MyMedR

A 16-year-old female from Rantau Panjang, Kelantan reported having diarrhoea for three months. During this period, she lost 15 lb in weight and was treated with antibiotics and anti-spasmodic tablets with no improvement. Stool examinations by private laboratories revealed "worm-like eggs". She was treated for worms with mebendazole which helped to reduce the symptoms but not completely. The patient continued passing out the abnormal "worm-like eggs" which were later identified as pollen grains.

Matched MeSH terms: Diarrhea/etiology*; Diarrhea/parasitology*

Emergence of Vibrio parahaemolyticus as an important cause of diarrhea in Malaysia

Jegathesan M, Paramasivam T

Am J Trop Med Hyg, 1976 Jan;25(1):201-2.

PMID: 943960

Vibrio parahaemolyticus was isolated from 47 of 2,699 stools examined primarily for the exclusion of cholera. All strains grew well in alkaline peptone water containing 0.5% NaCl and in Monsur's medium. Serotyping showed them to be of various types. Adults were mainly affected. The importance of looking for V. parahaemolyticus in clinical specimens from cases of diarrhea is emphasized.

Matched MeSH terms: Diarrhea/etiology*; Diarrhea/epidemiology

Potential role of flavonoids against SARS-CoV-2 induced diarrhea

Paul AK, Jahan R, Bondhon TA, Jannat K, Hasan A, Rahmatullah M, et al.

Trop Biomed, 2021 Sep 01;38(3):360-365.

PMID: 34508344 DOI: 10.47665/tb.38.3.079

COVID-19, caused by the SARS-CoV-2 virus, can lead to massive inflammation in the gastrointestinal tract causing severe clinical symptoms. SARS-CoV-2 infects lungs after binding its spike proteins with alveolar angiotensin-converting enzyme 2 (ACE2), and it also triggers inflammation in the gastrointestinal tract. SARS-CoV-2 invades the gastrointestinal tract by interacting with Toll-like receptor-4 (TLR4) that induces the expression of ACE2. The influx of ACE2 facilitates cellular binding of more SARS-CoV-2 and causes massive gastrointestinal inflammation leading to diarrhea. Diarrhea prior to COVID-19 infection or COVID-19-induced diarrhea reportedly ends up in a poor prognosis for the patient. Flavonoids are part of traditional remedies for gastrointestinal disorders. Preclinical studies show that flavonoids can prevent infectious diarrhea. Recent studies show flavonoids can inhibit the multiplication of SARS-CoV-2. In combination with vitamin D, flavonoids possibly activate nuclear factor erythroid-derived-2-related factor 2 that downregulates ACE2 expression in cells. We suggest that flavonoids have the potential to prevent SARS-CoV-2 induced diarrhea.

Matched MeSH terms: Diarrhea/etiology; Diarrhea/prevention & control*

A new medical device applied in a case of acute fecal impaction with overflow diarrhea: a case report

Huang Q, Zheng F, Wang H, Yang Y, Ma C, Zhu L

J Med Case Rep, 2024 Mar 06;18(1):89.

PMID: 38444013 DOI: 10.1186/s13256-024-04407-4

BACKGROUND: Fecal impaction is a digestive system disease, that is most common in the elderly population and becomes more prevalent with increasing age. Manual removal can successfully remove the impaction in 80% of fecal impaction cases. In severe cases, endoscopy and surgery may be necessary.

CASE PRESENTATION: A 78-year-old Han Chinese man living in a nursing home was diagnosed with fecal impaction; his initial symptom was overflow diarrhea, which is a rare occurrence with regard to fecal impaction. Nevertheless, we were able to effectively treat this situation by employing a new medical device that presents a novel method for addressing fecal impaction.

CONCLUSION: Early identification of fecal impaction with atypical symptoms is crucial to provide proper emergency management. A safe and noninvasive treatment method, especially for elderly patients with fecal impaction, should be chosen.

Matched MeSH terms: Diarrhea/etiology; Diarrhea/therapy

Fulltext Knowledge and use of oral rehydration therapy for childhood diarrhoea in Tumpat District

Shaw DD, Jacobsen CA, Konare KF, Isa AR

Med J Malaysia, 1990 Dec;45(4):304-9.

PMID: 2152051

A community based study was conducted on the understanding and knowledge of childhood diarrhoea and use of oral rehydration therapy (ORT), in four selected villages in Tumpat District, Kelantan. The calculated annual incidence of diarrhoeal disease in children aged 0 to four years in all study villages was 1.38 episodes for each child. The main care-givers of children aged 0 to four years were interviewed and asked to demonstrate how to mix a standard ORS (oral rehydration solution) sachet if they had previously used ORT. Forty percent of care-givers had heard of the locally available ORT and 30% had actually used ORT. Of those who had heard of or used ORT, 10% had good knowledge of what it was and what it was used for, 51% had some knowledge and 39% had either no knowledge or inaccurate knowledge. Of care-givers who had previously used ORT only 20.5% demonstrated the correct volume of water to add to one sachet of ORT, but 82% would discard an unused solution within 24 hours. Significantly more literate women had used ORT than those not literate (p = 0.002). Mothers, particularly those literate, are the primary target group for ORT intervention strategies. Components of health education should include advice on what ORS is, what it is used for, and how to correctly mix a standard sachet.

