Home >Documents >Diareea Cronica 2016

Diareea Cronica 2016

Date post:06-Jul-2018
Category:
View:218 times
Download:0 times
Share this document with a friend
Transcript:
  • 8/17/2019 Diareea Cronica 2016

    1/64

    DIAREEACRONICA

     CONSTIPATIA

    CRONICA

  • 8/17/2019 Diareea Cronica 2016

    2/64

    Medicaţie prokinetică

    • Metoclopramid cp 10 mg cp!"i#

    • Motili$m %Domperidona& cp 10 mg cp!"i#

    • I'$tin ! De'ridat %Trime'$tina& cp 100 mg(

    00 mg) 00mg!"i#

    • Pro*taglandine + Mi*opro*tol#

    Agoni*ti *erotonina,

    • -elmac %Tega*erod& cp . mg / cp!"i#

    • Re*olor %Pr$caloprid& cp 1mg( / mg!"i#

  • 8/17/2019 Diareea Cronica 2016

    3/64

    aati2e o*motice ! de 2ol$m

    • act$lo"ă *irop 13 + 43 ml %apro 10 + 0 g

    • aati2e *aline, Mg# S$l5at Mg 13 + 0 g!"i#

    Citrat Mg 130 + 00 ml!"i# 6idroid Mg 0 + .0

    ml!"i#

    • Sor'itol 13 + 0 ml 1 + /!"i#

    7ortran* %Macrogol 8 NaSo4 8 NaCl etc& 1 plic !1 l apa / 9 4 plic$ri#

  • 8/17/2019 Diareea Cronica 2016

    4/64

    aati2e o*motice ! de 2ol$m

    • 7orla %Macrogol 9 polietilenglicol& plic 10 g

    + 4 plic$ri!"i#

    • P$rgola cp ! Planta'en plic %I*pag:$la +

    *eminţe de p*;lla&( 1 cp!"i *a$ 1 +

    plic$ri!"i#

    • P*;lli$m /(3 + 0 g!"i#

  • 8/17/2019 Diareea Cronica 2016

    5/64

    aati2e emoliente ! cli*me

    • S$po"itoare de glicerina %/ + g& 1!"i#

  • 8/17/2019 Diareea Cronica 2016

    6/64

    aati2e iritati2e

    • D$lcola %=i*acod;l& cp 3 mg 3 9/0 mg!"i#

    Tia*en %Senna( Reg$la& cp 10 mg 1 + cp!"i#

    • D$lcopic %Pico*$l5at de natri$& *ol$ţie 10 + /0

    picat$ri#

    • Colc:icina 0(3 + 1 mg !"i#

  • 8/17/2019 Diareea Cronica 2016

    7/64

    Noi laati2e

    • inaclotid />0 mcg!"i# Agoni*t g$anilat

    cicla"a + cre*te *ecretia de clor *i 'icar'onat

    in l$men#

    •$'ipro*tone /4 mcg!"i# Acti2ator al

    canalelor de clor( cre*te *ecretia de lic:id

    intral$minal#

  • 8/17/2019 Diareea Cronica 2016

    8/64

    Medicatie anti*pa*tică !

    anti'alonare• Papa2erină cp 100 mg cp!"i#• No9*pa %Drota2erina& cp 40 mg + . cp !"i#

