Dr. Hugo Rams Jr

Hugo Rams Jr., MD

Acute Diarrhea

 

Normal bowel frequency ranges from three times a day to three times a week in the normal population. Increased stooling, with stool consistency less solid than normal, constitutes a satisfactory, if somewhat imprecise, definition of diarrhea. Acute diarrhea is defined as a greater number of stools of decreased form from the normal lasting for less than 14 days. If the illness persists for more than 14 days, it is called persistent. If the duration of symptoms is longer than 1 month, it is considered chronic diarrhea. Most cases of acute diarrhea are self limited, caused by infectious agents (e.g. viruses, bacteria, parasites), and do not require medication unless the patient is immunocompromised.

 

Prevalence

 

Worldwide, acute diarrhea constitutes a major cause of morbidity and mortality, especially among the very young, very old, and infirm. It is estimated that each year, U.S. adults experience 99 million episodes of acute diarrhea or gastroenteritis, resulting in about 8 million physician visits and more than 250,000 hospital admissions each year (1.5% of adult hospitalizations) caused by acute diarrhea or gastroenteritis. Most cases are caused by enteric infections. Food- and waterborne outbreaks involving a relatively small subset of population and recurrent bouts of illness in others comprise most cases.

Diarrhea is more prevalent among adults who are exposed to children and non–toilet-trained infants, particularly in a daycare setting. It is also more prevalent in travelers to tropical regions; homosexual males, persons with underlying immunosuppression, and those living in nonhygienic environments, with exposure to contaminated water or foods.

 

Evaluation

 

-Laboratory tests help in the diagnosis of electrolyte imbalances(such as low potassium) and kidney function.
-Stool testing is used in an attempt to identify a cause of the diarrhea(bacteria,parasites,viruses, or other substances that can cause diarrhea).
-Other rare causes can present with what seems to be recurrent Diarrhea,ie carcinoid,endocrine tumors of the pancreas and intestine,etc..

 

Treatment

-The most important factor is preventing dehydration specially the young and old with medical problems.
-Since most acute episodes are self limited(that is lasting less than a few days) staying well hydrated with electrolyte replacement fluids that can be bought over the counter,avoiding milk products, and using sparingly antispasmodics to help the frequency of bowel movements(while avoiding constipation) are the mainstay of therapy. Again those young and old with medical problems should be with the guidance of their physician.
- Those that do not improve readily should seek medical attention.