bacterial enterocolitis
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BACTERIAL enterocolitis. Ingestion of bacterial toxins Staph Vibrio Clostridium Ingestion of bacteria which produce toxins Montezuma’s revenge (traveller’s diarrhea), E.coli Infection by enteroinvasive bacteria Enteroinvasive E. coli (EIEC) Shigella Clostridium difficile. E. coli.

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bacterial enterocolitis
BACTERIAL enterocolitis
  • Ingestion of bacterial toxins
    • Staph
    • Vibrio
    • Clostridium
  • Ingestion of bacteria which produce toxins
    • Montezuma’s revenge (traveller’s diarrhea), E.coli
  • Infection by enteroinvasive bacteria
    • Enteroinvasive E. coli (EIEC)
    • Shigella
    • Clostridium difficile
e coli
E. coli
  • Toxin, invasion, many subtypes
  • Food, water, person-to-person
  • Usually watery, some hemorrhagic
  • INFANTS often, in epidemics
salmonella
SALMONELLA

Food, not hemorrhagic

SHIGELLA

(person-to-person, invasive, i.e., often hemorrhagic)

camplyobacter
CAMPLYOBACTER
  • Toxins, Invasion
  • Food spread
yersinia enterocolitica
YERSINIA (enterocolitica)
  • Food
  • Invasion
  • LYMPHOID REACTION
vibrio cholerae
VIBRIO cholerae
  • Water, fish, person-to-person
  • Cholera epidemics
  • NO invasion (watery)
  • ENTEROTOXIN
clostridium difficile
CLOSTRIDIUM DIFFICILE
  • CYTOTOXIN (lab test readily available)
  • NOSOCOMIAL
  • PSEUDOMEMBRANOUS (ANTIBIOTIC ASSOCIATED) COLITIS
malabsorption
MALABSORPTION
  • INTRALUMINAL
  • BRUSH BORDER (microvilli)
  • (TRANS)EPITHELIAL
  • OTHER
    • REDUCED MUCOSAL AREA: Celiac, Crohns
    • LYMPHATIC OBSTRUCTION: Lymphoma, TB
    • INFECTION
    • IATROGENIC: Surgical
intraluminal
INTRALUMINAL
  • PANCREATIC
  • DEFECTIVE/REDUCED BILE
  • BACTERIAL OVERGROWTH
brush border
BRUSH BORDER
  • DISACCHARIDASE DEFICIENCY
  • BRUSH BORDER DAMAGE, e.g., by bacteria
trans epithelial
(Trans)EPITHELIAL
  • ABETALIPOPROTEINEMIA
  • BILE ACID TRANSPORTATION DEFECTS
celiac disease
CELIAC DISEASE
  • Also called SPRUE
  • Also called NON-tropical SPRUE
  • Also called GLUTEN-SENSITIVE ENTEROPATHY
    • Sensitivity to GLUTEN, a wheat protein, gliadin
    • Immobilizes T-cells
    • Also in oat, barley, rye
    • Progressive mucosal “atrophy”, i.e. villous flattening
    • Relieved by gluten withdrawal
tropical sprue
“TROPICAL” SPRUE
  • Epidemic forms
  • NOT related to gluten, cause UN-known
  • RECOVERY with antibiotics
whipple s disease
WHIPPLE’s DISEASE
  • DISTENDED MACROPHAGES in the LAMINA PROPRIA
  • PAS positive
  • ROD SHAPED BACILLI
disaccharidase deficiency
DISACCHARIDASE DEFICIENCY
  • LACTASE by far MOST COMMON
  • ACQUIRED, NOT CONGENITAL
  • LACTOSE GLUCOSE + GALACTOSE
  • LACTOSE (fermented)XXXXXXXXX
  • OSMOTIC DIARRHEA
abetalipoproteinemia
ABETALIPOPROTEINEMIA
  • Autosomal recessive
  • Rare
  • Inability to make chylomicrons from FFAs and MONOGLYCERIDES
  • Infant failure to thrive, diarrhea, steatorrhea
angiodysplasia
ANGIODYSPLASIA
  • NOT really “dysplasia”
  • NOT neoplastic
  • TWISTED, DILATED SUBMUCOSAL VESSELS, can rupture!
  • Common X-ray finding
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