Other: Appendicitis, diverticulitis, human immunodeficiency virus infection, systemic infections, amyloidosis, adnexitis Gastrointestinal: Ulcerative colitis, Crohn disease, irritable bowel syndrome, celiac disease, lactose intolerance, ischemic colitis, colorectal cancer, short bowel syndrome, malabsorption, gastrinoma, VIPoma, bowel obstruction, constipation with overflow Medical conditions associated with diarrheaĮndocrine: Hyperthyroidism, adrenocortical insufficiency, carcinoid tumors, medullary thyroid cancer Human immunodeficiency virus infection, immunosuppressionĬryptosporidium, Microsporida, Isospora, Cytomegalovirus, Mycobacterium aviumintracellulare complex, Listeria Shigella, Salmonella, Campylobacter, protozoal disease Rotavirus, Cryptosporidium, Giardia, Shigella cereus (beef and pork), Yersinia (beef and pork), Campylobacter (poultry) Staphylococcus aureus, Clostridium perfringens, Salmonella, Listeria (beef, pork, poultry), Shiga toxin–producing E. Seafood, especially raw or undercooked shellfish Salmonella, Campylobacter, Shiga toxin–producing E. coli, Clostridium difficile, Entamoeba histolytica, YersiniaĬonsumption of food commonly associated with foodborne illness Salmonella, Shigella, Campylobacter, Shiga toxin–producing E. Severe fluid loss can still occur, especially in malnourished patientsĪfebrile, abdominal pain with bloody diarrhea coli, Clostridium difficile, Entamoeba histolytica, Yersinia Salmonella (non-Typhi species), Shigella, Campylobacter, Shiga toxin–producing E. Nausea, vomiting normothermia abdominal cramping larger stool volume nonbloody, watery stoolįever, abdominal pain, tenesmus, smaller stool volume, bloody stoolĮnterotoxigenic Escherichia coli, Clostridium perfringens, Bacillus cereus, Staphylococcus aureus, Rotavirus, Norovirus, Giardia, Cryptosporidium, Vibrio cholerae More likely to disrupt mucosal integrity, which may lead to tissue invasion and destruction More likely to promote intestinal secretion without significant disruption in the intestinal mucosa Generally invasive or toxin-producing bacteria ![]() Usually viral, but can be bacterial or parasitic The first step to treating acute diarrhea is rehydration, preferably oral rehydration.Ĭombination loperamide/simethicone may provide faster and more complete relief of acute nonspecific diarrhea and gas-related discomfort than either medication alone.Īntibiotics (usually a quinolone) reduce the duration and severity of traveler's diarrhea. Routine testing for ova and parasites in acute diarrhea is not necessary in developed countries, unless the patient is in a high-risk group (i.e., diarrhea lasting more than seven days, especially if associated with infants in day care or travel to mountainous regions diarrhea in patients with AIDS or men who have sex with men community waterborne outbreaks or bloody diarrhea with few fecal leukocytes). Testing for Clostridium difficile toxins A and B should be performed in patients who develop unexplained diarrhea after three days of hospitalization. In patients with acute diarrhea, stool cultures should be reserved for grossly bloody stool, severe dehydration, signs of inflammatory disease, symptoms lasting more than three to seven days, immunosuppression, and suspected nosocomial infections. Prevention of acute diarrhea is promoted through adequate hand washing, safe food preparation, access to clean water, and vaccinations. When used appropriately, antibiotics are effective in the treatment of shigellosis, campylobacteriosis, Clostridium difficile, traveler's diarrhea, and protozoal infections. Probiotic use may shorten the duration of illness. Antimotility agents should be avoided in patients with bloody diarrhea, but loperamide/simethicone may improve symptoms in patients with watery diarrhea. Oral rehydration therapy with early refeeding is the preferred treatment for dehydration. Diagnostic investigation should be reserved for patients with severe dehydration or illness, persistent fever, bloody stool, or immunosuppression, and for cases of suspected nosocomial infection or outbreak. Treatment focuses on preventing and treating dehydration. Most patients do not require laboratory workup, and routine stool cultures are not recommended. A history and physical examination evaluating for risk factors and signs of inflammatory diarrhea and/or severe dehydration can direct any needed testing and treatment. Increases in travel, comorbidities, and foodborne illness lead to more bacteria-related cases of acute diarrhea. The most common etiology is viral gastroenteritis, a self-limited disease. Acute diarrhea in adults is a common problem encountered by family physicians.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |