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Diarrhea, Acute

Marie L Borum, MD, EdD, MPH, Ankit Patel, MD and Ivan Berezowski, MD Reviewed 04/2024
 


BASICS

DESCRIPTION

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

  • Most commonly secondary to infectious etiology; often...

DIAGNOSIS

HISTORY

  • Duration of symptoms <14 days

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

  • Description of ...

TREATMENT

GENERAL MEASURES

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

    • Oral intake, as tolerated—“if the gut works, use it”

    • IV fluids if patient cannot tolerate oral rehy...

ONGOING CARE

DIET

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

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

REFERENCES

1
Hamilton KW, Cifu AS. Diagnosis and management of infectious diarrhea. JAMA. 2019;321(9):891–892.
2
Ferris A, Gaisinskaya P, Nandi N. Approach to Diarrhea. Prim Care. 2023;50(3):447-459. doi...

ADDITIONAL READING

  • da Cruz Gouveia MA, Lins MTC, da Silva GAP. Acute diarrhea with blood: diagnosis and drug treatment. J Pediatr (Rio J). 2020;96(Suppl)1:20–28.

  • ...

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.

  • Consider broad infectious etiologies if patients are immunocompromised (Cytomegalovirus, Cryptosporid...

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