Diarrhoea-Introduction, Types, Etiological Agent, Keynotes, and Further Readings

Diarrhoea-Introduction, Types, Etiological Agent, Keynotes, and Further Readings

Introduction of Diarrhoea

Diarrhoea may be defined as increase infrequency, fluidity, or volume of bowel movements relatives to usual habits of each individual. Dysentry is the passage of blood and mucus with motion often with tenesmus. Traveller’s diarrhoea  is an acute diarrhoea illness that sometimes occurs in visitors from foreign countries, within a week or two of arrival in developing countries or develops diarrhoea soon after return to home.

Food poisoning: Any type of illness acquired through consumption of food or drinks contained with micro-organisms, their toxins or chemical poisons, but traditionally it is related to acute diarrhoea with or without vomiting caused by microbial contamination of food.

The pathogenic mechanism of agents of gastrointestinal infection:

  1. By producing a toxin that affects fluid secretion, cell function and neurological function e.g. ETEC
  2. By growing within or close to intestinal mucosal cells and destroying them thus disrupting function e.g.. EPEC
  3. By invading the mucosal epithelium causing cellular destruction and occasionally invading the bloodstream and going on to systemic disease eg EIEC
  4. Via adhering to intestinal mucosa thus preventing the normal function of absorption and secretion e.g. EHEC
  5. By preformed toxin e.g.. Staphylococcal food poisoning



  • Acute diarrhoea lasts a few days, often due to infections.
  • Moreover, viral and bacterial pathogens frequently trigger these episodes.
  • Persistent diarrhoea extends beyond two weeks, indicating underlying conditions.
  • In contrast, chronic diarrhoea persists for over a month, signifying long-term issues.
  • Furthermore, it can result from digestive disorders like IBS.
  • Secretory diarrhoea involves excessive fluid secretion in the intestines.
  • Additionally, it is common in cases of cholera.
  • Osmotic diarrhoea occurs when substances pull water into the intestines.
  • For instance, lactose intolerance can lead to this type.
  • Meanwhile, inflammatory diarrhoea results from diseases causing intestinal inflammation.
  • Conditions such as Crohn’s disease are typical examples.
  • Lastly, travellers’ diarrhoea affects people visiting new places.
  • It usually stems from consuming contaminated food or water.


Etiological agents of diarrhoea disease


  1. Vibrio cholera 01
  2. V. cholera non 01 (NAG, 0139)
  3. Vibrio parahaemolyticus
  4. Escherichia coli: ETEC, EPEC, EHEC, EIEC
  5. Salmonella: S. typhimurium, S. enteritidis, S. senftenberg
  6. Shigella: S. dysenteriae, S. flexnari, S. boydii, S. sonnei
  7. Clostridium: Cl. perfringens, Ci. difficile
  8. Bacillus cereus: due to enterotoxin
  9.  Staphylococcus aureus: due to enterotoxin
  10. Campylobacter jejuni
  11.  Yersinia enterocolitica
  12.  Other bacteria:

Pseudomonas aeruginosa, Aeromonas hydrophila, Pseudomonas shigelloides


  1. Rotavirus
  2. Norwalk virus
  3. Adenovirus type 40 and 41


  1. Entamoeba histolytica
  2. Giardia lamblia
  3. Cryptosporidium


  1. Candida albicans


Diarrhoea remains a significant global health concern, especially in developing countries. Children under five are particularly vulnerable to severe cases. Moreover, contaminated water sources often contribute to outbreaks. In addition, poor sanitation practices exacerbate the spread of diarrhoeal diseases. Furthermore, malnutrition and weakened immunity increase susceptibility. On the other hand, proper hygiene and sanitation can prevent many cases.

Notably, rotavirus and E. coli are common diarrhoeal pathogens. While antibiotics treat bacterial infections, they are ineffective against viral causes. In such instances, rehydration therapy is crucial for recovery. Another critical factor is the timely administration of oral rehydration salts. Additionally, breastfeeding provides essential protection for infants. Despite advancements, diarrhoea remains a leading cause of childhood mortality. Therefore, public health initiatives are vital for education and prevention. For instance, community programs promoting handwashing can reduce incidence rates. Nonetheless, challenges persist in resource-limited settings. Consequently, international support and funding are necessary. Not only do they aid in immediate relief, but they also support long-term solutions. Importantly, ongoing research aims to develop better vaccines. Meanwhile, healthcare infrastructure improvements are essential for effective treatment. In conclusion, addressing diarrhoea requires a multifaceted approach. Collectively, these efforts can significantly reduce the global burden.

Further Readings

  • https://rehydrate.org/diarrhoea/tmsdd/1med.htm
  • https://www.ncbi.nlm.nih.gov/books/NBK448082/
  • https://pubmed.ncbi.nlm.nih.gov/2101388/


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