Diarrhoea
What is diarrhoea?
Diarrhoea is a condition involving abnormally frequent bowel movements with thin watery stools in larger amounts than usual. It is generally a symptom of another problem.
Acute diarrhoea is usually caused by an infection (virus, bacterium, parasite). Chronic diarrhoea is often caused by another physical problem, examples being irritable bowel syndrome, food hypersensitivity (coeliac disease), chronic inflammation of the intestines (Crohn's disease, ulcerative colitis), an unhealthy diet, side-effects of medication and false diarrhoea (a symptom of constipation).
What are the complaints associated with diarrhoea?
Diarrhoea results in the following complaints: abdominal pain, going to the toilet more frequently, possible incontinence prior to defecation, thin (pasty or watery) stools, sometimes in conjunction with general malaise, fever and dehydration.
How common is diarrhoea in the general population?
The one-year prevalence rate in general practice is 0.94%. 297 Not everyone with diarrhoea goes to the GP and so the actual rate will be higher.
How common is diarrhoea in people with intellectual disabilities?
No figures are available for the group as a whole.
Communal living and moderate hygiene standards mean that it is reasonable to expect that the prevalence of acute diarrhoea will match or exceed prevalence in the general population. In addition, there are syndromes in which intestinal disorders are more common, such as coeliac disease in Down syndrome.
298
A study of medical problems in 146 children with Down syndrome found that 5.2% had had diarrhoea or colitis frequently in the past year and that 10.6% had had a stomach or intestinal condition involving vomiting or diarrhoea in the previous two weeks. This was significantly more frequent than in the 95,454 children included in this study without Down syndrome and without intellectual disabilities (1.2% and 5.7%). No significant difference was found between the children with Down syndrome and 604 children with intellectual disabilities but without Down syndrome (6.5% and 11.5%).
299
It is also known that people with intellectual disabilities use medication frequently and polypharmacy is also found in this group, with the risk of diarrhoea or disruption of bowel movements as a side-effect. The European POMONA study showed that 65% used one or more types of medication
560
and that percentage actually increased to 78% in Dutch elderly people with intellectual disabilities.
561
225
225Linden van der MW, Wester GP, de Bakker DH, Schellevis FG. Tweede Nationale Studie naar ziekten en verrichtingen in de huisartspraktijk: klachten en aandoeningen in de bevolking en in de huisartspraktijk. Utrecht/Bilthoven: NIVEL/RIVM 2004.
Linden van der MW, Wester GP, de Bakker DH, Schellevis FG. Tweede Nationale Studie naar ziekten en verrichtingen in de huisartspraktijk: klachten en aandoeningen in de bevolking en in de huisartspraktijk. Utrecht/Bilthoven: NIVEL/RIVM 2004.
226
226Cohen WI. Current dilemmas in Down syndrome clinical care: celiac disease, thyroid disorders, and atlanto-axial instability. Am J Med Genet C Semin Med Genet. 2006 Aug 15;142C(3):141-8.
Cohen WI. Current dilemmas in Down syndrome clinical care: celiac disease, thyroid disorders, and atlanto-axial instability. Am J Med Genet C Semin Med Genet. 2006 Aug 15;142C(3):141-8.
227
227Schieve LA, Boulet SL, Boyle C, Rasmussen SA, Schendel D. Health of children 3 to 17 years of age with Down syndrome in the 1997 2005 National Health Survey. Pediatrics. 2009; 123; e253-60.
Schieve LA, Boulet SL, Boyle C, Rasmussen SA, Schendel D. Health of children 3 to 17 years of age with Down syndrome in the 1997 2005 National Health Survey. Pediatrics. 2009; 123; e253-60.
530
530Haveman M, Perry J, Salvador-Carulla L, Walsh PN, Kerr M, Van Schrojenstein Lantman-de Valk H, Van Hove G, Berger DM, Azema B, Buono S, Cara AC, Germanavicius A, Linehan C, Määttä T, Tossebro J, Weber G. Ageing and health status in adults with intellectual disabilities: results of the European POMONA II study. J Intellect Dev Disabil. 2011 Mar;36(1):49-60
Haveman M, Perry J, Salvador-Carulla L, Walsh PN, Kerr M, Van Schrojenstein Lantman-de Valk H, Van Hove G, Berger DM, Azema B, Buono S, Cara AC, Germanavicius A, Linehan C, Määttä T, Tossebro J, Weber G. Ageing and health status in adults with intellectual disabilities: results of the European POMONA II study. J Intellect Dev Disabil. 2011 Mar;36(1):49-60
531
531Zaal RJ, van der Kaaij AD, Evenhuis HM, van den Bemt PM. Prescription errors in older individuals with an intellectual disability: prevalence and risk factors in the Healthy Ageing and Intellectual Disability Study. Res Dev Disabil. 2013 May;34(5):1656-62
Zaal RJ, van der Kaaij AD, Evenhuis HM, van den Bemt PM. Prescription errors in older individuals with an intellectual disability: prevalence and risk factors in the Healthy Ageing and Intellectual Disability Study. Res Dev Disabil. 2013 May;34(5):1656-62