DIARRHEA

Introduction


Thanks to our God, Allah SWT that gives us a lot of strength to construct this paper, which is “Diarrhea” properly. It was construsted to complete our English assignment.
Unforgettable,we thank for the support and the guidance from everyone,so it can be finished. We knew that this paper wasn’t perfect at all,from the typing, the presentation, and because of our knowledge is only limited. But we have tried optimally to be near of perfection.
We apologize, this paper constraction has a lot of mistakes. Therefore we hope some suggestion and some criticsm from all of the readers to develop our paper.
We hope this paper can be usefull for us. Amin………..



Cilacap,januari 2009















PART I
FOREWORD


A. History 
Diarrhea refers to frequent loose or liquid bowel movement. Althougth for many people diarrhea is merely unpleasant, diarrhea that is both acute and severe is a commont cause of death in developing contries and a major cause of infant death worldwide.it is often due to gastroenteritis.

B. The Purpose
1. To know about diarrhea.
2. To know about the causes of diarrhea.
3. To know the types of diarrhea.
4. To know, how to make the diarrhea be a better.

C. The Benefit
This paper is usefull to increase our knowledge about diarrhea and to complete our Englishs assignment from the English’s lectures.












PART II
DIARRHEA

In medicine, diarrhea refers to frequent loose or liquid bowel movement. Althougth for many people diarrhea is merely unpleasant, diarrhea that is both acute and severe is a commont cause of death in developing contries and a major cause of infant death worldwide.it is often due to gastroenteritis.

A. CAUSES
Diarrhea is most commonly caused by viral infections, parasites or bacterial toxins. In sanitary living conditions where there is ample food and a supply of clean water,and otherwise healthy patient usually recovers from viral infections in a few days. However, for ill and malnourished individuals diarrhea can lead to severe dehydration and become life-threatening without treatment.
Diarrhea can also be a symptom of more serious diseas, such as dysentery,cholera, or botulism, and can also be indicative of a cronic syndrome such as Crohn’s disease or severe mushroom poisoning syndromes. Though appendicitis patient do not generally have diarrhea, it is common symptom of ruptured appendix. It is also an effect of severe radiation sickness. Diarrhea can also be caused by dairy intake in those who are lactose intolerant.
Symptomatic treatment for diarrhea involves the patient consuming adequate amounts of water to replace that loss, preferably mixed with electrolytes to provides essential salts and some amount of nutrients. For many people, further treatment is unnecessary. The following types diarrhea indicate medical supervision is required:
• Diarrhea of infant;
• Moderate or severe diarrhea in young children;
• Diarrhea associated with blood;
• Diarrhea that continues for morethan two days;
• Diarrhea that is associated with more general illness such as non-cramping abnominal pain, fever, weight loss, etc;
• Diarrhea in travelers, since they are more likely to have exotic infections such as parasites;
• Diarrhea in food handlers, because of the potential to infect others;
• Diarrhea in institutions such as hospitals, child care centers, or geriatric and convalescent home.

B. Mal Absorption
These tend to be more severe medical illnesses. Mal absorption is the inability to absorb food, mostly in the small bowel but also due to the pancreas.
Causes include celiac disease (intolerance to wheat, rye, and barley gluten, the protein of the grain), lactose intolerance (Intolerance to milk sugar, common in non-Europeans), fructose malabsorption, pernicious anemia (impaired bowel function due to the inability to absorb vitamin B12), loss of pancreatic secretion (may be due to cystic fibrosis or pancreatitis), short bowel syndrome (surgically removed bowel), radiation fibrosis (usually following cancer treatment), and other drugs such as chemotherapy.

C. Inflammatory bowel disease
The two overlapping types here are of unknown original :
• Ulcerative colitis is marked by chronic bloody diarrhea and inflammation mostly affects the distal colon near the rectum.
• Crohn’s disease typically affects fairly well demarcated segments of bowel in the colon and often affects the end of the small bowel.

D. Irritable Bowel Syndrome
Another possible cause of diarrhea is Irritable Bowel Syndrome (IBS). Symptoms defining IBS: abdominal discomfort or pain relieved by defecation and unusual stool (diarrhea or constipation or both) or stool frequency, for at least 3 days a week over the previous 3 mounths. IBS symptoms can be present in patients with a variety of conditions including food allergies, infective diarrhea, celiac, and inflammatory bowel diseases. Treating the underlying condition (celiac diseases, food allergy, bacterial dysbiosis, etc.) usually resolves the diarrhea. IBS can cause visceral hypersensitifity. While there is no direct treatment for undifferentiated IBS, symptoms, including diarrhea, can sometimes be managed through a combination of dietary changes, soluble fiber supplements, and/or medications.

