MyMedR

An interesting finding in a patient with chronic diarrhoea

Marwan AA, Ngiu CS, Periyasamy P

Ann Acad Med Singap, 2013 Feb;42(2):97-8.

PMID: 23515696

Matched MeSH terms: Diarrhea/etiology*

Fulltext Unusual faecal elements in a human diarrhoeal stool

Sinniah B, Sheikh Omar AR, Lee CC, Surin J, Subramaniam K

Med J Malaysia, 1994 Dec;49(4):419-23.

PMID: 7674981

A 16-year-old female from Rantau Panjang, Kelantan reported having diarrhoea for three months. During this period, she lost 15 lb in weight and was treated with antibiotics and anti-spasmodic tablets with no improvement. Stool examinations by private laboratories revealed "worm-like eggs". She was treated for worms with mebendazole which helped to reduce the symptoms but not completely. The patient continued passing out the abnormal "worm-like eggs" which were later identified as pollen grains.

Matched MeSH terms: Diarrhea/etiology*

Fulltext Gay men-bowel syndrome: a report of parasitic infection in homosexual patients

Khairul Anuar A

Med J Malaysia, 1985 Dec;40(4):325-9.

PMID: 3842734

Matched MeSH terms: Diarrhea/etiology*

Emergence of Vibrio parahaemolyticus as an important cause of diarrhea in Malaysia

Jegathesan M, Paramasivam T

Am J Trop Med Hyg, 1976 Jan;25(1):201-2.

PMID: 943960

Vibrio parahaemolyticus was isolated from 47 of 2,699 stools examined primarily for the exclusion of cholera. All strains grew well in alkaline peptone water containing 0.5% NaCl and in Monsur's medium. Serotyping showed them to be of various types. Adults were mainly affected. The importance of looking for V. parahaemolyticus in clinical specimens from cases of diarrhea is emphasized.

Matched MeSH terms: Diarrhea/etiology*

Potential role of flavonoids against SARS-CoV-2 induced diarrhea

Paul AK, Jahan R, Bondhon TA, Jannat K, Hasan A, Rahmatullah M, et al.

Trop Biomed, 2021 Sep 01;38(3):360-365.

PMID: 34508344 DOI: 10.47665/tb.38.3.079

COVID-19, caused by the SARS-CoV-2 virus, can lead to massive inflammation in the gastrointestinal tract causing severe clinical symptoms. SARS-CoV-2 infects lungs after binding its spike proteins with alveolar angiotensin-converting enzyme 2 (ACE2), and it also triggers inflammation in the gastrointestinal tract. SARS-CoV-2 invades the gastrointestinal tract by interacting with Toll-like receptor-4 (TLR4) that induces the expression of ACE2. The influx of ACE2 facilitates cellular binding of more SARS-CoV-2 and causes massive gastrointestinal inflammation leading to diarrhea. Diarrhea prior to COVID-19 infection or COVID-19-induced diarrhea reportedly ends up in a poor prognosis for the patient. Flavonoids are part of traditional remedies for gastrointestinal disorders. Preclinical studies show that flavonoids can prevent infectious diarrhea. Recent studies show flavonoids can inhibit the multiplication of SARS-CoV-2. In combination with vitamin D, flavonoids possibly activate nuclear factor erythroid-derived-2-related factor 2 that downregulates ACE2 expression in cells. We suggest that flavonoids have the potential to prevent SARS-CoV-2 induced diarrhea.

Matched MeSH terms: Diarrhea/etiology

A new medical device applied in a case of acute fecal impaction with overflow diarrhea: a case report

Huang Q, Zheng F, Wang H, Yang Y, Ma C, Zhu L

J Med Case Rep, 2024 Mar 06;18(1):89.

PMID: 38444013 DOI: 10.1186/s13256-024-04407-4

BACKGROUND: Fecal impaction is a digestive system disease, that is most common in the elderly population and becomes more prevalent with increasing age. Manual removal can successfully remove the impaction in 80% of fecal impaction cases. In severe cases, endoscopy and surgery may be necessary.

CASE PRESENTATION: A 78-year-old Han Chinese man living in a nursing home was diagnosed with fecal impaction; his initial symptom was overflow diarrhea, which is a rare occurrence with regard to fecal impaction. Nevertheless, we were able to effectively treat this situation by employing a new medical device that presents a novel method for addressing fecal impaction.

