Diagnosis and Treatment of Acute or Persistent Diarrhea

Abstract

Studies of microbial pathogens and the toxins they produce are important for determining the mechanisms by which they cause disease and spread throughout a population. Some bacteria produce secretory enterotoxins (such as choleratoxin or the heat-labile or stable enterotoxins produced by E. coli) that invade cells directly. Others produce cytotoxins (such as those produced by Shigella, enteroinvasive E. coli, or C. difficile) that damage cells or trigger host responses that cause small or large bowel diseases (such as enteroaggregative or enteropathogenic E. coli or Salmonella). Viruses (such as noroviruses and rotaviruses) and protozoa (such as Cryptosporidium, Giardia or Entameba histolytica) disrupt cell functions and cause short-or long-term disease. Much epidemiological data about these pathogens have been collected from community-and hospital-acquired settings, as well from patients with traveler's or persistent diarrhea. These studies have led to practical approaches for prevention, diagnosis and treatment.

Interleukin-13 (IL-13)/IL-13 Receptor α1 (IL-13Rα1) Signaling Regulates Intestinal Epithelial Cystic Fibrosis Transmembrane Conductance Regulator Channel-dependent Cl− Secretion

“…Thus, it is not likely that IL-13-induced electrogenic Cl Ϫ secretion is the primary pathway involved in inflammatory bowel disease-associated diarrhea; however, the effect of increased CFTR Cl Ϫ secretion on Cl Ϫ /HCO 3 Ϫ exchanger-mediated Cl Ϫ reabsorption is unclear. Notably, diarrheal diseases of the small bowel, such as that observed in viral, bacterial and parasitic diseases and food allergy, are associated with secretory diarrhea that is thought to be driven by both Cl Ϫ secretion and sodium absorption (65,66). Cholera toxin and heat-stable enterotoxin stimulate CFTR-mediated Cl Ϫ secretion (67,68).…”

HIV/AIDS-Associated Opportunistic Protozoal Diarrhea

“…In developing countries, these parasites often result in weight loss and wasting syndrome leading to profound morbidity and mortality. 4 Identification of these parasites will help the proper management of these patients, because effective drugs are available for the treatment of most of these opportunistic infections. 4 To date, up to 14 species in eight genera of microsporidia and 13 Cryptosporidium species/genotypes have been reported to infect humans.…”

“…4 Identification of these parasites will help the proper management of these patients, because effective drugs are available for the treatment of most of these opportunistic infections. 4 To date, up to 14 species in eight genera of microsporidia and 13 Cryptosporidium species/genotypes have been reported to infect humans. [5][6] C. hominis is the most prevalent species reported from developing countries, suggestive of anthroponotic transmission.…”

Efficacy and Safety of Saccharomyces boulardii for Acute Diarrhea

“…Other causes include side effects of medicine (especially antibiotics), infections not associated with the gastrointestinal tract, food poisoning, and allergy. 1 Diarrhea is also categorized into acute (lasts several hours or days) and persistent (continues for 14 days or longer). Diarrhea with any cause and any period of time may lead to dehydration and even may be lethal in infants, children, and the elderly if not corrected immediately.…”