Day #80 - Diarrhea

Today we talked about a case of acute diarrhea. The discussant took us through an excellent approach to acute diarrhea. Some highlights below:

Etiology:

• Infection (great article -- also IDSA diarrhea guidelines)
  
  • Viral: rotavirus, enterovirus, norovirus, etc. (CMV in immunocomprimized)
    
  • Bacterial: shigella, yersinia, e. coli, salmonella, campylobacter, C. difficile, TB (usually chronic), atypical mycobacterial (immunocomprimised)
    
  • Protozoal/Parasitic: Giardia, amebiasis, etc.
    
• Inflammatory
  
  • UC/Crohn's
• Ischemic
  
  • Small bowel -- pain out of proportion, post prandial pain
  • Large bowel -- bloody stool, colitis
• Osmotic
  
  • Laxatives, chewing gum diarrhea (xylulose), sorbitol, sucrose, post-surgical "dumping"
    
• Endocrine
  
  • Hyperthyroidism, carcinoid syndrome, VIPoma