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Diarrhea, Adult, Emergency Medicine

Isam F. Nasr Reviewed 06/2017
 


Basics

Description

Bowel movements characterized as frequent (>3/day), loose, and watery owing to an infectious or toxin exposure 

Etiology

  • Viruses:

    • 50–70% of all cases

  • Invasive bacteria:

    • Campylobacter:

      • C...

Diagnosis

Signs and Symptoms

History

  • Loose, watery bowel movements

  • Bloody stools with mucus

  • Abdominal pain and cramps, tenesmus, flatulence

  • Fever, headache, myalgias

  • Nausea, vomiting

  • Dehydration, lethargy, a...

Treatment

Pre-Hospital

  • Difficult IV access with severe dehydration

  • Avoid exposure to contaminated clothes or body substances.

Initial Stabilization/Therapy

  • ABCs

  • IV fluid with 0.9% normal saline (NS) resusc...

Follow-Up

Disposition

Admission Criteria

  • Hypotension, unresponsive to IV fluids

  • Significant bleeding

  • Signs of sepsis or toxicity

  • Intractable vomiting or abdominal pain

  • Severe electrolyte imbalance or metabo...

Pearls and Pitfalls

Additional Reading

  • Denno  DM, Shaikh  N, Stapp  JR, et al. Diarrhea etiology in a pediatric emergency department: A case control study. Clin Infect Dis.  2012;55:897–904.

  • DuPont  HL. Clinical prac...

Codes

ICD9

  • 008.5 Bacterial enteritis, unspecified

  • 008.8 Intestinal infection due to other organism, not elsewhere classified

  • 787.91 Diarrhea

  • 008.43 Intestinal infection due to campylobacter

  • 003.0 Salmonell...

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