CONCLUSION: Early identification of fecal impaction with atypical symptoms is crucial to provide proper emergency management. A safe and noninvasive treatment method, especially for elderly patients with fecal impaction, should be chosen.

Matched MeSH terms: Diarrhea/etiology

Fulltext A case of neonatal diarrhoea caused by congenital glucose-galactose malabsorption

Lee WS, Tay CG, Nazrul N, Paed M, Chai PF

Med J Malaysia, 2009 Mar;64(1):83-5.

PMID: 19852331 MyJurnal

A five-month-old Indian girl, product of consanguineous marriage, presented with diarrhoea with an onset within two days after birth, severe malnutrition and metabolic acidosis. The diarrhoea persisted even with lactose-free formula, amino acid-based formula and glucose-containing oral rehydration solution, but stopped when fasted. She required prolonged parenteral nutrition. Fructose and glucose tolerance tests were performed, confirming the child was able to absorb and metabolize fructose but not glucose, indicating a diagnosis of glucose-galactose malabsorption. This case illustrate how simple and pertinent clinical observations and laboratory investigations is sufficient to allow a firm diagnosis to be made.

Matched MeSH terms: Diarrhea/etiology*

Fulltext Enteropathy-associated T-cell lymphoma: An extremely rare cause of chronic diarrhoea

Liong CC, Ravindran S, Gnana Kumar G, Chin EF, Koh PS, Chan WK

Med J Malaysia, 2016 04;71(2):88-90.

PMID: 27326953 MyJurnal

Chronic diarrhoea in tropical countries may be due to a myriad of causes from infective to non-infective. This case report illustrates the challenges faced in the investigation of a middle-age Chinese gentleman who presented with chronic diarrhoea and weight loss. The diagnosis of type II enteropathy-associated T-cell lymphoma (EATL) was finally made. The diagnosis of EATL was least suspected as the condition is almost unheard of in this part of the world. The epidemiology, presentation, diagnosis, management and prognosis of this rare condition are discussed.

Matched MeSH terms: Diarrhea/etiology*

Microscopic colitis: a histopathological study of nine cases

Jayalakshmi P, Malik AK, Wong NW

Malays J Pathol, 1994 Dec;16(2):145-50.

PMID: 9053563

A retrospective histological analysis of colonic biopsies received by the Department of Pathology, University of Malaya during the 4-year-period between 1990 and 1993 revealed nine cases of microscopic colitis (MC). The ages of the patients ranged from 18 to 53 years. Seven patients were females with a female to male ratio of 3.5 :1. The main clinical symptom was chronic diarrhoea of duration varying from 4 months to 5 years. None of the patients had any systemic illness or were on any prior medication. Colonoscopy and barium enema observations in all the subjects were essentially normal. Colonic biopsies showed diffuse plasmacytic infiltration of the lamina propria, intraepithelial lymphocytic infiltration and normal crypt pattern. To the best of our knowledge, this is the first documented report on MC from Malaysia. It is envisaged that better recognition of this condition by histopathologists would reduce the numbers in the often diagnosed category of "nonspecific colitis".

Matched MeSH terms: Diarrhea/etiology*

Fulltext The prevalence of cryptosporidiosis in children and adults at University Hospital, Kuala Lumpur

Ng KP, Shekhar KC

Med J Malaysia, 1993 Sep;48(3):293-6.

PMID: 8183141

A total of 320 faecal specimens obtained from 295 patients (192 children and 103 adults) with diarrhoea and 47 faecal specimens from healthy adults were screened for Cryptosporidium oocysts. Faecal specimens were first screened by modified Ziehl Neelsen stain and specimens with oocysts were confirmed by direct immunofluorescence technique. Cryptosporidium oocysts were detected in 4 children but not in normal healthy adults or in diarrhoeic adults.

Matched MeSH terms: Diarrhea/etiology

Paediatric viral infections

Lam SK

Ann Acad Med Singap, 1987 Apr;16(2):250-1.

PMID: 3318653

Viral infections are probably the most important cause of childhood morbidity and mortality in the world. In many developing countries in South East Asia and the Western Pacific, priority health problems include acute respiratory infections, acute diarrhoeas and arboviral infections. Where studies have been carried out, there is no significant difference in the aetiological agents involved or in the manifestation of clinical childhood disease. Surveillance of these diseases have improved with the introduction of rapid viral diagnosis. The better understanding of the immunopathogenesis of many diseases have also encouraged research in this area and will lead to the better control and management of these diseases. However, the search for antivirals has been disappointing but fortunately new vaccines are on the horizon and the prospect for bringing some of these diseases under control through vaccination are bright.

