Diarrhoea in adults (acute)

Area of Science:

• Gastroenterology
• Infectious Diseases
• Public Health

Background:

• Diarrhoeal diseases cause millions of deaths annually, particularly in resource-poor settings.
• Acute diarrhoea affects millions worldwide, necessitating effective treatment strategies.

Purpose of the Study:

• To systematically review the effectiveness and safety of various treatments for acute diarrhoea in adults.
• To address clinical questions regarding diarrhoea management in resource-rich and resource-poor countries, including traveler's diarrhoea.

Main Methods:

• Conducted a systematic literature review up to January 2007, searching major databases (Medline, Embase, Cochrane Library).
• Included 71 systematic reviews, randomized controlled trials (RCTs), and observational studies.
• Incorporated harms alerts from regulatory agencies like the FDA and MHRA.
• Utilized GRADE methodology to evaluate the quality of evidence for interventions.

Main Results:

• Evaluated a wide range of interventions including antibiotics, antimotility agents, antisecretory agents, bismuth subsalicylate, diet modifications, and various rehydration methods.
• Assessed the effectiveness and safety of different oral rehydration solutions (ORS) such as standard, reduced osmolarity, rice-based, and amino acid-based ORS.
• Considered intravenous and nasogastric tube rehydration for severe cases.

Conclusions:

• Presents comprehensive information on the effectiveness and safety of diverse diarrhoea treatments for adults.
• Highlights the importance of tailored treatment approaches based on geographical location and diarrhoea severity.
• Provides evidence-based guidance for managing acute diarrhoea in various clinical scenarios.