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

Video Transcription

Video Summary

In this video, the speaker discusses acute and chronic diarrhea. They review the definition of diarrhea as increased liquidity or frequency and decreased consistency of stools. Acute diarrhea is defined as lasting 14 days or fewer, while persistent diarrhea lasts more than 14 but fewer than 30 days, and chronic diarrhea lasts more than 30 days. Most cases of acute diarrhea are due to an infectious cause and can resolve with symptomatic treatment. Common infections include norovirus, rotavirus, and bacterial infections like salmonella and E. coli. Protozoa infections are also possible. The speaker emphasizes the importance of taking a thorough history, including looking for alarm symptoms such as rectal bleeding, nocturnal diarrhea, and unexplained weight loss, as these may indicate a need for further evaluation. They also discuss evaluation and management of chronic diarrhea, including ruling out malabsorptive or maldigestive causes, secretory diarrhea, inflammatory causes, motility-related causes, or osmotic causes. Diagnostic testing may include blood work, stool studies, colonoscopy, radiology studies, and upper GI series. Treatment depends on the underlying cause and may include empiric therapy, restriction of certain substances like lactose, and targeted medications. The speaker also mentions a case study of a patient with intermittent diarrhea who was diagnosed with microscopic colitis and discusses its association with medications like proton pump inhibitors and NSAIDs. The importance of volume repletion in diarrheal illness is highlighted, and red flag alarm symptoms that require urgent evaluation are mentioned. The speaker concludes by thanking the audience and other presenters for their contributions to the video.

Asset Subtitle

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

Keywords

acute diarrhea

chronic diarrhea

infectious cause

alarm symptoms

diagnostic testing

treatment