Diarrhoea

A09.0/A09.9/K52.2/K52.9 + (Z51.5)

See: Diarrhoea.

• Description
• General measures
• Medicine treatment
• Referral

DESCRIPTION

The commonest cause of diarrhoea in palliative care is laxative use. Other causes include partial intestinal obstruction, HIV-associated diarrhoea, pancreatic insufficiency, Clostridium difficile infection, chemotherapeutics, and radiation enteritis.

Severe constipation and faecal impaction can also cause diarrhoea as backed-up, liquefied stool may be all that the patient can pass (“overflow diarrhoea").

GENERAL MEASURES

Refer to a dietician.

Consider faecal impaction and perform rectal examination if indicated.

MEDICINE TREATMENT

Rehydrate the patient as appropriate if necessary. See: Diarrhoea, acute in children and Diarrhoea, acute, without blood in adults.

Adults:

• Loperamide, oral, 4 mg immediately and 2 mg as required after each loose stool up to 6 hourly.
  • Not more than 12 mg daily
  • Contraindicated in antibiotic-induced diarrhoea and overflow diarrhoea.

REFERRAL

Persistent diarrhoea (> 2 weeks) in children.