    • Colo*pa*min( D$*patalin %Me'e2erina& cp

    100 mg + 4 cp!"i#• Spa*momen %Otiloni$m 'romid& cp 40 mg /

     + cp!"i#

    • Meteo*pa*m;l %al2erina 8 dimeticona& 1 cp !"i#

    • Dimeticona ! *imeticon 19 / cp /9 !"i

  • 8/17/2019 Diareea Cronica 2016

    9/64

    Medicaţie antidiareică

    • Normi %Ri5aimina& cp /00 mg + . cp!"i#

    • Erce5$r;l %Ni5$roa"id& cp /00 mg 4 cp!"i#

    • 7$ra"olidon cp 100 mg 4 cp!"i#

    • Sapro*an %Clorc:inaldol& cp 100 mg + .cp!"i#

    • Cipro5loacina cp 300 mg / cp!"i#

    • Metronida"ol cp /30 mg + . cp!"i# 

  • 8/17/2019 Diareea Cronica 2016

    10/64

    Medicaţie antidiareică /•

    operamid %Imodi$m& cp / mg / mg /9 4!"i#Opioid minor#

    • Dio*mectita %Smecta& plic g( 1 plic / + 4 !"i#

    Argila c$ e5ect ad*or'ant#• Car'$ne medicinal + / + 4 g!"i#

    • Racecadotril %6idra*ec& + 100 mg !"i#

    =locant al canalelor de clor#• Pro'iotice, E$'iotic cp cp !"i# -ir5o* 1 plic ! "i#

    Erce5lora / cp !"i# ine / cp ! "i# Enterol

    %Sacc:arom;ce* 'o$lardii& cp* /30 mg 4 cp*!"i#•

  • 8/17/2019 Diareea Cronica 2016

    11/64

    Date generale• Sca$n normal, !"i 9 !*apt) 1009/00 g!"i#

    Dietă 'ogată ?n 5i're *ca$n normal @ 400 ml !

    g ! "i#

    •Inte*tin *$'tire > + colon 1 + *ca$n 0(/ #

    • Ileon terminal rol de re"er2or#

    • Inte*tin *$'ţire + MMC comple motor

    migrator 4 min$te ! .09>0 min$te#• Po*tprandial 9 contracţii nereg$late( mai

    lente( amplit$dine mică#

  • 8/17/2019 Diareea Cronica 2016

    12/64

    Date generale

    • Colon a*cendent *i tran*2er* rol re"er2or +

    tran"it 13 ore ! colon de*cendent rol

    tran*port + ore#

    • Colon + contracţii 5a"ice c$ rol de ame*tecare

    3 ! "i) contracţii tonice#

    • Po*tprandial 9 creterea contracţiilor 5a"ice *i

    tonice pentr$ / ore#

  • 8/17/2019 Diareea Cronica 2016

    13/64

    C$loarea *ca$n$l$i

  • 8/17/2019 Diareea Cronica 2016

    14/64

  • 8/17/2019 Diareea Cronica 2016

    15/64

    Con*tipatie

    • De5initie, B *ca$ne ! *aptamana#

    •Cea mai 5rec2enta ac$"a dige*ti2a 1/ + 1>pop$laţie generală#

    • 7!= /!1#

    • Ca$"e, >0 5ara ca$"a decela'ila( o'*tr$ctiemecanica( 'oli ne$rologice ! m$*c$lare( 'oli

