DIARRHEA, ACUTE

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General Illness Information

Medical Term:

Diarrhea, Acute

Common Name:

None Specified

Description:

Diarrhea is an increase in the frequency of bowel movements, or increased stool liquidity or increase in the volume. Normally, stool is 60 to 90 percent water: diarrhea mainly results when the percentage exceeds 90.

Diarrhea is considered to be acute, when there is passage of three or more loose stools in a 24 hour period, and lasts less than 3 weeks.

Diarrhea is a symptom, not a disease. Also, it is a common condition amongst all age groups.

Causes:

Acute diarrhea is most commonly caused by infectious agents, bacterial toxins, and drugs. Many organisms can cause diarrhea. These include viruses, bacteria, parasites or certain fungi.

There are numerous other causes of diarrhea, including anxiety, food allergies, hyperthyroidism, irritable bowel syndrome, Crohn's disease, Ulcerative colitis etc.

Prevention:

Infectious diarrhea is usually very contagious. Therefore hand washing after using the toilet or diaper changing is crucial to prevent spread.

Avoid undercooked or raw seafood, buffet or picnic foods left out several hours, and food served by street vendors.

Signs & Symptoms

	. Loose, watery or unformed bowel movements.
	Cramping abdominal pain.
	Fever (sometimes).
	Lack of bowel control (sometimes).
	Lethargy- because of loss of electrolytes and fluids.

Risk Factors

	Food poisoning- recent ingestion of improperly stored or prepared food.
	Crowded or unsanitary living conditions.
	. Immunosuppression due to illness or drugs.
	Travel to foreign country.
	. Ingestion of unpurified water from streams, springs or untested wells.

Diagnosis & Treatment

Diagnostic tests may include a blood analysis and laboratory studies of the stool. A detailed history about the symptoms, time and duration of diarrhea, the severity, and the patient's general health can help determine a cause. If there is evidence of a more serious disorder, further medical tests may be conducted.

In 90% of patients with acute diarrhea, the illness is mild and self-limited and responds within 5 days to simple rehydration therapy . In such case, a laboratory investigation to determine the cause of diarrhea is not necessary, because it is costly , often unrevealing, and does not affect therapy or outcome. Thus the goal of initial evaluation is to distinguish these patients from those with more serious illness.

General Measures:

The main goal of therapy is to prevent dehydration. Maintain fluid intake. Severe diarrhea may require urgent fluid and electrolyte replacement to correct dehydration. For rehydration , readily available oral electrolyte solutions may be used or one can prepare a mixture at home. An easy mixture is 1/2 tsp salt, 1 tsp baking soda, 8 tsp sugar and 8oz orange juice diluted in 1 liter of water. Fluids should be given at 50-200ml/ kg /24 hours depending on the state of hydration. Intravenous fluids may need to be given in patients with severe dehydration.

If cramps are present, place hot compresses, a hot-water bottle or an electric heating pad on the abdomen.

If you think a prescription drug is causing the diarrhea, consult with the doctor before discontinuing it.

Diarrhea is a symptom. If possible, the underlying disorder should be treated.

Medications:
	For minor discomfort, you may use non-prescription drugs such as Pepto-Bismol or loperamide (brand name Imodium); follow the package instructions.
	Other antidiarrheal medications may be prescribed. However, they should not be used in patients with bloody diarrhea and high fever and who are very ill for the fear of worsening the disease.
	Antibiotic may be prescribed if a particular parasite or bacteria is identified or in a patient who has bloody stools and high fever. Antibiotics of choice are the fluoroquinolones ( ciprofloxacin 500mg twice daily) or trimethoprim-sulfamethoxazole or erythromycin.

Activity:
Decrease activity until diarrhea stops.

Diet:
	If diarrhea is accompanied by nausea, suck ice chips only.
	If you are not nauseated, drink small amounts of clear liquids only, such as herbal tea, ginger ale, broth, gelatin, or soups until diarrhea stops.
	Avoid alcohol, caffeine, milk and dairy products.
	After symptoms disappear, eat soft foods, such as cooked cereal, rice, eggs, custard, baked potato and yogurt for 1 or 2 days
	Resume a normal diet 2 or 3 days after the diarrhea stops. Avoid fruit, alcohol and highly seasoned foods for several more days.

Possible Complications :
	Dehydration if diarrhea is prolonged, especially in infants.
	Severe diarrhea can lead to a loss of water and electrolytes such as sodium, potassium, magnesium and chloride. If large amounts of fluid and electrolytes are lost, blood pressure can drop enough to cause fainting, heart rhythm abnormalities (arrhythmias) and other serious disorders.
	If caused by a virulent organism, spread may occur.

Prognosis

Usually spontaneous recovery in 24 to 48 hours.

Other

'Nothing Specified'.