Treatments for Traveler's diarrhea
Traveler's diarrhea: Is the Diagnosis Correct?
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Differential diagnosis list for Traveler's diarrhea may include:
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Drugs and Medications used to treat Traveler's diarrhea:
Note:You must always seek professional medical advice about any prescription drug, OTC drug, medication, treatment
or change in treatment plans.
Some of the different medications used in the treatment of Traveler's diarrhea include:
- Loperamide
- Anit-Diarrheal
- Apo-Loperamide
- Diarrid
- Dom-Loperamide
- Imodium
- Imodium AD
- Kaopectate 1-D
- Maalox A/D
- Pepto Diarrhea Control
- Rifaximin
- Redactiv
Unlabeled Drugs and Medications to treat Traveler's diarrhea:
Unlabelled alternative drug treatments for Traveler's diarrhea include:
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Discussion of treatments for Traveler's diarrhea:
Travelers' Diarrhea: DBMD (Excerpt)
TD usually is a self-limited disorder and often resolves without
specific treatment; however, oral rehydration is often beneficial
to replace lost fluids and electrolytes. Clear liquids are routinely
recommended for adults. Travelers who develop three or more loose
stools in an 8-hour period---especially if associated with nausea,
vomiting, abdominal cramps, fever, or blood in stools---may benefit
from antimicrobial therapy. Antibiotics usually are given for
3-5 days. Currently, fluoroquinolones are the drugs of choice.
Commonly prescribed regimens are 500 mg of ciprofloxacin twice
a day or 400 mg of norfloxacin twice a day for 3-5 days. Trimethoprim-sulfamethoxazole
and doxycycline are no longer recommended because of the high
level of resistance to these agents. Bismuth subsalicylate also
may be used as treatment: 1 fluid ounce or 2 262 mg tablets every
30 minutes for up to eight doses in a 24-hour period, which can
be repeated on a second day. If diarrhea persists despite therapy,
travelers should be evaluated by a doctor and treated for possible
parasitic infection. (Source: excerpt from Travelers' Diarrhea: DBMD)
Travelers' Diarrhea: DBMD (Excerpt)
Antimotility agents (loperamide, diphenoxylate, and paregoric)
primarily reduce diarrhea by slowing transit time in the gut,
and, thus, allows more time for absorption. Some persons believe
diarrhea is the body's defense mechanism to minimize contact time
between gut pathogens and intestinal mucosa. In several studies,
antimotility agents have been useful in treating travelers' diarrhea
by decreasing the duration of diarrhea. However, these agents
should never be used by persons with fever or bloody diarrhea,
because they can increase the severity of disease by delaying
clearance of causative organisms. Because antimotility agents
are now available over the counter, their injudicious use is of
concern. Adverse complications (toxic megacolon, sepsis, and disseminated
intravascular coagulation) have been reported as a result of using
these medications to treat diarrhea. (Source: excerpt from Travelers' Diarrhea: DBMD)
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Book Excerpts: Treatment of Traveler's diarrhea
Treatments of Traveler's diarrhea: Online Medical Books
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for more information about the treatments of Traveler's diarrhea.
Diarrhea - Acute:
Treatment
(In a Page: Signs and Symptoms)
-
Treatment is generally supportive
-
Fluid resuscitation (oral, if possible, or IV)
-
Antimotility agents: Opiates (e.g., loperamide) and parasympathetic inhibitors (e.g., diphenoxylate plus atropine); former concerns that these agents may slow the clearance of pathogens have been disproved
- Antibiotic therapy is reserved for severe disease
–Most authorities recommend empiric treatment with a fluoroquinolone or trimethoprin-sulfamethoxasole in patients with severe or bloody diarrhea, fever, or fecal leukocytes
–If Giardia, C. difficile, or E. histolytica is suspected, treat empirically with metronidazole
–Antibiotic therapy increases the risk of hemolytic-uremic syndrome in children with E. coli O157:H7
–There is no good evidence that antibiotics prolong the carrier state in Salmonella infections
- Advise patient to hydrate with glucose-containing, caffeine-free beverages, and to avoid lactose, sorbitol-containing gum, and raw fruit until symptoms subside
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Diarrhea - Chronic:
Treatment
(In a Page: Signs and Symptoms)
-
Fluid resuscitation: Oral, if possible, or IV (e.g., normal saline or lactated Ringer's)
-
Nonspecific antidiarrheal agents (e.g., loperamide, codeine, tincture of opium) and fiber supplementation may be attempted initially
-
Diabetic neuropathy: Control blood sugar, metoclopramide may be used
-
Irritable bowel syndrome: High-fiber diet, anticholinergics
-
Inflammatory bowel disease is treated with steroids for acute exacerbations and daily prophylactic therapy with 5-aminosalicyclic agents
–Bowel resection may be necessary
-
Lactose intolerance: Lactose-free diet
-
Diseases of malabsorption: Gluten-free diet, long-term antibiotics
-
Intestinal neoplasm: Consultation with gastroenterology, oncology, and/or surgery
