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Query: UMLS:C0740441 (acute diarrhea)
 2,275 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Diarrhoea is defined as the frequent passage of loose or watery stools. Most patients can easily recognise and accurately define acute diarrhoea as an abrupt change in their bowel habits. Chronic or recurrent diarrhoea is more difficult for the patient to define, since it may mean malabsorption, tenesmus or true diarrhoea. Serious disorders not to be missed include neoplasia, AIDS, various serious infections such as amoebiasis, and inflammatory bowel disease.
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PMID:Diarrhoea. 152 Jan 38

Before 1970, laboratory staff could not only identify the causative organism of acute diarrhea in 20% of cases, but in 1990, they could identify it in 80% of cases. These organisms are either bacteria, virus, or parasites. The bacteria include enterotoxigenic bacteria (Vibrio cholerae, enterotoxigenic Escherichia coli, Clostridium perfringens, and Staphylococcus aureus) and enteroinvasive bacteria (Campylobacter jejuni, C. coli, and Salmonella and Shigella species). The leading cause of death in diarrhea patients is dehydration. Oral rehydration solutions (ORS) can alleviate mild and moderate dehydration regardless of the etiology of the diarrhea or the age of the patient. WHO recommends an ORS containing glucose and various electrolytes which permit salt and water absorption in many cases of acute diarrhea. Due to the possibility of excess salt entering the bloodstream (hypernatremia), some pediatricians do not use the WHO recommended ORS in newborns and young infants. Instead they use 2 parts ORS followed by 1 part water. This treatment is not easy for illiterate mothers to follow, however. Continued breast feeding during diarrheal episodes along with administration of ORS protects not only against dehydration, but also hypernatremia. ORS should not be administered in severe case of dehydration, however. Medical personnel need to administer replacement fluid such as Ringer's Lactate solution intravenously regardless of the age group. Once the initial deficit has been controlled, ORS administration and reintroduction of foods can follow. Antibiotics should only be administered if the medical personnel suspect severe cholera in an endemic area (tetracycline and furazolidone); shigellosis, but 1st the bacteria must be tested to see if the strain is multiple drug resistant (ampicillin, trimethoprim-sulphamethoxazole, furazolidone, nalidixic acid), and acute amebiasis or giardiasis (metronidazole and tinidazole). Antidiarrheals should not be used.
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PMID:Management of acute diarrhoea. 210 85

The role of Entamoeba histolytica and Giardia lamblia as causative agents of paediatric diarrhoea was studied in a southern Indian population. Relationship between infant feeding practices, co-existing malnutrition and the occurrence of intestinal amoebiasis and giardiasis was also examined. The subjects were 361 paediatric patients with acute diarrhoea and 70 hospitalized control children without diarrhoea. Faecal samples from cases and controls were examined for the protozoal pathogens using faecal preservatives, permanent staining and formalin-ether concentration. Bacteriological studies were conducted on 244 of the 361 cases. A high prevalence of invasive amoebiasis was seen in the 0-6 month (12.5%) and 7-12 month (20.3%) age groups. Giardiasis was uncommon under 6 months (2.1%) but occurred in 8-10% of all other age groups. Invasive amoebiasis occurred mainly in children on weaning foods (45.9%) but also [corrected] in exclusively breast-fed children (13.5%). Giardiasis was not seen in exclusively breast-fed infants, but commonly occurred in older children on normal diets. There was no association between amoebiasis or giardiasis and malnutrition.
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PMID:Intestinal amoebiasis and giardiasis in southern Indian infants and children. 226 Jan 73

The aetiology of acute diarrhoea was investigated in 245 children less than 3 years old in a paediatric outpatient clinic in southern India. In 55% of the children organisms were found in the stools, and one quarter were infected with multiple organisms. Viruses, enteropathogenic E. coli, shigella and campylobacter species accounted for 75% of all isolates. Cholera and helminthiasis were rare, and no child had amoebiasis. Clinical findings were useful in the diagnosis of shigella and rotavirus infection only. Children with shigellosis had classical dysentery, and a greater number of stools; they were unlikely to be breast-fed, to be less than 6 months old, or to have watery stools. Rotavirus infections were characterized by vomiting. Only 20% of the 245 children had an infection which could be treated effectively with antimicrobials.
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PMID:Aetiology and clinical features of acute childhood diarrhoea in an outpatient clinic in Vellore, India. 244 63

