Most cases of acute diarrhea are mild and in short duration. These cases are most often viral and require no specific treatment. However, diarrhea accompanied by high fever, bloody stool, and severe pain could cause a bacterial infection. Because of this, an evaluation by a GI specialist is needed. Salmonella, Shigella, and Campylobacter are the most common types of infections. If a patient has recently undergone treatment with antibiotics, they may have an increased chance of suffering from an infection by C. Difficile. This is a type of bacteria that can cause severe acute colitis
History of recent travel, antibiotic exposure, duration, food intake, and animal exposure are
important clues in determining the possible causes of diarrhea. Laboratory evaluation to screen for dehydration and kidney dysfunction is an essential part of the evaluation.
If severe diarrhea occurs along with dehydration, severe abdominal pain, the passage of
bloody stool, or fever, further evaluation should be ordered. Stool multiplex molecular panel will screen for multiple different bacterial, parasitic, and viral infections. Consultation with a GI specialist can facilitate this testing.
Regardless of the cause, management of acute diarrhea starts with fluid repletion. Diluted fruit juices with saltine crackers, broths, and soup may meet fluid requirements. The fluid should contain sugar, salt, and water. However, sports drinks that are used to replace sweat are not particularly useful.
Since a viral infection causes most cases of acute diarrhea, antibiotics are not sufficient.
Indications for antibiotic treatment include high fever, dehydration, blood in the stool, and
immunocompromised patients. Consultation with a GI specialist can determine appropriate
therapy.