Matched MeSH terms: Diarrhea/therapy*; Diarrhea, Infantile/therapy

Fulltext Melanosis coli in a peritoneal dialysis patient: a case report

Zakaria NF, Ahmad NI, Mokhtar E, Zukiman WZHHW, Shah AM

J Med Case Rep, 2021 Jul 30;15(1):420.

PMID: 34325745 DOI: 10.1186/s13256-021-02895-2

BACKGROUND: Patients who undergo peritoneal dialysis (PD) are at risk of gut bacteria translocation leading to peritonitis when there is chronic diarrhea. Chronic diarrhea is defined as any course of diarrhea that lasts at least 4 weeks, which can be continuous or intermittent. Chronic diarrhea of any duration may cause dehydration, electrolyte imbalance, and life-threatening hypovolemic shock. In PD patients, excessive ultrafiltration from the exchanges, combined with severe gastrointestinal loss, may cause hypovolemic shock, electrolyte imbalance, and metabolic acidosis. There are multiple causes of chronic diarrhea in PD patients including infective causes, mitotic lesions, and rarely the regular and excessive use of laxatives, which is a diagnosis of exclusion.

CASE PRESENTATION: We report a case of Melanau lady with chronic diarrhea secondary to laxative usage in a patient being treated with automated peritoneal dialysis (APD). The patient went into hypovolemic shock, but luckily did not contract peritonitis. A colonoscopy revealed brown to black discoloration of the colon, a feature suggestive of melanosis coli. A biopsy of the intestine further confirmed the diagnosis by histopathological examination. Withdrawal of laxatives and the introduction of probiotics improved the symptoms tremendously.

CONCLUSIONS: The chronic use of laxatives in PD patients can potentially lead to a devastating problem; thus, the management team must monitor treatment commencement appropriately.

Matched MeSH terms: Diarrhea

Acute diarrhoea

Matched MeSH terms: Diarrhea

Fulltext The applicability of Cary Blair medium as a sole transport medium for the recovery of enteropathogens in the Malaysian context

Jegathesan M, Paramasivam T

Med J Malaysia, 1981 Jun;36(2):108-11.

PMID: 7343818

The efficacy of Cary Blair medium was compared with that of Selenite 'F'in the isolation of enteropathogens from 805 cases of diarrhoea. It was shown that use of the Cary Blair medium resulted in a significantly higher rate of isolation. Not only were organisms found which were not isolated from the Selenite 'F' but there was a much higher isolation rate of Salmonella from Cary Blair medium althougn Selenite 'F' is generally considered as an enrichment medium for
Salmonella. The findings indicate that it would be advantageous to introduce Cary Blair medium as the sole transport medium for the isolation of enteropathogensfrom cases ofdiarrhoea.

Matched MeSH terms: Diarrhea/microbiology

Fulltext The use of antimotility drugs in COVID-19 associated diarrhea

Kow CS, Hasan SS

J Infect, 2021 02;82(2):e19.

PMID: 32956731 DOI: 10.1016/j.jinf.2020.09.017

Matched MeSH terms: Diarrhea/drug therapy

Paediatric gastroenteritis in the eastern Malaysian state of Sarawak: an epidemiological and clinical study

Barker RA, Maxwell PH, Hong CP, Cordery MC, Chrystie IL

Trans R Soc Trop Med Hyg, 1988;82(6):898-901.

PMID: 2855768

Over a period of 2 months, 35 of 69 (51%) cases of juvenile diarrhoea studied in eastern Malaysia were associated with rotavirus excretion; rotavirus associated diarrhoea occurred most commonly in the 6-24 month age group. Polyacrylamide gel electrophoresis (PAGE) of genome ribonucleic acid showed that only 4 rotavirus electropherotypes could be detected. Of those, 2 predominated and 2 were detected only once each; one of these may have been a reassortment of the two predominant electropherotypes. Analysis of the clinical features of patients excreting rotavirus subgroup 1 or 2, determined by PAGE, demonstrated that rotavirus subgroup 1 was associated with more hypotonic dehydration and need for intravenous therapy: lethargy was significantly more common among those excreting rotavirus subgroup 2.

Matched MeSH terms: Diarrhea/microbiology; Diarrhea/epidemiology*; Diarrhea, Infantile/epidemiology

Fulltext Acute gastroenteritis in Malaysian children: aetiological and therapeutic considerations

Iyngkaran N, Abidin Z, Lam SK, Puthucheary SD

Med J Malaysia, 1980 Jun;34(4):403-8.

PMID: 7219272

In a prospective study of 300 infants with acute gastroenteritis 150 infants had enteropathogens in the stools, 58 being due to rotavirus, 130 to adenovirus, 32 to Sahnonella, 18 Shigella and 29 E. coli. Hypernatraemic dehydration was present in 11% and acquired carbohydrate intolerance in 30% of the infants. Protracted diarrhoea was observed in 8% of infants and was commoner in the bacterial than viral group. The study shows that clinical features and simple blood tests cannot be used as reliable indices of predicting the aetiology of AGE. Despite the diverse aetiology of acute gastroenteritis, rehydration by the oral or intravenous route remained the mainstay of therapy.
Keywords: Kuala Lumpur, university hospital,

Matched MeSH terms: Diarrhea, Infantile/etiology*; Diarrhea, Infantile/therapy

An interesting finding in a patient with chronic diarrhoea

Marwan AA, Ngiu CS, Periyasamy P

Ann Acad Med Singap, 2013 Feb;42(2):97-8.

PMID: 23515696

Matched MeSH terms: Diarrhea/etiology*

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