Amebiasis, an infection of humans with the protozoan Entamoeba histolytica, has a wide distribution in Mexico. The lumenal, asymptomatic infection, as measured by the presence of cysts in stools has been recorded from 2.4% at Ometepec, Guerrero to over 55% at Mixquic, D.F., but only a small percentage of those having intestinal infection will develop invasive amebiasis, the main clinical forms being dysentery and liver abscess. In Mexico City, from 0.8 up to 14% of cases of acute diarrhoea in children requiring hospitalization were found to be associated with E. histolytica. Serological surveys for antibodies, suggest that approximately 5.98% of people had intestinal mucosal or liver invasion, but amebic dysentery may be five to 50 times more frequent than liver abscess, namely in children. Amebiasis may cause death when it manifests itself as fulminating colitis or liver abscess. Lethality in adults has been estimated to be around 0.2 to 2%, but in children with liver abscess it may be 1.1 to 26%. In addition to being a potentially lethal disease, it has important socioeconomic consequences, because incapacitating infections are rather frequent in wage-earning adult males requiring several weeks of hospitalization and from two to three months for full recovery. In Mexico, amebiasis has been more closely associated with poverty and low levels of sanitation than to climate, and in view of the high rates of morbidity and mortality caused by E. histolytica, more research into better and cheaper methods of diagnosis, treatment and prevention is clearly necessary plus a substantial improvement in control strategies.
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PMID:[Invasive amebiasis as a public health problem]. 271 60

Acute diarrhoea is still a leading cause of child mortality and morbidity, second only to pneumonia as a killer of children, in India and Indonesia. Untreated diarrhoea precipitates malnutrition and is often the underlying cause of marasmus and kwashiorkor. Shigella and salmonella dysenteries are responsible for about 60% of all cases in Indonesia and India. These bacillary agents respond well to trimethoprim. Amoebiasis responds well to metronidazole. Most cases can be managed in the home, even if the exact cause is unknown, by giving liquids or a simple rehydration drink. Diarrhoea can be prevented by improving communal sanitation and personal hygiene, and by giving breast as opposed to bottle feeding of infants. Earlier introduction of supplementary feeding could provide the child with higher energy reserves giving it a better chance of survival when diarrhoeal insults occur.
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PMID:Acute diarrhoeal disease in India and Indonesia. 281 85

To study the etiology of chronic childhood diarrhea among Nigerian children, 142 patients, aged 6 months to 5 years, with diarrhea for at least 1 month, were evaluated; the study took place during January-December 1983 at the Ahmadu Bello University Teaching Hospital, Zaria, Northern Nigeria. Enteropathogenic agents were identified in stools of 90 (63%) patients. Giardia lamblia and Entamoeba histolytica were most commonly detected, representing 41% and 23%, respectively, of all parasitic pathogens. In children with negative stool microscopy, chronic diarrhea was associated with primary lactose intolerance (2 cases), abdominal tuberculosis (2 cases), hyponatremia, low serum albumin, anemia due to sickle cell disease, or Staphylococcus aureus infection. In contrast with chronic diarrhea etiologies reported among children in Europe and North America, infections were the major cause of chronic childhood diarrhea among these children. In general, it is accepted that intestinal infection usually produces acute diarrhea--and that, if the host fails to mount a competent immune response, if there is repeated exposure to infectious agents, or if severe infection damages a substantial proportion of absorptive cells, then severe, protracted diarrhea may result. The high case fatality rate of 9% in this series was associated with specific infectious complications of septicemia, bronchopneumonia, lobar pneumonia and measles. Severe malnutrition also worsened the prognosis in chronic diarrhea. The results indicate that early detection and treatment of amebiasis and giardiasis is a useful approach in the treatment of chronic diarrhea cases among children.
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PMID:Chronic diarrhoea in Nigerian children. 383 11

