- Cholera
Essential Evidence Topics, 30-Mar-2021
Overall Bottom Line: Prevention using decontaminated water and good food hygiene can be very effective. Profound diarrhea can develop very quickly and become life threatening. Rapid, aggressive rehydration is essential for control of dehydration and r - Clostridium difficile infection
Essential Evidence Topics, 2-Feb-2022
Overall Bottom Line: Suspect Clostridium difficile in any patient with acute watery diarrhea during or shortly after antibiotic therapy. When there is a high baseline likelihood of CDI (i.e. hospitalized patient, antibiotic use, no other explanation) o - Colonoscopy (procedure)
Essential Evidence Topics, 30-Aug-2021
Background: Indications for Procedure Screening colonoscopy Colonoscopy is performed to evaluate an asymptomatic patient for cancer or polyps believed to be precursors of colorectal cancer. (CRC) There is indirect evidence from observational studies tha - Colorectal cancer
Essential Evidence Topics, 14-Jan-2022
Overall Bottom Line: Start screening in average-risk adults at the age of 50 using any of the following: biennial fecal immunochemical test (FIT); flexible sigmoidoscopy every 10 years with biennial FIT; fecal DNA every 1 to 3 years; or colonoscopy eve - Constipation (adult)
Essential Evidence Topics, 19-Apr-2021
Overall Bottom Line: Ask about a feeling of incomplete evacuation, obstruction, and digital manipulation (disordered defecation), as well as infrequent bowel movements and abdominal bloating (slow transit). Consider testing CBC, electrolytes, BUN, creat - Constipation (child)
Essential Evidence Topics, 7-Feb-2022
Overall Bottom Line: A thorough history and physical exam are sufficient to diagnose children with functional constipation in most cases. Fever, abdominal distension, bloody diarrhea, anorexia, nausea, vomiting, weight loss, and poor weight gain are sym - Crohn's disease
Essential Evidence Topics, 5-Jan-2021
Overall Bottom Line: Consider Crohn’s when patients present with chronic (>6 weeks) or nocturnal diarrhea, abdominal pain, weight loss, fever, or symptoms indicating an intestinal blockage or fistula. Initial studies if Crohn’s is suspected should in - Cryptosporidiosis
Essential Evidence Topics, 8-Jun-2021
Overall Bottom Line: Patients typically present with prolonged watery diarrhea. Direct fluorescent antigen detection, enzyme immunoassays, rapid antigen tests, and PCR are available diagnostic tests with good accuracy. Most immunocompetent patients re - Cyclospora
Essential Evidence Topics, 4-Oct-2021
Overall Bottom Line: Cyclospora cayetanensis is an uncommon cause of infectious diarrhea that should be considered in those with diarrhea during known outbreaks, who travel to endemic areas, or who are immunosuppressed with persistent diarrhea. Standar - Cystic fibrosis
Essential Evidence Topics, 27-Dec-2021
Overall Bottom Line: Screen newborns for cystic fibrosis (CF) using an IRT-based protocol. The sweat chloride test is the gold standard to confirm the diagnosis, in conjunction with DNA testing (see ). Initiate pancreatic enzyme replacement in patient - Delayed gastric emptying
Essential Evidence Topics, 25-Mar-2021
Overall Bottom Line: Suspect delayed gastric emptying when patients present with nausea, vomiting, early satiety, and abdominal pain (especially in the setting of diabetes, scleroderma, and neurologic disorders). After a mechanical obstruction is ruled - Dermatitis herpetiformis
Essential Evidence Topics, 8-Sep-2021
Overall Bottom Line: Suspect dermatitis herpetiformis (DH) in patients presenting with pruritic grouped papulovesicles distributed symmetrically in classical extensor areas, buttocks, back, or scalp. After an initial lesional biopsy demonstrating histop - Diarrhea (chronic)
Essential Evidence Topics, 13-Feb-2022
Overall Bottom Line: Chronic diarrhea is defined as increased stool frequency of more than 3 per day, stool weight greater than 200 g per day, decreased fecal consistency, and all this occurring for over 4 weeks. Classify diarrhea into three categories - Diarrhea (travelers)
Essential Evidence Topics, 20-Oct-2021
Overall Bottom Line: Bacteria transmitted by contaminated food or water cause the majority of cases of traveler's diarrhea. Careful selection of food and drinks and taking bismuth subsalicylate help prevent diarrhea. Traveler's diarrhea is usually a b - Diverticular bleeding
Essential Evidence Topics, 24-Dec-2021
Overall Bottom Line: High fiber diet reduces the risk of symptomatic diverticular bleeding. Rule out upper GI bleeding. If heavy bleeding, stabilize patient and consider transfusion. Obtain colonoscopy; if non-diagnostic, consider radionuclide imagi - Diverticulitis
Essential Evidence Topics, 31-Mar-2022
Overall Bottom Line: Initial evaluation should include a problem-focused history and physical, CBC, urinalysis, and plain abdominal radiographs. Obtain CT of the abdomen and pelvis in patients with moderate to severe signs and symptoms. Several systemat - Dumping syndrome
Essential Evidence Topics, 15-Jul-2021
Overall Bottom Line: A group of symptoms that happen traditionally following high carbohydrate diet consumption or with undigested food rapidly reaching the small intestine from altered gastric anatomy and innervation after certain upper gastrointestinal - Dyspepsia (diagnostic evaluation)
Essential Evidence Topics, 3-Apr-2021
Overall Bottom Line: The history and physical examination are not very accurate for differentiating the causes of dyspepsia. Patients over the age of 60 years with new onset dyspepsia and patients at increased risk for malignancy due to residency in a h - Encopresis in children
Essential Evidence Topics, 19-Aug-2021
Overall Bottom Line: A thorough history and physical examination is sufficient to diagnose children with functional constipation and encopresis in most cases. Fever, abdominal distension, anorexia, bloody diarrhea, nausea, vomiting, weight loss, or poor - Entameba histolytica infection (amebiasis)
Essential Evidence Topics, 30-Jan-2022
Overall Bottom Line: Consider ordering a stool antigen test or stool PCR test for E. histolytica in patients with diarrhea and other risk factors (e.g., travel to endemic area). Treat symptomatic patients with tinidazole (preferred) or metronidazole to
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