Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Apr 1;29(2):138-144.
doi: 10.1097/MCC.0000000000001024. Epub 2023 Feb 22.

Diarrhea in the critically ill: definitions, epidemiology, risk factors and outcomes

Joanna C Dionne  1 , Lawrence Mbuagbaw  2
Affiliations
Review

Diarrhea in the critically ill: definitions, epidemiology, risk factors and outcomes

Joanna C Dionne et al. Curr Opin Crit Care. .

Abstract

Purpose of review: In this paper, we review the current evidence with respect to definitions, risk factors, and outcomes of diarrhea in the critically ill and highlight research gaps in the literature.

Recent findings: Definitions of diarrhea in the intensive care unit (ICU) include the World Health Organization quantified as >3 liquid bowel movements per day and the Bristol Stool Chart score of 7. Diarrhea incidence is 37.7-73.8% and varies based on definition applied. Clostridioides difficile associated diarrhea (CDAD) is uncommon with an incidence of 2.2%. Risk factors for diarrhea include total number of antibiotics, enteral nutrition, and suppository use. The composition of enteral nutrition including high osmolarity and high fiber feeds contributed to diarrhea occurrence. Opiates decrease diarrhea incidence whereas probiotics have no effect on the incidence or duration of diarrhea. Outcomes of diarrhea include increased length of stay in the ICU and hospital, however its impact on mortality is unclear.

Summary: Diarrhea remains a common problem in clinical practice and attention must be paid to modifiable risk factors. Further research is needed on interventions to decrease its burden.

PubMed Disclaimer

References

    1. Reintam A, Parm P, Redlich U, et al. Gastrointestinal failure in intensive care: a retrospective clinical study in three different intensive care units in Germany and Estonia. BMC Gastroenterol 2006; 6:19.
    1. Lewis SJ, Heaton KW. Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol 1997; 32:920–924.
    1. Dionne JC, Sullivan K, Mbuagbaw L, et al. Diarrhoea: interventions, consequences and epidemiology in the intensive care unit (DICE-ICU): a protocol for a prospective multicentre cohort study. BMJ Open 2019; 9:e028237.
    1. Whelan K, Judd PA, Taylor MA. Assessment of fecal output in patients receiving enteral tube feeding: validation of a novel chart. Eur J Clin Nutr 2004; 58:1030–1037.
    1. Ronan Thibault SG, Aurelie Cler, Nathalie Delieuvin, et al. Diarrhoea in the ICU: respective contribution of feeding and antibiotics. Critical Care 2013; 17:1–8.

Publication types