Less than 3 weeks in duration.
Greater than 3 months.
Bloody vs Non-Bloody Diarrhea
The #1 most important question to ask. Narrows down the differential.
Commonly caused by...
E. coli 0157
C. difficile (sometimes)
Indications for Antibiotic Treatment of Diarrhea
- C. difficile
- At the extremes of age. This can kill old people, and in young children it can be bad if E. coli is present.
- "Toxic" patient
Sugar and salt in the proper concentration. Even if everything else is screwed up in the gut, the glucose / Na+ channel will still work and you will be able to rehydrate your body.
Anaerobic, gram-positive bacilli of the clostridium genus.
Spore forming bacteria. This is important because it is hard to completely get rid of.
5-15% of healthy adults carry C. difficile.
Treatment of CDI
Empiric treatment if high index of suspicion.
For mild-moderate disease, treat with metronidazole.
For severe disease, use vancomycin.
If recurrence, pulse vancomycin. If it recurs again, then you need to use a fecal transplant which is very successful.
Very loud rumbling sounds of the stomach.
Approach to Chronic Diarrhea
Malabsorption of Fat Causes