Ferrara Marco. La diarrea cronica

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DIARREA CRONICA Classificazione clinica definizione : durata > 4 settimane (volume fecale >250 gr., numero delle evacuazioni >3) acquosa, ematica o grassa secretiva (isosmolare al plasma) od osmotica (iperosmolare) ,[object Object],[object Object],[object Object],[object Object]

CAUSE DI DIARREA CRONICA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

DIAGNOSI DIFFERENZIALE DI BASE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Sintomi d’allarme ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

S. dell’Intestino Irritabile (SII) : criteri di Roma III (2006) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Approccio diagnostico per gradi 1° livello - mmg (modificato da Donowitz, NEJM’95) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Approccio diagnostico-terapeutico per gradi 2° livello - mmg ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Approccio diagnostico per gradi ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

INDICAZIONI ALLA COLONSCOPIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Approccio diagnostico per gradi 3° livello - gastroenterologo ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

COLITE MICROSCOPICA (Collagena – Linfocitica) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Colonic histopathology and other diagnoses found in 809 patients with chronic diarrhea Kenneth D. Fine, GIE 2000 Diagnosis Number % of total Patients with colonic histopathology Microscopic colitis 80 10 Crohn’s disease 23 3 Melanosis coli 8 1 Ulcerative colitis 5 0.6 Nonspecific colitis 3 0.4 Granulomatous ileocolitis due to tuberculosis 1 0.1 Eosinophilic colitis 1 0.1 Nodular lymphoid hyperplasia 1 0.1 Patients without colonic histopathology 85% Diseases associated with steatorrhea 332 41 Non-steatorrheic secretory or dysmotility processes 283 35 Osmotic diarrhea 72 9

SIBO ( S mall I ntestinal B acterial O vergrowth) ,[object Object],[object Object],[object Object]

Condizioni associate alla SIBO ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Ferrara Marco. La diarrea cronica

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