Always On EM - Mayo Clinic Emergency Medicine

Chapter 43 - Code Brown: When the runs run the room! - Management of Acute Diarrheal Emergencies

May 1, 2025
Dive into the messy world of acute diarrhea management in emergency medicine! Learn about the critical role of hydration strategies, including the WHO’s Oral Rehydration Solution. Discover when zinc supplementation may benefit patients, and gain insights into differentiating viral from bacterial causes. The hosts discuss the significance of Complete Blood Count results, the risks of infections like E. coli, and share real case studies for a practical understanding. Join for an engaging exploration of a vital yet often overlooked issue in urgent care!
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INSIGHT

Four Mechanisms of Diarrhea

  • Diarrhea occurs mainly via four mechanisms: secretory, osmotic, exudative/inflammatory, and motility-related.
  • Each mechanism produces distinct stool characteristics that can guide diagnosis and treatment.
ADVICE

Key History Questions

  • Ask about stool quality, frequency, presence of mucus/blood, recent travels or suspicious foods, and immune status.
  • Inquire about unusual symptoms like paresthesias or palpitations for rare toxin-mediated diarrheas.
ADVICE

When to Test Stool Pathogens

  • Order stool culture and pathogen PCR testing mainly in patients with severe symptoms, immunosuppression, travel history, or persistent diarrhea.
  • Avoid routine testing in mild, self-limited cases to reduce unnecessary diagnostics.
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