    endocrine ! meta'olice( medicatii#

  • 8/17/2019 Diareea Cronica 2016

    16/64

  • 8/17/2019 Diareea Cronica 2016

    17/64

    Criterii Roma con*tipatie cronica

    • /!. criterii#

    • E5ort de5ecatie 1 ! 4 oca"ii#

    Sca$ne d$re 1 ! 4 oca"ii#• Sen"atie de e2ac$are incompleta 1 ! 4 oca"ii#

    • Mane2re man$ale pentr$ 5acilitarea *ca$nelor

    1 ! 4 oca"ii#• Sen"atie de o'*tr$ctie anorectala 1 ! 4

    oca"ii#

    Mai p$tin de *ca$ne pe *aptamana#

  • 8/17/2019 Diareea Cronica 2016

    18/64

  • 8/17/2019 Diareea Cronica 2016

    19/64

    O'*tr$ctie mecanica colon

    • Cancer colorectal#

    • =oala in5lamatorie inte*tinala#

    Strict$ri colonice ! anale#• Corpi *traini intrarectali#

    • 6emoroi"i( 5i*$ri anale#

    Endometrio"a#

  • 8/17/2019 Diareea Cronica 2016

    20/64

  • 8/17/2019 Diareea Cronica 2016

    21/64

    =oli endocrine ! meta'olice

    • Dia'et "a:arat#

    • 6ipotiroidie#

    • 7eocromocitom#

    • In*$5icienta :ipo5i"ara#

    • Fl$cagonom#

    • Por5irie#

    • 6ipopota*emie# 6ipercalcemie

  • 8/17/2019 Diareea Cronica 2016

    22/64

    Medicatii ! di2er*e

    • Opioide# Anticolinergice# Antidepre*i2e#

    • Ne$roleptice# Antiparkin*oniene#

    Anticon2$l*i2e# Anti:iperten*i2e#• S$plimente 7e ! Ca# Antiacide c$ Al#

    • S$l5at de =a#

    Di2er*e

    • Intoicatii metale grele %P'( A*( 6g

  • 8/17/2019 Diareea Cronica 2016

    23/64

    Antecedente ! i*toric

    • Antecedente 5amiliale#

    • D$rata ! aparitie#

    =oli ! medicatii concomitente ! recente#• Simptome ! *emne concomitente,

    genito$rinare( c$tanate( CG( etc#

    Sca$n H

  • 8/17/2019 Diareea Cronica 2016

    24/64

    Atentie

    • Con*tipatie 8

    Scadere in gre$tate#• Sca$n c$ *ange#

    • Anemie#

    Gar*ta @ 30 ani#

    • Colono*copie

  • 8/17/2019 Diareea Cronica 2016

    25/64

    Eamen 5i"ic

    • E2identiere ca$"e dige*ti2e ! nondige*ti2e#

    • Eaminare a'domen( torace( ganglioni etc#

    • TR( ton$* *5incter( a*pect *ca$n#

    • Prolap* m$coa*a rectala( 5i*$ri#

    Eamen ginecologic ! $rologic#

  • 8/17/2019 Diareea Cronica 2016

    26/64

    Eamene de la'orator

    • Sca$n#

    • 6F( GS6( CRP#

    Te*te tiroidiene#• Na( J( Ca#

    • Por5irine#

    •Te*te :epatice *i pancreatice#

    • Te*te a$toim$nitate#

  • 8/17/2019 Diareea Cronica 2016

    27/64

    Eplorari

    • Sigmoido*copie( colono*copie 8 'iop*ii#• Irigogra5ie#

    • Timp de tran"it colonic + admini*trare orala(

    e2ac$are @ K0 la 3 "ile( 5ara laati2e• Ecogra5ie a'dominala#

    • Manometrie anorectala#

    • De5ecogra5ie# Te*t e2ac$are 'alona*#

    • CT( RM#

  • 8/17/2019 Diareea Cronica 2016

    28/64

    Gariante

    • Anemie( *ca$n c$ *ange( pierdere ponderala +neopla*m ( 'oala in5lamatorie inte*tinala#

    • 6epatomegalie( adenopatii( ma*e palpa'ile

    a'dominale + neopla*m#• Modi5icari piele( 5anere( intoleranta la 5rig(

    ca*tig ponderal + :ipotiroidie#

    • =alonare( e2ac$are incompleta( di*pep*ie(*imptome $rinare + *indrom de inte*tin

