Acute diarrhea overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Hereditary pancreatitis from Other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications, and Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-ray
Ultrasound
CT scan
CT scan is not routinely performed for cases of acute diarrhea. However, it may help in the detection of certain rare causes of acute diarrhea such as inflammatory bowel disease, intestinal lymphoma, carcinoid syndrome, and other neuroendocrine tumors.
MRI
There are no MRI findings associated with acute diarrhea.
Other Imaging Findings
There are no other imaging findings associated with acute diarrhea.
Other Diagnostic Studies
Sigmoidoscopy and colonoscopy may help in the diagnosis of conditions such as melanosis coli due to laxative abuse, amebiasis, polyps, ulceration, Crohn's disease, and ulcerative colitis. Upper GI endoscopy and biopsy help in the diagnosis of Crohn's disease, giardiasis, intestinal lymphoma, lymphangiectasia, eosinophilic gastroenteritis, Whipple's disease, mastocytosis, abetalipoproteinemia, fungal and protozoal infections.
Treatment
Medical Therapy
The majority of cases of acute diarrhea are self-limited and require only supportive care. Symptomatic treatment for diarrhea includes consumption of adequate amounts of water, mixed with electrolytes to replace water and salt depletion. According to the ACG Clinical Guideline, use of balanced electrolyte rehydration is recommended in patients with traveller’s diarrhea, excessively watery and severe diarrhea. Medical supervision is required in infants with diarrhea, moderate or severe diarrhea in young children, bloody diarrhea, diarrhea for more than two weeks and diarrhea associated with non-cramping abdominal pain, fever and weight loss. Empiric therapy is used as an initial treatment for diagnostic testing, after testing has failed to confirm a diagnosis, when there is no specific treatment or when specific treatment fails to effect a cure. Pharmacotherapy for acute diarrhea includes the use of antibiotics, anticholinergics, antimotility agents and other nonspecific antidiarrheal agents (probiotics).
Surgery
Surgical intervention is not recommended for the management of acute diarrhea.
Primary Prevention
Primary prevention of acute diarrhea includes measures such as counseling in patients and their close contacts. In addition, counseling prior to travel and hand washing using alcohol-based sanitizers are other recommended practices. Hand washing is particularly important for prevention of community-acquired diarrhea outbreaks in cruise ships or institutions.
Secondary Prevention
There are no established measures for the secondary prevention of acute diarrhea.