Friday, September 19, 2008

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

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