    irita'il#

  • 8/17/2019 Diareea Cronica 2016

    29/64

    Con*tipatie 1

    • 7emeie 33 ani#

    • Con*tipatie @ 4 l$ni( accent$ata progre*i2#

    • Ca*tig ponderal . kg# Piele $*cata( a*pra#

    • Edeme gam'iere# 7atiga'ilitate#

    • AG 33!min#

    • Goce rag$*ita# entoare in 2or'ire#

    • In2e*tigatii( diagno*tic( tratamentH

  • 8/17/2019 Diareea Cronica 2016

    30/64

    Con*tipatie /

    • =ar'at 44 ani# A*tenie( 5atiga'ilitate#

    • Con*tipatie de aproimati2 / l$ni#

    D$reri a'dominale intermitentepredominant in 5o*a iliaca dreapta#

    • 6g' 10(/ g!dl#

    Endo*copie dige*ti2a *$perioara +normala#

    • In2e*tigatii( diagno*tic( tratamentH

  • 8/17/2019 Diareea Cronica 2016

    31/64

    Con*tipatie

    • 7emeie 3. ani#

    • Anietate# Con*tipatie de 3 l$ni#

    A5e'rila( 5ara pierdere ponderala#• T$*e$ rectal normal#

    • Colono*copie normala#

    Te*te de la'orator + normale#• In2e*tigatii( diagno*tic( tratamentH

  • 8/17/2019 Diareea Cronica 2016

    32/64

    Con*tipatie cronica

    Lamada* 6and'ook o5 Fa*troenterolog; /01

    Tran"it colonicManometrie ano rectala

    De5ecogra5ie

    Te*t ep$l"ie 'alona*

    Normal

    Te*t terape$tic

    E2al$are

    p*i:ologica

    Tran"it

    lent

    Prokinetice(

    laati2e(

    *ecretoare#C:ir$rgie

    Manometrie

    anormalaA5ectare

    *en*# rect

    =io5eed'ack 

    Antrenamentpel2in

    Modi5icari

    *tr$ct$rale

    C:ir$rgie

  • 8/17/2019 Diareea Cronica 2016

    33/64

    Complicatii

    • 6emoroi"i#

    • Prolap* m$coa*a#

    Sangerari#• 7i*$ri anale#

    • 7a2ori"area aparitiei :erniilor#

    Di2ertic$li( di2ertic$lite#• O'*tr$ctie( per5oratii#

    • Melano*i* coli d$pa laati2e#

  • 8/17/2019 Diareea Cronica 2016

    34/64

    Tratament

    • Eerciti$ 5i"ic# Antrenament pel2in#

    • Aport 5i're 13 + 0 g ! "i#

    Aport adec2at lic:ide#• Relaare# =io5eed'ack#

    • S$po"itoare glicerina#

    •Cre*tere 2ol$m *ca$n %p*;lli$m(metilcel$lo"a& macrogol + 7orla#

    • $'ri5iante %$lei para5ina

  • 8/17/2019 Diareea Cronica 2016

    35/64

    Tratament

    • aati2e o*motice %lact$lo"a 3 + 10 g 1 +

    ! "i Sol$tii macrogol 9 7ortran* #

    •  $'ipro*tone#

    inaclotid

    • aati2e emoliente + doc$*ate#

  • 8/17/2019 Diareea Cronica 2016

    36/64

    Tratament /

    • aati2e iritante %*enna

    Prokinetice, Tega*erod ( Trime'$tine 100mg !"i( pro*taglandine( colc:icina#

    Cli*me#

    • Tratament c:ir$rgical#

  • 8/17/2019 Diareea Cronica 2016

    37/64

    Diaree

    • Diaree @ /00 + //3 ml!g *ca$n!"i) con*i*tenta*ca"$ta( n$mar mare *ca$ne# Cantitate mare

    de *ca$n, *ecretie marita de anioni ! a'*or'tie

    *ca"$ta de electroliti#• Mecani*me, o*motic( *ecretor( le"ional#

    • Diaree c$ cantitate normala de *ca$n#

    • Diaree cronică / + pop$laţie generală#• 7!= /!1#

  • 8/17/2019 Diareea Cronica 2016

    38/64

    Mecani*m o*motic

    •aati2e *aline, *ar$ri Mg( etc#

    • Car'o:idrati nere*or'a'ili, lact$lo"a(

    *or'itol( polietilenglicol#

    •Orli*tat + in:i'itor lipa"a#

    • Acar'o"a + mala'*or'tie gl$cide#

    • De5icienta di"a:arida"e %lacta"a etc

    • A5ectarea inte*tin$l$i *$'tire %2irala(Q:ipple( celiaca( ma*tocito"a( amiloido"a(

