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Diarrhea, Acute

Rahma Ali Aldhaheri, MD, Stephen M. Testa, MD and Marie L. Borum, MD, EdD, MPH, MACP, FACG, AGAF Reviewed 06/2019
 


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; noni...

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.

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

  • Balanced electrolyte rehydration solutions rec...

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
Barr W, Smith A. Acute diarrhea. Am Fam Physician.  2014;89(3):180–189. [View Abstract on OvidMedline]
2
Riddle MS, Connor BA, Beeching NJ, et al. Guidelines for the prevention and trea...

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...

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 and effective treatment for acute diarrhea.

  • Routine stool cultu...

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