Diarrhea

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Diarrhea (sometimes spelled diarrhoea) is "an increased liquidity or decreased consistency of feces, such as running stool. Fecal consistency is related to the ratio of water-holding capacity of insoluble solids to total water, rather than the amount of water present. Diarrhea is not hyperdefecation or increased fecal weight."[1]

When constant abdominal pain accompanies diarrhea, a problem requiring surgery may be present.[2]

Treatment

The underlying cause of the diarrhea should be treated. Above all, if the diarrhea is severe, as in a disease such as cholera, death can result not from the infection per se, but from the dehydration caused by the diarrhea. Rehydration can be a more life-saving intervention than antibiotics, and the non-specific anti-motility drugs can be dangerous because they inhibit the excretion of the cholera toxin.

Avoiding severe dehydration, by oral rehydration therapy in epidemics especially with limited healthcare resources, and with intravenous fluid replacement in other circumstances, should be a high priority. Even with a clearly minor cause, when a patient explains his office went to a place serving greasy chili that always upset his intestines, drinking large amounts of fluid, containing salt and carbohydrate, is wise.

In addition, non-specific treatment includes anti-motility drugs such as loperamide (Imodium®, others), which is available over-the-counter in the United States and diphenoxylate (Lomotil®) is a synthetic opiate agonist available by prescription. Anti-motility drugs are contraindicated in situations where a biological or chemical toxin may be present, such as with foodborne diseases.

References

  1. Anonymous (2015), Diarrhea (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. Chen, Esther H. et al. 2008. Derivation of a clinical prediction rule for evaluating patients with abdominal pain and diarrhea. The American Journal of Emergency Medicine 26, no. 4:450-453. DOI:10.1016/j.ajem.2007.07.023