    i*c:emie( lim5om

  • 8/17/2019 Diareea Cronica 2016

    39/64

    Mecani*m o*motic /

    • Scaderea *$pra5etei inte*tinale#

    • In*$5icienţă pancreatică#

    A5ectarea cicl$l$i aci"ilor 'iliari %'acterii(Cro:n( re"ecţii ileale

    • Mala'*or'tie ! *teatoree#

    =oli in5lamatorii inte*tinale#

  • 8/17/2019 Diareea Cronica 2016

    40/64

    Mecani*m *ecretori$ 1

    • aati2e, 'i*acodil( $lei ricin#

    • Medicatii, colc:icina( teo5ilina( di$retice(

    ne$roleptice#

    • Toine 'acteriene, Gi'rio( E# coli(

    Clo*tridi$m#

    • Con*$m cronic de alcool#

    • Ca$"e :ormonale, GIP %QaDr:kAcl&(

    *erotonina( calcitonina %MEN&( ga*trina

    %alergatori&( gl$cagon( PF#

  • 8/17/2019 Diareea Cronica 2016

    41/64

    Mecani*m *ecretori$ /

    • Ne$ropatie 2egetati2a %D-

    • A5ectarea cicl$l$i aci"ilor 'iliari,

    po*tcoleci*tectomie( Cro:n( proli5erare'acteriana#

    • In5lamatie m$coa*a, colita lim5ocitara(

    colagenica#• T$l'$rari tran*port, adenom 2ilo*(

    clor:idroree congenitala#

  • 8/17/2019 Diareea Cronica 2016

    42/64

    Mecani*m le"ional 1•

    =oli in5lamatorii inte*tinale, 'oala Cro:n(colita $lceroa*a 'oli in5lamatorii

    inte*tinale#

    • I*c:emie, atero*clero"a( 2a*c$lite#

    Di2er*e, 'oala =e:cet( iradiere( proctite(alergii proteine lapte( *oia( ga*troenterită

    eo"ino5ilică#

  • 8/17/2019 Diareea Cronica 2016

    43/64

    Mecani*m le"ional /

    In5ectii!para"ito"e,

    • Girale %rota2ir$*$ri( Noralk

    • =acteriene %E# coli( S:igella( Salmonella(

    Ler*inia( Clo*tridi$m( T=C

    • Para"itare %Fiardia( Cr;pto*poridi$m (

    Ciclo*pora( Entamoe'a

  • 8/17/2019 Diareea Cronica 2016

    44/64

    Diaree c$ cantitate normala de *ca$n

    • Sindrom de inte*tin irita'il#

    • 6ipertiroidi*m#

    • Proctite in5ectioa*e( $lcerati2e#

    • Incontinenta 5ecala, 5i*$ri anale !

