbidden to have long-term diarrhea or abdominal distension; it is also not suitable to take it with vitamins, antibiotics, alkaloids, lactase and various digestive enzymes, because medicinal charcoal can Adsorption of these drugs affects the efficacy
.

7.
Long-term or severe diarrhea can easily lead to disorders of water and salt metabolism in the body.
Dehydration and sodium and potassium metabolism disorders are common.
Therefore, while treating the cause, attention should be paid to supplementing the oral solution of salt rehydration in time to strengthen the The balance of electrolytes in the body
.

7.
Long-term or severe diarrhea can easily lead to disorders of water and salt metabolism in the body.
Dehydration and sodium and potassium metabolism disorders are common.
Therefore, while treating the cause, attention should be paid to supplementing the oral solution of salt rehydration in time to strengthen the The balance of electrolytes in the body
.
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