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Diarrhea, Acute

Stephen M. Testa, MD and Marie L. Borum, MD, EdD, MPH Reviewed 06/2018
 


BASICS

DESCRIPTION

  • An abnormal increase in stool water content, volume, or frequency (≥3 in 24 hours) for <14 days duration

  • Acute viral diarrhea (50–70%)

    • Most common cause of infectious diarrhea; no...

DIAGNOSIS

HISTORY

  • Duration of symptoms <14 days

  • Historical clues for dehydration: orthostatic hypotension, dizziness, increased thirst, decreased urinary output, or altered mental status

  • Description o...

TREATMENT

GENERAL MEASURES

  • Oral rehydration and electrolyte management are key to successful treatment.

  • Diet, as tolerated—“if the gut works, use it.”

  • Balanced electrolyte rehydration solutions recommend...

ONGOING CARE

DIET

  • Early refeeding is encouraged. Regular diets are as effective as restricted diets.

  • The traditional bananas, rice, applesauce, toast (BRAT) diet has little evidence-based support, despi...

REFERENCES

1
1 Barr W, Smith A. Acute diarrhea. Am Fam Physician.  2014;89(3):180–189. {L-End} {L-End} [View Abstract on OvidMedline]
2
2 Riddle MS, Connor BA, Beeching NJ, et al. Guidelines for ...

ADDITIONAL READING

  • Chapman BC, Moore HB, Overbey DM, et al. Fecal microbiota transplant in patients with Clostridium difficile infection: a systematic review. J Trauma Acute Care Surg.  2016;81(4...

SEE ALSO

Botulism; Cholera; Food Poisoning, Bacterial 

CODES

ICD10

  • R19.7 Diarrhea, unspecified

  • A09 Infectious gastroenteritis and colitis, unspecified

  • A08.4 Viral intestinal infection, unspecified

  • A04.9 Bacterial intestinal infection, unspecified

  • K52.2 Allergi...

CLINICAL PEARLS

  • Viruses are the most common causes of acute diarrheal illness in the United States.

  • Oral rehydration is the most important step in treating acute diarrhea.

  • Routine stool culture is not r...

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