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Acute diarrhea: a practical review.

J Aranda-Michel1, R A Giannella

  • 1Division of Digestive Diseases, University of Cincinnati College of Medicine, Ohio 45267-0595, USA.

The American Journal of Medicine
|June 23, 1999
PubMed
Summary
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This review outlines a practical approach to diagnosing and managing acute infectious diarrhea, emphasizing that most cases are self-limiting and require supportive care, primarily focusing on preventing dehydration. Investigations and specific therapies like antibiotics are generally not needed unless influencing patient outcomes.

Area of Science:

  • Clinical Medicine
  • Infectious Diseases
  • Gastroenterology

Background:

  • Acute infectious diarrhea is a prevalent clinical diagnosis.
  • Specific populations like immunocompromised patients, travelers, and hospitalized individuals present unique challenges.
  • Most episodes of acute diarrhea are self-limiting.

Purpose of the Study:

  • To present a practical, simple, and logical approach to the diagnosis and management of acute infectious diarrhea.
  • To guide clinicians on when investigations are necessary and which therapies are most effective.
  • To discuss management strategies for specific patient groups and types of diarrhea.

Main Methods:

  • Review of clinical practice guidelines and literature on acute infectious diarrhea.

Related Experiment Videos

  • Emphasis on history taking and physical examination for diagnosis and severity assessment.
  • Discussion of therapeutic options including oral rehydration, antidiarrheal agents, and antibiotics.

    • Main Results:

    • Most acute diarrheal episodes are self-limited and do not require extensive investigations.
    • The primary therapeutic goal is preventing dehydration, with oral rehydration solutions being key for significant fluid loss.
    • Antidiarrheal agents (opiate derivatives, bismuth subsalicylate) can reduce symptoms and fluid loss; antibiotics are rarely indicated.

    Conclusions:

    • A systematic approach to acute infectious diarrhea focuses on assessment, severity evaluation, and supportive care, primarily hydration.
    • Specific investigations and treatments should be reserved for cases where they will alter management and improve outcomes.
    • Clinicians should judiciously consider antidiarrheal agents and antibiotics based on individual patient factors and illness severity.