Teaching Pearls

• Duration of Diarrhea
  • Acute < 14 days
  • Chronic >4 weeks
• Types of Diarrhea
  • Secretory
    • Stool osmole gap <50
  • Osmotic
    • Stool osmole gap >100
  • Inflammatory
    • Evidence of blood and/or mucoid stools
  • Malabsorption
    • Protein-losing enteropathy
    • CHO malabsorption
    • Fat malabsorption
• Bacterial Causes of Blood Diarrhea
  

  	Source	Presentation	Complications	Treatment
  STEC (EHEC)	Uncooked hamburger meat. Fecal-oral route	Abd pain with bloody diarrhea +/- fever	HUS	No antibiotics indicated; supportive care
  Shigella	Shellfish, fecal oral route	Dysentery (bloody mucoid stools), tenesmus, fever, abdominal pain	Reiters Disease	Flouroquinolone; 3rd generation cephalosporin
  Salmonella	Undercooked raw eggs, chicken, fruits	Fever, abdominal pain, occult/overt bleeding	Bacteremia, aortitis, osteomyelitis in those with sickle cell disease	Only treat when symptoms are severe
  Campylobacter	Poultry	Occult bleeding	Reiters disease, Guillain-Barre Syndrome	Treat only if severe with macrolides