Diarrhea Flashcards
Indications for evaluation of diarrhea include
profuse diarrhea with dehydration, grossly bloody stools, fever ≥38.5°C (≥101°F), duration >48 h without improvement, recent antibiotic use, new community outbreaks, associated severe abdominal pain in patients >50 years, and elderly (≥70 years) or immunocompro- mised patients
If stool studies are unrevealing,
flexible sigmoidoscopy with biopsies and upper endoscopy with duodenal aspirates and biopsies may be indicated
is an increasingly recognized entity characterized by an abrupt-onset diarrhea that persists for at least 4 weeks, but may last 1–3 years, and is thought to be of infectious origin.
Brainerd diarrhea
It may be associated with subtle inflammation of the distal small intestine or proximal colon.
Brainerd diarrhea
Empirical treatment can also be considered for suspected giardiasis with
metronidazole (250 mg qid for 7 d)
may reduce the frequency of traveler’s diarrhea.
Bismuth subsalicylate
Use of ciprofloxacin, azithromycin, or rifaximin may reduce bacterial diarrhea in such travelers by
90%,
is not suitable for invasive disease, but rather as treatment for uncomplicated traveler’s diarrhea.
rifaximin
Diarrhea lasting >4 weeks
CHRONIC DIARRHEA
are due to derangements in fluid and electrolyte transport across the enterocolonic mucosa.
Secretory diarrheas
are the most common secretory causes of chronic diarrhea
Side effects from regular ingestion of drugs and toxins
(the most sensitive test for giardiasis).
Giardia antigen assay
For those with more severe diarrhea,
codeine or tincture of opium may be beneficial.
Clonidine, an α2-adrenergic agonist, may allow control of
diabetic diarrhea
may relieve diarrhea and urgency in patients with IBS diarrhea.
The 5-HT3 receptor antagonists (e.g., alosetron)
