ASGE Annual GI Advanced Practice Provider Course - Day Two (On-Demand) | April 2022-Evaluation of the Patient with Diarrhea

Video Transcription

Video Summary

In this video, Erika Hagee, a nurse practitioner specializing in inflammatory bowel disease, discusses the evaluation and management of diarrhea. She begins by defining diarrhea as increased liquid frequency and consistency of the stools, specifically loose, watery stools three times in a 24-hour period. Acute diarrhea lasts for 14 days or fewer and is often self-limited. Common causes include viral or bacterial infections, such as norovirus, rotavirus, salmonella, and shigella. Hagee advises asking about the duration, frequency, and characteristics of the stool, as well as potential exposures, medical history, and sexual history, in order to determine the cause of acute diarrhea. Evaluation includes physical examination, assessment for volume depletion, and infectious stool studies. Chronic diarrhea, lasting more than 30 days, may be caused by malabsorption, secretory disorders, inflammatory bowel disease, or motility disorders. Hagee emphasizes the importance of a meticulous history and provides a list of red flag symptoms that warrant further evaluation, such as age of onset after 50, rectal bleeding, unexplained weight loss, or iron deficiency anemia. Diagnostic testing includes blood work, stool tests, endoscopy with biopsies, and imaging studies as needed. Treatment involves addressing the underlying cause, considering empirical therapy such as rifaximin or cholestyramine, and providing symptomatic relief with medications like Imodium or fiber supplementation. Hagee concludes with practice pearls, including the importance of volume repletion in diarrheal illnesses and the need for an expedited evaluation in patients with red flag symptoms.

Asset Subtitle

Erica Heagy, MSN, FNP-BC

Keywords

diarrhea

evaluation

management

inflammatory bowel disease

acute diarrhea

chronic diarrhea