Health Questions and Answers

Archive for the 'Diarrhea' Category

Question: What prophylactic regimens are recommended for traveler’s diarrhea?

Monday, March 10th, 2008

Answer:

Ciprofloxacin, 500 mg twice daily for 5 days (or one of the other fluoroquinolones)
Bismuth subsalicyate (Pepto-Bismol), 2 tablets with every meal and at bedtime for 5 days
Bactrim DS, one tablet twice daily for 3 days (Note: Many organisms are now resistant to Bactrim.)

Reference: Sleisenger MH, Fordtran JS (eds): Gastrointestinal Disease: Pathophysiology, Diagnosis, and Management, 7th [...]

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Question: What are most common organisms implicated in traveler’s diarrhea?

Wednesday, March 5th, 2008

Answer:

Enterotoxigenic E. coli
Shigella sp.
Campylobacter jejuni
Plesiomonas sp.
Rotavirus
Cryptosporidium sp.
Enteroaggregative E. coli
Salmonella sp.
Aeromonas sp.
Norwalk virus
Giardia sp.
Cyclospora sp.

Reference: Lichetenstein GR, Wu GD (eds): The Requisites in Gastroenterology: Vol 2: Small and Large Intestines. St. Louis, Mosby, 2003

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Question: How can traveler’s diarrhea be prevented?

Wednesday, March 5th, 2008

Answer:
Travelers should carefully select, handle and prepare food and dairy products. Everything should be washed thoroughly and freshly cooked. Commercially bottled water, carbonated beverages, and beer are safe-but ice is not!
Reference:  Lichetenstein GR, Wu GD (eds): The Requisites in Gastroenterology: Vol 2: Small and Large Intestines. St. Louis, Mosby, 2003

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Question: What is traveler’s diarrhea?

Wednesday, March 5th, 2008

Answer:
Traveler’s diarrhea is a common term given to the onset of diarrhea in patients who have traveled to other countries, usually in the third world, where the enteric flora are different. Eighty percent of cases are caused by bacteria that can be transmitted via a fecal-oral route. Viruses account for 10% of cases, and parasites [...]

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Question: What organisms are responsible for bacillary dysentery?

Wednesday, March 5th, 2008

Answer:
The term dysentery refers to a diarrheal stool that contains inflammatory exudate (pus) and blood. Bacillary dysentery refers to infectious diarrhea caused by invasive pathogens, most commonly, Shigella, Salmonella, Campylobacter, and enteroinvasive or enterohemorrhagic Escherichia coli.
Reference:  Sleisenger MH, Fordtran JS (eds): Gastrointestinal Disease: Pathophysiology, Diagnosis, and Management, 7th ed. Philadelphia, W.B. Saunders, 2003

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Question: Which three diagnostic features can distinguish secretory from osmotic diarrhea?

Monday, March 3rd, 2008

Answer:

The stool osmolar gap is < 50 mOsm/kg in secretory diarrhea but is > 50 mOsm/kg in osmotic diarrhea.
Secretory diarrhea is typically unrelated to ingested foods or solutes and persists during a 24-72-hour fast, whereas osmotic diarreha stops when ingestion of the offending solute ends.
Patients with a pure secretory diarrhea do not have WBCs, RBCs, [...]

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Question: What causes osmotic diarrhea?

Monday, March 3rd, 2008

Answer:
Osmotic diarrhea is caused by ingestion of excessive amounts of a poorly absorbable but osmotically active solute. Commonly implicated substances include mannitol or sorbitol (seen in patients chewing large quantities of sugar-free gum), magnesium sulfate (Epsom salt), and some magnesium-containing antacids. Carbohydrate malabsorption also may cause osmotic diarrhea through the action of unabsorbed sugars (lactulose). [...]

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