    perianale( po*toperatorii( :emoroi"i(

    ne$ropatii( *clerodermie#• 7ecaloame ! t$mori 9 5al*a diaree#

  • 8/17/2019 Diareea Cronica 2016

    45/64

    Diareea cronica

    • Diaree ac$ta B / *aptamani#

    • Diaree per*i*tenta / + 4 *aptamani#

    • Diaree cronica @ 4 *aptamani# De o'icei

    nein5ecţioa*ă

  • 8/17/2019 Diareea Cronica 2016

    46/64

    E2al$are

    • A6C, 'oala celiaca( 'oala in5lamatorie

    inte*tinală( pancreatită#

    • APP, D-( *clerodermie( 'oli endocrine(

    iradiere( atero*clero"a( etili*m( 'oli p*i:ice(

    in5ectii( 6IG# Inter2entii c:ir$rgicale#

    •  

  • 8/17/2019 Diareea Cronica 2016

    47/64

    E2al$are

    7actori de ri*c• Giata per*onala( o'icei$ri alimentare#

    • Pro5e*ie ! calatorii 9 con*$m alimente ! apa

    potential contaminate ( contact toine(germeni( radiatii#

    • Tratamente cronice ! recente#

    • 7enomene a*ociate, 5e'ra( d$reri a'd( 2ariatii

    TA( AG( *angerari( incontinenta( er$ptii(

    paloare( edeme#

  • 8/17/2019 Diareea Cronica 2016

    48/64

    Eamen 5i"ic 1

    Stare generala( TA( AG( temp( pli$ c$tanat#•  

    • Ma*e a'dominale palpa'ile#

    • 6epatomegalie 8! 9 *plenomegalie#

    • TR, :emoroi"i( 5i*$ri( colectii perianale( ton$**5incter( a*pect *ca$n#

  • 8/17/2019 Diareea Cronica 2016

    49/64

    Eamen 5i"ic /

    • Teg$mente ( m$coa*e, icter( paloare(pete*ii ! ec:imo"e( $lceratii( nod$li( c:eilita(

    glo*ita#

    • Edeme( *cadere ponderala( :ipocrati*m

    digital#

    • A5ectare ne$rologica %:TA( p$pile&(

    cardiaca( p$lmonara( o5talmologica

    %iridociclita( con$ncti2ita&( a5ectare

  • 8/17/2019 Diareea Cronica 2016

    50/64

    Eamene de la'orator•

    6F( GS6( CRP#• Te*te :epatice %TFO( TFP( 'ilir$'ina( FFT( 7#

    Alc( al'$mine ! proteine( T

    •Electroliti *erici *i 5ecali#

    • 7e( =1/( 5olati( cole*terol( T( T4#

    • ASCA( ANCA( ac antiendomi*i$m( anti tTF#

    E d l ' t !

  • 8/17/2019 Diareea Cronica 2016

    51/64

    Eamene de la'orator !

    eplorari• Te*t Sc:illing 8 2ariante#

    • Te*te re*piratorii gl$co"a ! lacto"a marcate#

    • Do"are *ecreţii pancreatice#

    • Sigmoido ! colono*copie 8 ! 9 'iop*ii#

    • =iop*ii inte*tinale# C$lt$ri inte*tinale#

    CT ! RM a'dominal#• ERCP#

    • Angiogra5ie a'dominală#

  • 8/17/2019 Diareea Cronica 2016

    52/64

    E2al$are *ca$n

    • Steatoree 8!9 %@ . 9 g gra*imi ! *ca$n /4 oreCalprotectină 5ecală# 6emoragii oc$lte#

    • Coproc$lt$ri# Eamen copropara"itologic#

    • p6 5ecal acid + mala'*or'tie gl$cide#

    • O*molaritate *ca$n />0 mo*m %o*molaritate

    *er& 9 / U %Na 8 J 5ecale Di5erenţă @ 30 + 1/3

    mo*m diaree o*motică)

    B 30 diaree de alte ca$"e 9 *ecretorie#

  • 8/17/2019 Diareea Cronica 2016

    53/64

    E2al$are *ca$n

    • Tip diaree, 2ol$m mare ! normalH• Gol$m normal + inte*tin irita'il#

    • Gol$m B 1 !/4 ore + diaree o*motica *a$

    le"ionala#• Gol$m @ 1 !/4 ore + diaree *ecretorie#

    • Ra*p$n* la oprire alimentatie, *top diaree

    o*motica) contin$a diareea *ecretorie#

     

