October 10, 2015
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Diarrhea (cont.)


When should antibiotics be used for diarrhea?

Most episodes of diarrhea are acute and of short duration and do not require antibiotics. Antibiotics are not even necessary for the most common bacterial infections that cause diarrhea.

Antibiotics, however, often are used when

  • patients have more severe and persistent diarrhea,
  • patients have additional debilitating diseases such as heart failure, lung disease, and AIDS,
  • stool examination and testing discloses parasites, more serious bacterial infections (for example, Shigella), or C. difficile, and
  • traveler's diarrhea.

What are the complications of diarrhea?

Dehydration occurs when there is excessive loss of fluids and minerals (electrolytes) from the body due to diarrhea, with or without vomiting.

  • Dehydration is common among adult patients with acute diarrhea who have large amounts of stool, particularly when the intake of fluids is limited by lethargy or is associated with nausea and vomiting.
  • It also is common in infants and young children who develop viral gastroenteritis or bacterial infection.
  • Patients with mild dehydration may experience only thirst and dry mouth.
  • Moderate to severe dehydration may cause orthostatic hypotension with syncope (fainting upon standing due to a reduced volume of blood, which causes a drop in blood pressure upon standing), a diminished urine output, severe weakness, shock, kidney failure, confusion, acidosis (too much acid in the blood), and coma.

Electrolytes (minerals) also are lost with water when diarrhea is prolonged or severe, and mineral or electrolyte deficiencies may occur. The most common deficiencies occur with sodium and potassium. Abnormalities of chloride and bicarbonate also may develop.

Finally, there may be irritation of the anus due to the frequent passage of watery stool containing irritating substances.

Medically Reviewed by a Doctor on 2/12/2015

Source: MedicineNet.com

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