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Review
. 2009 Jul 21;15(27):3341-8.
doi: 10.3748/wjg.15.3341.

Focus on acute diarrhoeal disease

Fabio Baldi  1 , Maria Antonia Bianco, Gerardo Nardone, Alberto Pilotto, Emanuela Zamparo
Affiliations
Review

Focus on acute diarrhoeal disease

Fabio Baldi et al. World J Gastroenterol. .

Abstract

Diarrhoea is an alteration of normal bowel movement characterized by an increase in the water content, volume, or frequency of stools. Diarrhoea needs to be classified according to the trends over time (acute or chronic) and to the characteristics of the stools (watery, fatty, inflammatory). Secretory diarrhoeas, mostly acute and of viral aetiology in more than 70% of cases, are by far the most important subtype of diarrhoeas in terms of frequency, incidence and mortality (over 2.5 million deaths/year in developing countries). Natural and synthetic opiates such as morphine, codeine, and loperamide which react with endogenous opiates (enkephalins, beta-endorphins, dynorphins) mainly act on intestinal motility and slow down transit. An antidiarrhoeal drug developed in recent years, racecadotril, acts as an enkephalinase inhibitor. Clinical studies have shown that it is just as effective as loperamide in resolving acute diarrhoea but with greater reduction in pain and abdominal distension. Some studies have explored the prevalence of diarrhoea in old age. An epidemiological study carried out in Italy by 133 General Practitioners on 5515 elderly outpatients reported a prevalence of diarrhoea, defined according to the Rome criteria, of 9.1%. Infectious diseases (19%) and drug use (16%) were the most common causes of diarrhoea in old age. Regardless of the cause, the treatment of elderly patients with diarrhoea must include rehydration and nutritional support. Every year, more than 50 million tourists travel from industrialized countries to places where hygiene levels are poor. At least 75% of those travelling for short periods mention health problems, and in particular traveller's diarrhoea.

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Figures

Figure 1
Figure 1
Algorithm for patients with acute diarrhoea (modified from Schiller LR. Diarrhea. Med Clin North Am 2000; 84: 1259).
Figure 2
Figure 2
Treatment-related adverse events associated with antidiarrhoeal therapy (from Prado et al[20]).
Figure 3
Figure 3
Prevalence of diarrhoea and disability according to ADL and IADL. 423 patients with diarrhea (GSRS score ≥ 2), M = 178, F = 245, mean age = 75.0 ± 6.3 years, range = 65-100 years.
Figure 4
Figure 4
TD risk areas (Health Information for International travel, CDC 2005-2006).
See this image and copyright information in PMC

References

    1. Guerrant RL, Van Gilder T, Steiner TS, Thielman NM, Slutsker L, Tauxe RV, Hennessy T, Griffin PM, DuPont H, Sack RB, et al. Practice guidelines for the management of infectious diarrhea. Clin Infect Dis. 2001;32:331–351. - PubMed
    1. Gadewar S, Fasano A. Current concepts in the evaluation, diagnosis and management of acute infectious diarrhea. Curr Opin Pharmacol. 2005;5:559–565. - PubMed
    1. Farthing MJ. Functional diarrhea. Curr Gastroenterol Rep. 2005;7:350–357. - PubMed
    1. Guerrant RL. Why America must care about tropical medicine: threats to global health and security from tropical infectious diseases. Am J Trop Med Hyg. 1998;59:3–16. - PubMed
    1. Feldman RA, Banatvala N. The frequency of culturing stools from adults with diarrhoea in Great Britain. Epidemiol Infect. 1994;113:41–44. - PMC - PubMed