Diarrhea, Adult

Front 1

Most common causes of acute diarrhea?

Back 1

1. viral infection

2. most severe forms due to bacterial infn

3. protozoa

Front 2

Causes of acute diarrhea?

Back 2

• infection
  
• meds
  
• malabsorption
  
• ischemic bowel in elderly pts with history of PVD and bloody diarrhea
  
• intestinal tumours
  

Front 3

Causes of chronic diarrhea?

Back 3

• IBS, IBD
  
• meds
  
• infection
  
• colon cancer, diverticulitis
  
• malabsorption
  
• post-surg, endocrine
  
• fecal impaction
  
• laxative abuse
  
• immunocompromised patients with acute infectious diarrhea
  

Front 4

Diagnosis of diarrhea?

Back 4

• acute diarrhea - labs usually unnescessary
  
• some indications for diagnostic studies
• laboratory tests to order: CBC, stool sample, bacterial stool culture, stool sample - C diff
• colonoscopy or flexible sigmoidoscopy may be considered for patients with blood in stool or for patients with chronic diarrhea for which cause can't be IDd

Front 5

approach to pt with acute diarrhea?

Back 5

1. histoory and physical exam
2. assess for complications
3. if complications, microscopic exam
4. if positive, do stool cultue for wbcs
5. if positive, consider c diff toxin. if positive the treat. if negative, flexible sigmoidoscopy with biopsy

Front 6

What to do if acute diarrhea uncomplicated?

Back 6

symptomatic treatment with:

• rehydration
• consider lopiramide

Front 7

treatment of acute diarrhea?

Back 7

• typically self limited, but hospitalize if:
• dehydrated
• unable to tolerate PO fluids
• bloody diarrhea
• high fever, toxic appearance

Front 8

Do you need to id specific agent for acute infectious diarrhea?

Back 8

No

Front 9

Specific therapy for diarrhea

Back 9

1. rehydration

2. treat underlying cause

3. consider ABx

4. loperamide for moderate diarrhea, not recommended if blood in stool

Front 10

When to use antibiotics?

Back 10

1. high fever, bloody stools, or severe diarrhea

2. stool culture grows pathogenic organizms

3. patient has travellers diarrhea

5. c diff infection - metronidazole