In acute diarrhea of infancy we distinguish between infectious and noninfectious causes. In the latter we know some autosomal recessive disorders, e.g. the glucose-galactose-malabsorption, the lactase deficiency as well as the sucrase-isomaltase deficiency. In addition the most frequent acquired disorders like the cow's milk protein intolerance and celiac disease contribute also to the group of noninfectious causes of diarrhea. Here the most effective therapy consists of the elimination of the toxic agent from the diet. In infectious diarrhea we find most frequently rotavirus as the agent but also yersinia, campylobacter fetus, salmonella, shigella, E. coli, lamblia giardia and entameba hystolytica. Generally a conservative treatment with a dietetic regimen is preferred. Only in severe cases with yersinia and campylobacter infection the addition of antibiotic drugs is necessary. Giardia lamblia and amebiasis however have to be treated with metronidazol. As the absorption of glucose is coupled with that of sodium within the small intestine in acute gastroenteritis we find a combined disturbance between salt and carbohydrate absorption. A solution containing glucose and salt is recommended therefore for oral rehydration. The amount administered within the first 24 hours should be between 150-250 ml/kg per day. So called "antidiarrhoic drugs" are questionably effective.
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PMID:[Useful and superfluous measures in the treatment of infant diarrhea]. 717 37

Acute diarrhoeal diseases are an important cause of morbidity and mortality, particularly in children. Acute diarrhoea may be watery, where features of dehydration are more prominent or dysenteric, where the stools contain blood and mucous. Rehydration therapy is the key to the management of acute watery diarrhoea, whereas antibiotics play a vital role in the management of acute invasive diarrhoea, particularly shigellosis. Rehydration may be done either by the oral or intravenous routes depending upon the degree of dehydration. Oral rehydration salt solution of WHO formula is recommended for oral rehydration therapy (ORT). Ringer's lactate is the ideal intravenous fluid for correction of severe dehydration due to diarrhoea. Antibiotic therapy is beneficial for cholera and shigellosis only. Antiparasitic agents are indicated only if amoebiasis or giardiasis is present. Antidiarrhoeals are of no benefit for the treatment of acute diarrhoea. Appropriate feeding during diarrhoea is recommended with beneficial outcome.
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PMID:Management of acute diarrhoea. 878 11

We review the pathophysiology of intestinal water and electrolyte transport leading to diarrhoea, the currently available pharmacological strategies for its treatment, and the economic implications of such treatments. Diarrhoea occurs most frequently and is associated with highest mortality in children under 5. Oral rehydration therapy (ORT) is the cornerstone of its management. The safety and efficacy of ORT in the prevention of death from dehydration, both in field and also in hospital settings, are now well established. Because it is also inexpensive, ORT is widely applicable worldwide. More recently, rice-based ORT has emerged, based on well known traditional remedies for diarrhoea in southeast Asia and the Far East. Rice-based ORT has the advantage of being more culturally acceptable, readily available even in rural homes in developing countries, and is more effective in reducing stool output and the duration of diarrhoea, compared with conventional glucose-electrolyte solutions such as World Health Organization ORT. For infants, the well known antidiarrhoeal properties of human milk needs emphasis for a variety of reasons including economic ones. Data concerning the economic benefits to a nations' health budget as a result of nationwide implementation of oral rehydration solution (ORS) use are limited. Available data from individual centres in developing countries, if projected to national level, would incur considerable economic advantage. Except for a few notable infections such as shigellosis, cholera, amoebiasis and giardiasis, the widespread use of antibiotics in acute diarrhoea, still a common practice in many developing countries, has no proven value and may be detrimental. The economic implications of antibiotic abuse in the treatment of diarrhoea in developing countries is enormous. Despite the availability of a wide spectrum of pharmacological agents for diarrhoea reviewed in this article, only a few such agents are of proven clinical efficacy: corticosteroids, aminosalicylates and immunosuppressants in the treatment of inflammatory bowel disease and opioid derivatives such as loperamide which may be useful in protracted diarrhoea in children and in disorders where rapid gastrointestinal transit is the main cause of diarrhoea. Opioids are not recommended for acute infective diarrhoea in childhood. Octreotide, a somatostatin analogue, is reported to be useful in the treatment of secretory diarrhoea due to noninfective causes and in the treatment of intractable diarrhoea associated with AIDS. Its high cost and need for parenteral administration prevent its wider application.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Pharmacoeconomics of the therapy of diarrhoeal disease. 1015 Jan 56


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