Matched MeSH terms: Diarrhea/etiology

Human rotavirus infection in Malaysia. II. A study on the influence of living standard on the prevalence of rotavirus-associated gastroenteritis in children hospitalized with diarrhoea

Yap KL, Sabil D, Muthu PA

J Trop Pediatr, 1984 10;30(5):269-71.

PMID: 6512912 DOI: 10.1093/tropej/30.5.269

Matched MeSH terms: Diarrhea/etiology

In-vitro and in-vivo studies of a cytotoxin from Campylobacter jejuni

Pang T, Wong PY, Puthucheary SD, Sihotang K, Chang WK

J Med Microbiol, 1987 May;23(3):193-8.

PMID: 3585956

Studies were performed on a cytotoxin (CT) from human strains of Campylobacter jejuni isolated in Malaysia. CT was detected by cytopathic effect (CPE) on HeLa cells at titres from 8 to 32, in culture filtrates from 14 (48%) of 29 human isolates. The CPE correlated well with a quantitative 51Cr-release assay where a specific release of 54-68% was noted. CT production was lost after 5-7 subcultures. CT activity was also detected in 5 (26%) of 19 faecal filtrates from which CT-producing isolates were subsequently obtained. The mol. wt of CT was estimated by Sephadex G-50 chromatography to be greater than 30,000. In a suckling-mouse assay, CT consistently failed to demonstrate fluid accumulation after intragastric inoculation of culture filtrate. The Removable Intestinal Tie Adult Rabbit Diarrhoea (RITARD) assay was also used. Rabbits given CT-producing strains of C. jejuni developed bacteraemia and severe watery mucus-containing diarrhoea for the duration of the experiment with death of some animals. Rabbits given CT non-producing strains had less severe disease and none died. Rabbits given partially-purified CT had diarrhoea for 3 days but none died.

Matched MeSH terms: Diarrhea/etiology

Heavy Trichuris infection and amoebic dysentery in Orang Asli children. A comparison of the two diseases

Gilman RH, Davis C, Fitzgerald F

Trans R Soc Trop Med Hyg, 1976;70(4):313-6.

PMID: 1006759

Children with heavy Trichuris infestation were compared with paediatric amoebic dysentery patients and normal children. Heavy Trichuris infestation was diagnosed by visualization of worms on anoscopy. Patients with heavy Trichuris infection had a longer duration of disease, more frequent hospitalization and a higher rate of rectal prolapse than did patients with amoebiasis. Five Trichuris children also had clubbing. Trichuris patients had lower mean haematrocrits (27%) and serum albumin (3-3 gm%) than did patients with amoebiasis (32% and 3-7 gm% respectively). Coinfection with Shigella and Salmonella was significantly increased in patients with heavy Trichuris infection compared to both amoebic and control group children. Trichuris patients were infected with Entamoeba histolytica more frequently (46%) than normal children. Heavy Trichuris infection is the probable cause of symptoms and signs seen in these patients.

Matched MeSH terms: Diarrhea/etiology

An unexpected cause of transient diarrhea

Chuah YY, Lee YY, Tsai TJ

Postgrad Med, 2017 May;129(4):488-490.

PMID: 28335674 DOI: 10.1080/00325481.2017.1311198

Migration of percutaneous endoscopic gastrostomy (PEG) tube to colon with gastro-colonic-cutaneous fistula formation is a rare complication of the procedure. Transient episodic diarrhea following each PEG tube feeding is typical of this complication. We present a 72-year-old man with cerebrovascular disease and scoliosis who encountered episodes of transient diarrhea after each PEG tube feeding. His diarrhea was refractory to medications. Colonoscopy demonstrated a mal-positioned PEG in the transverse colon. Computed tomogram (CT) of abdomen further confirmed the finding. After removal of the migrated PEG, his diarrhea had ceased completely. The gastro-colonic-cutaneous fistula was further managed with endoscopic clipping method with no complications encountered during follow up.

Matched MeSH terms: Diarrhea/etiology*

Fulltext Low prevalence of 'classical' microscopic colitis but evidence of microscopic inflammation in Asian irritable bowel syndrome patients with diarrhoea

Hilmi I, Hartono JL, Pailoor J, Mahadeva S, Goh KL

BMC Gastroenterol, 2013;13:80.

