Diarrhea is a common medical problem in the US. According to the Center for Disease Control (CDC) there are about 179 cases of acute diarrhea annually in the US. A study from American Journal of Gastroenterology suggests that this leads to about 2.5 million visits to US Emergency Departments annually, and approximately 700,000 hospitalizations.
There are many different causes for acute diarrhea that include different infections (viruses being the most common, but also bacterial infections and even parasites). Medications that are meant to be therapeutic can also cause severe diarrhea. The most common medication that causes diarrhea are actually antibiotics. And long term antibiotic-use can sometimes lead to a severe overgrown of “bad bacteria” in the intestines - an infection referred to as C. Diff colitis. C. Diff colitis can be life threatening, so it is important to catch it early.
Technically, diarrhea occurs when the digestive system fails to absorb enough water from the food we consume. This leads to frequent and watery bowel movement. Diarrhea is particularly common in infants, young children, and the elderly. Obviously, it can be more dangerous and more pervasive in developing countries where access to clean water and adequate sanitation is limited. So, a ContinuEM physician will be sure to ask about recent travel.
When evaluating a patient at ContinuEM, a physician will review vital signs and examine the patient’s abdomen to identify any tenderness or swelling, this exam alone will help the physician in differentiating the pain from diarrhea from more worrisome pains seen in appendicitis and other surgical emergencies.
Laboratory testing may also be necessary to confirm the diagnosis and to identify the underlying cause of the diarrhea and potential electrolyte abnormalities from decreased absorption of fluid. Lab tests may also include stool tests to look for signs of infection or inflammation, blood tests to evaluate for dehydration. If the provider is still unsure as to the and imaging studies such as an abdominal X-ray or CT scan to look for any structural abnormalities that may be contributing to the problem.
One of the pitfalls in patients with active diarrhea is the risk of dehydration, which can occur quickly, particularly in infants, young children, and the elderly. Signs of dehydration include a dry mouth, decreased urine output, and sunken eyes. It is important to monitor patients closely and to ensure that they are adequately hydrated with fluids and electrolytes.
Disposition for patients with diarrhea will depend on the severity of the condition and any underlying medical conditions. In most cases, patients with mild to moderate diarrhea can be managed on an outpatient basis with supportive care, including oral rehydration therapy and anti-diarrheal medications. However, patients with severe or persistent diarrhea, particularly those who are dehydrated or who have underlying medical conditions, may require hospitalization for closer monitoring and more aggressive treatment.
It is important for patients to seek medical attention if they are experiencing symptoms of diarrhea, particularly if they are at increased risk for complications such as dehydration. With appropriate evaluation and management, most patients with diarrhea can recover quickly and return to their normal activities.
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