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Acute diarrheal infections are a common health problem globally and among both individuals in the United States and traveling to developing world countries. Multiple modalities including antibiotic and non-antibiotic therapies have been used to address these common infections. Information on treatment, prevention, diagnostics, and the consequences of acute diarrhea infection has emerged and helps to inform clinical management. In this ACG Clinical Guideline, the authors present an evidence-based approach to diagnosis, prevention, and treatment of acute diarrhea infection in both US-based and travel settings.
Gut, 2018
Chronic diarrhoea is a common problem, hence clear guidance on investigations is required. This is an updated guideline from 2003 for the investigations of chronic diarrhoea commissioned by the Clinical Services and Standards Committee of the British Society of Gastroenterology (BSG). This document has undergone significant revision in content through input by 13 members of the Guideline Development Group (GDG) representing various institutions. The GRADE system was used to appraise the quality of evidence and grading of recommendations.
Journal of gastroenterology and hepatology, 2014
Diarrhea is best defined as passage of loose stools often with more frequent bowel movements. For clinical purposes, the Bristol Stool Form Scale works well to distinguish stool form and to identify loose stools. Laboratory testing of stool consistency has lagged behind. Acute diarrhea is likely to be due to infection and to be self-limited. As diarrhea becomes chronic, it is less likely to be due to infection; duration of 1 month seems to work well as a cut-off for chronic diarrhea, but detailed scientific knowledge is missing about the utility of this definition. In addition to duration of diarrhea, classifications by presenting scenario, by pathophysiology, and by stool characteristics (e.g. watery, fatty, or inflammatory) may help the canny clinician refine the differential diagnosis of chronic diarrhea. In this regard, a careful history remains the essential part of the evaluation of a patient with diarrhea. Imaging the intestine with endoscopy and radiographic techniques is us...
Aetiology of acute diarrhoea in adults
Gut, 1981
We have studied 73 adults with acute diarrhoea and identified a microorganism or toxin likely to be the cause in 58 %. In addition to routinely cultured bacteria, Campylobacter coli/jejuni and Clostridium difficile were important pathogens in the community. Patients who developed diarrhoea after antibiotic use had a distinctive clinical syndrome and comprised the third largest group of cases. Clinical, epidemiological, and histological features in an additional group with-negative cultures and no antibiotic history suggest that an additional bacterial pathogen remains to be identified as a cause of acute diarrhoea in adults. Acute diarrhoea is a common cause of hospital .admission. In children an aetiology can be documented in 83 % of the cases, infection with rotavirus being the most frequent.' 2 In contrast, in adults a specific cause is found in only 27-36 %.13 We undertook a prospective study of diarrhoea in adults in order to try to improve on this diagnostic rate by the application of methods for newly identified gastrointestinal pathogens such as Campylobacter colil jejuni and Clostridium difficile. This paper compares the relative frequency and symptomatology of the different infections. Methods Between July 1978 and July 1979, 106 patients aged from 15 to 94 years were admitted to Northwick Park Hospital with acute diarrhoea on the initial presumption that it was of an infective origin. In 12 patients the diarrhoea ceased on admission and in five more adequate stool samples were not collected. These cases were excluded. Another 16 were rejected because their final diagnosis was not infective-diarrhoea. These comprised two new cases of ulcerative colitis, one exacerbation of known Crohn's disease, two Gram-negative septicaemia, three spurious diarrhoea due to faecal impaction, and one case each of faecal incontinence, irritable