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DIARRHEA IN ADULTS - INFECTIOUS
Diarrhea is a change in normal bowel movements characterized by increased frequency, water content or volume of stools.
Infectious diarrhea is diarrhea of infectious origin (bacteria, virus, protozoal) and is usually associated with symptoms of nausea and vomiting and abdominal cramps.
Dysentery (invasive diarrhea) has the presence of visible blood in diarrheic stool.

Prevention

  • General measures to prevent diarrheal diseases may include the following:
    • Washing of hands with soap
    • Drinking clean and safe water
    • Proper human waste and garbage disposal
    • Safe food processing and handling

Traveler’s Diarrhea

  • Traveler should avoid:
    • Undercooked food except peeled fruits or vegetables
    • Non-bottled beverages and unpasteurized dairy products

Water Purification

  • Travelers who are going to be living in rustic circumstances overseas will need to make arrangements for a safe water supply

Prophylactic Antibiotics 

  • Effective but cannot be recommended unless the complications of diarrhea in a traveler or severe dehydration in a person with an underlying medical condition
  • cause the benefits of antibiotic prophylaxis to outweigh the risks

Bismuth Preparations

  • May have protective efficacy over a 7-day period

Probiotics

  • May decrease the incidence of diarrhea in travelers
  • May have some value in the prevention of antibiotic-associated diarrhea

Cholera

  • V cholerae is spread through contaminated food and water
  • Prevention depends on interruption of fecal-oral transmission
  • Travelers to regions with cholera should follow precautions for the prevention of traveler’s diarrhea
  • Water can be treated with chlorine or iodine, by filtration, or by boiling 

Consultation or hospitalization is considered in the following cases:

  • Bloody stools
  • Frequent and large-volume diarrhea
  • Persistent fever and vomiting
  • Severe dehydration
  • Altered consciousness
  • Absence of improvement within 48 hours
  • No urine output in preceding 12 hours
  • Elderly patients
  • Presence of chronic medical or concurrent illness
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