PMID: 23651739 DOI: 10.1186/1471-230X-13-80

There is increasing evidence for the role of microscopic inflammation in patients with IBS. We aimed to examine the prevalence of microscopic colitis and inflammation in Malaysian IBS patients with diarrhoea (IBS-D).

Matched MeSH terms: Diarrhea/etiology

Fulltext Trichuris Dysentery Syndrome: evidence that it may be underdiagnosed in Kelantan

Noorizan AM, Mahendra Raj S

Med J Malaysia, 2001 Mar;56(1):53-7.

PMID: 11503297

The prevalence rate of trichuriasis in children in certain areas of Kelantan is high. However the Trichuris Dysentery Syndrome (TDS), a condition in children characterized by chronic diarrhoea, stunting and anaemia is said to be rare. A recent change in policy at our institution to lower the threshold for undertaking colonoscopy in children with chronic diarrhoea resulted in the detection of 6 cases of TDS in less than a year. The median age was 7 years (range 3-13) and the median duration of symptoms before diagnosis was 2 years (range 1-8). The insidious nature of TDS and the low level of awareness of this condition even among health care workers may result in considerable underdiagnosis.

Matched MeSH terms: Diarrhea/etiology

[Tropical sprue as the cause of chronic diarrhea after travel to Southeast Asia]

Kirchgatterer A, Allinger S, Balon R, Tuppy H, Knoflach P

Z Gastroenterol, 1998 Oct;36(10):897-900.

PMID: 9846368

A 43-year-old woman developed abdominal pain and diarrhea following a travel to Malaysia. Examinations in another hospital proved no evidence of infection, an empirical antibiotic therapy with ciprofloxacin yielded no benefit. One and a half year later, the patient was admitted to our department because of persistent diarrhea and wasting. Laboratory tests showed megaloblastic anemia, folate deficiency and steatorrhea. Stool specimens for bacterial pathogens and parasites were negative. Endoscopy and biopsy from the distal portion of the duodenum revealed broadening and shortening of the villi and an increased infiltration of the lamina propria by chronic inflammatory cells (plasma cells and lymphocytes). In conclusion, diagnosis of tropical sprue was established. The therapy comprised of tetracycline for six weeks and folic acid for six months. Subsequently, the diarrhea disappeared, the patient continuously gained weight and was free of any complaints. The complete remission following this regimen proved the suspected diagnosis. Differential diagnosis in any patient who recently returned from the tropics may be a challenge. Tropical sprue predominantly occurs during or after a longer stay in endemic areas. However, if chronic diarrhea and signs of malabsorption develop after a short journey to India, South-East Asia and parts of the Caribbean, tropical sprue has to be considered, too.

Matched MeSH terms: Diarrhea/etiology*

Risk factors for the transmission of diarrhoea in children: a case-control study in rural Malaysia

Knight SM, Toodayan W, Caique WC, Kyi W, Barnes A, Desmarchelier P

Int J Epidemiol, 1992 Aug;21(4):812-8.

PMID: 1521988

In response to a recorded increasing incidence of diarrhoea in Tumpat District, Malaysia, a case-control study was performed to identify modifiable risk factors for the transmission of diarrhoea, in children aged 4-59 months. Ninety-eight pairs of children, matched on age and sex, were recruited prospectively from health centres. Exposure status was determined during a home visit. Interviewers were 'blinded' as to the disease status of each child. Odds ratios were measured through matched pair analysis and conditional logistic regression. Risk factors for diarrhoea identified were: reported--drinking of unboiled water, storage of cooked food before consumption and bottle feeding; and observations--animals inside the house and absence of washing water in latrines. Water quality, source of drinking water, reported hand washing behaviour, indiscriminate defecation by children, cup use and the absence of a functional latrine were not associated with diarrhoea. Nonsignificant associations were found for: accessibility of washing water source, type of water storage container and use of fly covers for food.

Matched MeSH terms: Diarrhea/etiology

Fulltext Cassava (ubi kayu) poisoning in children

Ariffin WA, Choo KE, Karnaneedi S

Med J Malaysia, 1992 Sep;47(3):231-4.

PMID: 1491651

Three sisters with cassava poisoning are described. A review of the toxic properties of cassava is presented together with discussion on the methods of its preparation, its adverse effects on man, its detoxification in the body, and the treatment of its poisoning.

Matched MeSH terms: Diarrhea/etiology

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