  • 8/17/2019 Diareea Cronica 2016

    54/64

    Diaree cronica

    In5ectioa*a ! nein5ectioa*aH• Ca$"e in5lamatorii ! le"ionaleH Sca$n c$

    *ange( anemie + colono*copie( 'iop*ii( c$lt$ri#

    Steatoree ! alte elemente de mala'*or'tie +te*te pancreatice *i inte*tinale %'iop*ie( c$lt$ri(

    imagi*tica( endo*copie

    D$reri in5l$entate de *ca$n( 2ol$m normal +inte*tin irita'il#

    • Medicatie ! laati2e ! t$l'$rari alimentatie#

  • 8/17/2019 Diareea Cronica 2016

    55/64

    Diaree ac$tă

    Nein5ecţioa*ă + tratament adec2at#

    In5ecţioa*ă,

    • Reec:ili'rare :idroeletrolitică

    • Agenţi antidiareici

    Coproc$lt$ri( tratament anti'iotic#

  • 8/17/2019 Diareea Cronica 2016

    56/64

    Diaree cronică 1

    • 7emeie 4 ani#

    • Diaree *ang:inolenta @ . *aptamani#

    • 6g' >(3 g!dl# CRP 1/mg!l %N 0 93 GS6

    3 mm !:#

    • Calprotectina 5ecala cre*c$ta#

    • Ce te*t recomandatiH

    • Ce diagno*tic *$*pectatiH Ce tratamentH

  • 8/17/2019 Diareea Cronica 2016

    57/64

    Diaree cronica /

    • =ar'at 3 ani( con*$mator cronic alcool#

    • Scadere ponderala 10 kg ! l$ni#

    Diaree @ / l$ni# Sca$ne 5rec2ente(cantitate mare#

    • Ec:imo"e la tra$mati*me $*oare#

    D$reri a'dominale de eta *$perior#• D$reri o*oa*e( :ipotro5ie m$*c$lara#

    • Te*te( diagno*tic( tratamentH

  • 8/17/2019 Diareea Cronica 2016

    58/64

    Diaree cronica

    • 7emeie 4 ani#

    • Diaree l$ni#

    • Scadere ponderala#

    • Colono*copie normala#

    • Anticorpi anti tTF tip IgA inten* po"iti2i#

    Ce in2e*tigatii recomandatiH• Ce tratament recomandati c$ ce

    *$*pici$ne de diagno*ticH

  • 8/17/2019 Diareea Cronica 2016

    59/64

    Diaree cronica 4

    • 7emeie . ani#

    • Diaree intermitenta @ 1 an#

    7ara *cadere ponderala#• D$reri pre*ca$n( ameliorate d$pă(

    *en"aţie de5ecaţie incompletă#

    Colono*copie 8 'iop*ii normale#• In2e*tigatii( diagno*tic( tratamentH

  • 8/17/2019 Diareea Cronica 2016

    60/64

    Te*te negati2e ! diareea contin$a

    • Rel$area anamne"ei *i a eamen$l$i 5i"ic#

    • Medicatii c$ e5ect laati2, Colc:icina(

    e5l$nomid( Orli*tat#

    • Etinderea in2e*tigatiilor#

    • A'$" de laati2e nerec$no*c$t# A$tocli*me#

    • 7al*a diaree# Pro'leme p*i:ice#

    • H

  • 8/17/2019 Diareea Cronica 2016

    61/64

    Complicatii

    • De*:idratare#

    • Mala'*or'tie#

    • Spitali"ari#

    • Tratamente ! diete co*ti*itoare#

    • Inter2entii c:ir$rgicale#

    Pierderea capacitatii de m$nca ! "ile deconcedi$ medical#

    • Co*t$ri per*onale ! *ociale#

  • 8/17/2019 Diareea Cronica 2016

    62/64

    Tratament

    • Tratament etiologic#

    • Re*trictii alimentare, gl$ten( lacto"a#

    • Inloc$irea medicatiei care pro2oaca

    diareea#

    • Tratament anti'iotic local ! general 9

    anti'iograma#

    • Tratament pro'iotice + =iotic*( Enterol(

    -ir5o* etc#

    • Anti*pa*tice#

  • 8/17/2019 Diareea Cronica 2016

    63/64

  • 8/17/2019 Diareea Cronica 2016

    64/64

    CONC

Embed Size (px)
Recommended