Understanding diarrhoea

Abstract 

Diarrhoeal diseases are among the most common causes of childhood mortality and morbidity throughout the world. In health, the gut is in a dynamic state with the secretion of intestinal juices being balanced by the absorptive capacity of the intestine. When this equilibrium is disturbed by increased secretion or reduced absorption, diarrhoea will occur.

The absorption of sugars and amino acids by the small intestine is facilitated by co-transport with sodium, with water following passively. Most secretory processes are dependent on the active transport of chloride into the lumen of the gut. In infectious diarrhoea, secretion may be stimulated by enterotoxins or by inflammation of the gut. Mucosal damage secondary to allergic processes, coeliac disease or surgical resection will reduce absorption.

Armed with an understanding of the pathophysiology of diarrhoea, the clinician is in a better position to diagnose and treat children with such problems.

Keywords: diarrhoea, paediatric, coeliac disease, food hypersensitivity, short gut syndrome

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• f1 E-mail: michael.bisset@arh.grampian.scot.nhs.uk