ASGE Annual GI Advanced Practice Provider Course (Virtual) - Clinical Case-Based Learning (Day Two) | April 2023-Evaluation of Acute and Chronic Diarrhea

Pdf Summary

Diarrhea can be classified as acute (lasting 14 days or fewer), persistent (lasting more than 14 but fewer than 30 days), or chronic (lasting more than 30 days). Acute diarrhea is commonly caused by viral, bacterial, or protozoal infections. Evaluating acute diarrhea involves assessing the patient's symptoms, history (including exposures and medical history), conducting a physical examination, and performing laboratory tests. Empiric antibiotic treatment is not recommended unless high-risk features are present.<br /><br />Chronic diarrhea is characterized by persistent alteration of stool consistency and increased stool frequency. It can be classified into different categories, including malabsorptive, secretory, inflammatory, motility-related, and osmotic diarrhea. Evaluating chronic diarrhea involves a thorough history, physical examination, and diagnostic tests such as blood tests, stool studies, endoscopy, and radiology.<br /><br />Treatment of acute diarrhea typically involves supportive measures such as oral hydration, a bland diet, and probiotics. Antibiotics may be prescribed in select patients with severe or invasive bacterial infections. Management of chronic diarrhea focuses on treating the underlying cause. Empiric therapy may be initiated in specific cases. Red flags or alarm features in patients with chronic diarrhea require further evaluation and imaging. The most common causes of chronic diarrhea include irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), malabsorption syndromes, and chronic infections.<br /><br />In conclusion, acute diarrhea is usually self-limiting and requires volume repletion, while chronic diarrhea necessitates identification and treatment of the underlying cause. A thorough history is essential in diagnosing the etiology of chronic diarrhea. The most prevalent causes of chronic diarrhea are IBS, IBD, malabsorption syndromes, and chronic infections.

Asset Subtitle

Jill Olmstead, DNPc, ANP-BC, CCS-P, FAANP

Keywords

acute diarrhea

persistent diarrhea

chronic diarrhea

viral infections

bacterial infections

protozoal infections

evaluation of diarrhea

empiric antibiotic treatment

management of chronic diarrhea

underlying cause of diarrhea