E. Other important causes
• Ischemic bowel disease. This usually affects older people and can be due to blocked arteries.
• Bowel cancer : some (but not all) bowel cancers may have associated diarrhea. Cancer of the large intestine is most common.
• Hormone-secreting tumors: some hormones (e.g. serotonin) can cause diarrhea if excreted in excess (usually from a tumor).
• Bile salt diarrhea: excess bile salt entering the colon rather than being absorbed at the end of the small intestine can cause diarrhea, typically shortly after eating. Bile salt diarrhea is a possible side-effect of gallbladder removal. It is usually treated with cholestyramine, a bile acid sequestrant.

F. Alcohol
Chronic diarrhea can be caused by chronic ethanol ingestion. Comsumption of alcohol affects the body’s capability to absorb water-this is often a symptom that accompanies a hangover after a heavy drinking session. The alcohol itself is absorbed in the intestines and as the intestinal cells absorb it, the toxicity causes these cells to lose their ability to absorb water. This leads to an outpouring of fluid from the intestinal lining, which is in turn poorly absorbed. The diarrhea usually lasts for several hours until the alcohol is detoxified and removed from the digestive system. Symptoms range from person to person and are influenced by both the amount consumed as well as physiological differences.

G. Types of diarrhea
There are at least four types of diarrhea: secretory diarrhea, osmotic diarrhea, motility-related diarrhea, and inflammatory diarrhea.
1. Secretory diarrhea
Secretory diarrhea means that there is an increase in the active secretion, or there is an inhibition of absorption. There is little to no structural damage. The most common cause of this type of diarrhea is a cholera toxin that stimulates the secretion of anions, especially chloride ions. Therefore, to maintain a charge balance in the lumen, sodium is carried with it, along with water.

2. Osmotic diarrhea
Osmotic diarrhea occurs when there is a loss of water due to a heavy osmotic load. This can occur when there is maldigestion (e.g., pancreatic disease or Coeliac disease), where the nutrients are left in the lumen, which pulls water into the lumen.

3. Motility-related diarrhea
Motility-related diarrhea occurs when the motility of the gastrointestinal tract is abnormally high. If the food moves too quickly, there is not enough time for sufficients and water to be absorbed. This can be due to a vagotomy or diabetic neuropathy, or a complication of menstruation.

4. Inflammatory diarrhea
Inflammatory diarrhea occurs when there is damage to the mucosal lining or brush border, which leads to a passive loss of protein-rich fluids, and a decreased ability to absorb these lost fluids. Features of all three of the other types of diarrhea can be found in this type of diarrhea. It can be caused by bacterial infections, viral infections, parasitic infections, or autoimmune problems such as inflammatory bowel disease.

5. Infectious diarrhea
Infectious diarrhea is diarrhea caused by a microbe such as a bacterium, parasite, or virus.

H. Treatment
In many cases of diarrhea, replacing lost fluid and salts is the only treatment needed. Medicines that are available without a doctor’s prescription include loperamide (Imodium) and bismuth subsalicylate Pepto Bismol and kaopectate.



























PART III
CLOSING


A. Conclusion
1. Diarrhea is most commonly caused by viral infections, parasites or bacterial toxins.
2. There are four types of diarrhea: secretory diarrhea, osmotic diarrhea, motility-related diarrhea, and inflammatory diarrhea.
3. Replacing lost fluid and salts is the only treatment needed.

B. Suggestion
1. Keep our personal hygiene.
2. Take a healthy diet.

GLOSARY



Acid : Asam 
Botulism : Keracunan makanan 
Accompany : Menyertai
Mushroom : Jamur
Poisoning : Peracunan
Unpleascent : Tidak menyenangkan 
Hangover : Perasaan sakit pada bangun pagi setelah minum keras 
Symptom : Gejala
Damage : Kerusakan  
Inflammantory : Yang menyebabkan radang 
Viral : Penyakit yang menyebabkan oleh virus 
Occur : terjadi
Sufficient : Cukup
Load : Beban
Outpouring : Pencurahan/penumpahan 
Unusual : Luar biasa
Convalescent home :Rumah penyembuhan

semoga bisa bermanfaat bagi yang memerlukan,amin amin amin ya robal alamin