Of special concern are infants and children and elderly or debilitated patients with diarrhea. These patient populations are at increased risk from complications from diarrhea, including dehydration and electrolyte imbalances. In addition, diarrhea may be a symptom of underlying disease in certain individuals. If diarrhea is secondary to another condition, treatment of the primary disorder is most important. Parents of infants and young children should be educated about the signs of dehydration (thirst, dry mouth, concentrated urine, etc.) and should seek medical treatment if their child becomes dehydrated. The American Academy of Pediatrics recommends that, as a general rule, pharmacologic agents not be used to treat acute diarrhea in children. Patients with chronic diarrhea should be managed by identifying and treating the cause or supportively managing each diarrheal episode. Psyllium or another … Read entire article »

Nonpharmacologic Adult individuals with acute diarrhea who are otherwise healthy are not likely to develop dehydration. Lost fluids and electrolytes can be replaced with virtually any beverage plus a source of sodium chloride (salted crackers, etc.). Patients can rest the bowel by avoiding high-fiber foods, fats, milk and other dairy products, caffeine and alcohol. A bland diet emphasizing such foods as bananas, clear soups, juice, gelatin and boiled vegetables may be helpful. The diet can gradually be returned to normal as tolerated and as stools become formed. For less than severe diarrhea, an oral glucose-electrolyte solution may be given if nausea and vomiting are not severe. Intravenous fluid therapy is necessary for the treatment of severe dehydration or diarrhea that is accompanied by severe vomiting. The degree of dehydration present determines the … Read entire article »

Diarrhea is a common symptom that can range in severity from an acute, self-limited annoyance to a severe, life-threatening illness. The frequency and consistency of bowel move-ments vary within and between individuals. Some individuals may normally defecate as many as three times a day, while others only two to three times per week. Diarrhea is defined as increased volume, fluidity, or frequency of fecal discharges compared with the patient’s normal stools. Clinical features vary greatly depending on the cause, duration, and severity of the diarrhea, on the area of bowel affected, and on the patient’s general health. Etiology and Pathophysiology While there are many causes of diarrhea (see Tables 1 and 2), it is most often due to an enteritis (inflammation of the small intestine) of infectious or noninfectious etiology. In the … Read entire article »

The term “diarrhea” originates from the Greek diarr, which means through, and rhein, which denotes flow. Although this descriptive term is appropriate for the symptoms, the word diarrhea may not have the same meaning for all patients and physicians. Diarrhea may denote an increase in the frequency, fluidity or volume of bowel contents, but there is no consensus on the interpretation of the term. To some, an increase in frequency without fluidity or increase in volume represents diarrhea, while for others a single component (e.g., increased frequency, or increased fluidity or volume without the other two components) does not represent this condition. To facilitate communication between physicians and patients, it is important that the history be elucidated in detail through a description of the frequency, volume and consistency of the … Read entire article »