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The emergency department approach to diarrhea
1Section of Emergency Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, USA.
Emergency Medicine Clinics of North America
|November 1, 1996
Summary
Evaluating patients with diarrhea involves a stepwise approach. Fecal leukocytes aid in assessing severe cases, while oral rehydration is the primary treatment, rarely needing antimicrobials.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Emergency Medicine
Background:
- Enteric diseases pose a significant global health challenge.
- Diarrhea evaluation in emergency departments requires a structured methodology.
- Identifying serious underlying disorders is crucial for patient management.
Purpose of the Study:
- To outline a stepwise approach for evaluating patients with diarrhea.
- To highlight the role of fecal leukocytes in differentiating disease severity.
- To emphasize appropriate treatment strategies for diarrhea.
Main Methods:
- Systematic review of diagnostic and treatment protocols for enteric diseases.
- Focus on clinical assessment, including stool analysis for fecal leukocytes.
- Evaluation of oral rehydration therapy and judicious use of antimicrobial/antidiarrheal agents.
Main Results:
- Fecal leukocyte examination is a key differentiator for moderately to severely ill diarrhea patients.
- Oral rehydration solution effectively treats most diarrhea cases by utilizing the sodium-glucose cotransport mechanism.
- Antimicrobial or antidiarrheal agents are infrequently indicated.
Conclusions:
- A stepwise diagnostic approach is essential for emergency department patients with diarrhea.
- Oral rehydration therapy is the cornerstone of treatment for the majority of diarrhea cases.
- The use of antimicrobials and antidiarrheals should be reserved for specific indications.