Acute Diarrhoea
INV -
Stool microscopy and bacterial culture. Hospitalized pts on abs - test stool sample for C. Difficile toxin, CBC for TC increase, Tempk > 38.5 C
Treatment
A. Diet - Tea, Soft digestible foods. Give bowel rest by avoiding high fibre foods, fats, milk, alc, coffee
B. Rehydration - ORS 50 - 200 ml/ kg/ 24 hrs
C. Antidiur - CI - bloody diar, high fever, sys toxicity,
Use - in mild to moderate diar, to decrease the stool number, liquidity and urgency
1. Loperamide - 4 mg initially, f/b 2 mg after each loose stool (max 8 mg/ day)
2. Bismuth salicylate (Pepto -bismol) - 2 tab / 30 ml orally qid
3. Diphenoxlate and Atropine- CI as anti cholinergic - leads to toxic megacolon
4. Antobiotics -
Emperic - FQ - CIpro 500, Oflox 400, Levo 500 od for 1-3 days.
Doxy 100 mg bd
Rifaximin 200 mg tid x 3 days, Azithro 500 mg tid x 3 days
Specific - in Shigella , cholera
INV -
Stool microscopy and bacterial culture. Hospitalized pts on abs - test stool sample for C. Difficile toxin, CBC for TC increase, Tempk > 38.5 C
Treatment
A. Diet - Tea, Soft digestible foods. Give bowel rest by avoiding high fibre foods, fats, milk, alc, coffee
B. Rehydration - ORS 50 - 200 ml/ kg/ 24 hrs
C. Antidiur - CI - bloody diar, high fever, sys toxicity,
Use - in mild to moderate diar, to decrease the stool number, liquidity and urgency
1. Loperamide - 4 mg initially, f/b 2 mg after each loose stool (max 8 mg/ day)
2. Bismuth salicylate (Pepto -bismol) - 2 tab / 30 ml orally qid
3. Diphenoxlate and Atropine- CI as anti cholinergic - leads to toxic megacolon
4. Antobiotics -
Emperic - FQ - CIpro 500, Oflox 400, Levo 500 od for 1-3 days.
Doxy 100 mg bd
Rifaximin 200 mg tid x 3 days, Azithro 500 mg tid x 3 days
Specific - in Shigella , cholera
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