Category: Blog

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. 

Chron’s Disease (CD) is a type of inflammatory bowel disease characterized by transmural inflammation of the bowel. Although CD can involve any segment of the GI tract, the ileum and cecum’s involvement is most common. If this occurs, the patient’s symptoms would include right lower abdominal pain, fever, and watery diarrhea. Fistula formation caused by abscesses often complicates CD. Crohn’s disease may also present more subtle symptoms such as mild diarrhea, crampy abdominal pain, and weight loss. 

These symptoms are often thought to be due to irritable bowel syndrome, and months may pass before the diagnosis of CD is made. Because of the variability of Crohn’s involvement, multiple symptoms such as nausea, vomiting, fatigue, and fever may occur. These symptoms should be addressed by a GI specialist with expertise in diagnosing CD.

With the introduction of multiple biologic agents, the treatment of CD has greatly improved. Prior to their introduction, treatment was limited to corticosteroids and immune modulators, which were often ineffective. The resulting clinical scenario was multiple operations with resulting complications, including malabsorption, chronic abdominal pain, anemia, and malnutrition. 

After a thorough investigation and discussion with a GI MD who treats Crohn’s disease, a treatment plan tailored to the patient’s specific needs can be started. The success rate of any biologic achieving endoscopic remission is 30% to 40%. Because of the number of biologics currently available, multiple options exist. A GI specialist can monitor this.