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Source: Fabel PH, Shealy KM. Diarrhea, constipation, and irritable bowel syndrome. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds., Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York, NY: McGraw-Hill; 2017. http://accesspharmacy.mhmedical.com/content.aspx?bookid=1861§ionid=146059459. Accessed March 14, 2017.
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Most common bacterial causes: Shigella, Salmonella, Campylobacter, Staphylococcus, and Escherichia coli
Most common viral causes: Norwalk and rotavirus.
Medications (Table 1)
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Initiate isolation techniques in daycare centers and nursing homes to prevent transmission of viral illness.
Practice strict food handling, sanitation, water, and other environmental hygiene practices to prevent transmission of bacterial, parasitic, and protozoal infections.
Treat drinking water and limit consumption of fresh vegetables; in addition, prophylactic antibiotics and bismuth subsalicylate may be indicated when traveling.
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CLINICAL PRESENTATION
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Acute diarrheal episodes subside within 72 hours of onset.
Chronic diarrhea involves frequent attacks over extended periods of time.
Abrupt onset of.
Nausea.
Vomiting.
Abdominal pain.
Headache.
Fever.
Chills.
Malaise.
Frequent, nonbloody bowel movements over 12–60 hours.
Pain described as gripping or aching localized to.
Chronic diarrhea associated with.
Weight loss.
Anorexia.
Chronic weakness.
Physical exam demonstrates hyperperistalsis with borborygmi and generalized or local tenderness.
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Stool analysis for microorganisms, blood, mucus, fat, osmolality, pH, electrolyte, and mineral concentration.
Stool cultures.
Stool test kits for detecting viruses, particularly rotavirus.
Antibody serologic testing is nonspecific and not practical.
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DIAGNOSTIC PROCEDURES
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