A 71-years old Omani man came last afternoon at around 5:30 pm with his son. He was passing loose motion since morning along with mild fever and one-time vomiting. He informed that he passed the motion for more than 20 times; completely watery. He had other comorbidities such as DM, HTN and dyslipidemia.
20 times the passage of loose stool is really a severe form of diarrhoea. However, when I checked his vitals, I didn’t find the features consistent with his statements. His vitals were as follows: BP- 120/70 mmHg; Pulse: 85 bpm; temperature 36.9-degree centigrade; mild to nil dehydration. If a person passes 20 times loose stool in a period of a few hours, he should have features of severe dehydration. He also informed that he didn’t eat or drink any regular food items as he felt abdominal discomfort. Meaning, he didn't have enough fluids or oral rehydration saline which could explain his normal vitals.
Anyway, I gave injectable medications according to those symptoms along with one pint of intravenous saline (without a pint of intravenous fluid, an Omani patient doesn’t satisfy!). I also prescribed oral tablets for home.
According to Davidson’s Principle and practice of medicine, diarrhoea is defined as the passage of more than 200 g of stool per day.
Acute diarrhoea is extremely common in the general population. It usually occurs following ingestion of bacteria or their toxins, viruses or parasites. Luckily these infective diarrhoea is usually short-lived. Besides infections, some antibiotics, cytotoxic drugs, anti-gas tablets (PPIs) and some painkillers (NSAIDs) are found responsible for diarrhoea. If diarrhoea persists for more than 10 days, we should think that there are causes other than infections.
According to the WHO, every year, globally around 1.7 people suffer from acute diarrhoea and around 760,000 under-5 children die due to it.
Was able to achieve 10k steps 🚶♂️ before 10pm. Here is the proof.