>
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Diarrhea – Acute:
Treatment
(In A Page: Pediatric Signs and Symptoms)
- Mainstay of treatment is rehydration to correct fluid and electrolyte deficits
–Oral route is best in mildly to moderately dehydrated
children who can tolerate PO fluid
–IV fluids: Useful in severe to moderate dehydration
–Estimate fluid deficit using % of weight loss, and add
this to maintenance requirement and ongoing losses
– Correct over 24–48 hours
-
Antibiotics
–Not necessary in most cases, can precipitate HUS
–Indicated for V. cholerae, Shigella, and G. lamblia
–Indicated in selected circumstances: Salmonella in very young infant, if febrile, or positive blood culture
–Metronidazole for C. difficile (if antibiotic elimination doesn’t help)
-
Refeeding: No benefit to withholding milk, incidence of lactose intolerance overstated
-
Probiotics: Lactobacillus rhamnosus for rotavirus
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Diarrhea – Chronic, No Blood or Weight Loss:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Treatment is directed at cause
-
Chronic nonspecific diarrhea
–Restriction of fluid intake to <90 mL/kg/day
–Reduction of fruit juices (<8 ounces/day)
–Elimination of sorbitol-containing juices
-
Carbohydrate malabsorption
–Trial elimination or reduction of offending sugar
–Lactase (Lactaid) for lactose intolerance
–Sucrase (Sucraid) for sucrase-isomaltase deficiency
-
Small intestine bacterial overgrowth
–Antibiotic therapy with metronidazole alone or in combination with ampicillin or Bactrim
–Surgery for partial small bowel obstruction
-
Low-fat diet: Increase fat intake to approximately 40% of total daily calorie intake
-
Irritable bowel syndrome
–Anticholinergic therapy or antidepressants
-
Acrodermatitis enteropathica: Zinc supplements
>>>>> >>
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Diarrhea – Chronic, with Weight Loss:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Correct malnourished states
-
IBD: Anti-inflammatories (e.g., steroids, 6MP, 5ASA)
-
CD: Lifelong gluten-free diet
-
CF: Pancreatic enzyme and nutritional supplements including fat-soluble vitamins (ADEK)
-
Allergy: Food antigen avoidance
-
Sucrase-isomaltase deficiency: “Sucraid” enzyme
-
Neural crest tumors: Surgical resections
-
VIPoma: Somatostatin
-
Gastrinoma: Proton pump inhibitors
-
Whipple disease: Trimethoprim-sulfamethoxazole
-
Abetalipoprotenemia: No specific treatment
–Supplements of fat-soluble vitamins and MCT oil
-
Acrodermatitis enteropathica: Zinc supplements
-
Giardiasis: Metronidazole or nitazoxamide
-
Hyperalimentation: Parenteral nutrition may be needed for familial enteropathies
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Diarrhea:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
If the patient’s diarrhea is profuse, check for signs of shock—tachycardia, hypotension, and cool, pale, clammy skin. If you detect these signs, place the patient in the supine position and elevate his legs 20 degrees. Insert an I.V. line for fluid replacement. Monitor the patient for electrolyte imbalances, and look for an irregular pulse, muscle weakness, anorexia, and nausea and vomiting. Keep emergency resuscitation equipment handy.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Diarrhea:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Administer an analgesic for pain and an opioid to decrease intestinal motility, unless the patient has a possible or confirmed stool infection. Ensure the patient’s privacy during defecation, and empty bedpans promptly. Clean the perineum thoroughly, and apply ointment to prevent skin breakdown.
ALERT: Excessive diarrhea may cause skin breakdown and excoriation. To decrease excoriation and facilitate drainage measurement, insert a rectal tube or large indwelling catheter.
Help the patient maintain adequate hydration, administering I.V. fluid replacements. Measure liquid stools, and weigh the patient daily. Monitor electrolyte levels and hematocrit.
Quantify the amount of liquid stool and carefully observe intake and output.
Patient teaching
Explain the purpose of diagnostic tests to the patient. These tests may include blood studies, stool cultures, X-rays, and endoscopy.
Advise the patient to avoid spicy or high-fiber foods (such as fruits), caffeine, high-fat foods, and milk. Suggest smaller, more frequent meals if he has had GI surgery or disease. If appropriate, teach the patient stress-reducing exercises, such as guided imagery and deep-breathing techniques, or recommend counseling.
Stress the need for medical follow-up to patients with inflammatory bowel disease (particularly ulcerative colitis), who have an increased risk of developing colon cancer.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Diarrhea:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
If the patient’s diarrhea is profuse, check for signs of shock, including tachycardia, hypotension, and cool, pale, clammy skin. If you detect these signs, place the patient in the supine position and elevate his legs 20 degrees. Insert an I.V. line for fluid replacement. Monitor patient for electrolyte imbalances, and look for an irregular pulse, muscle weakness, anorexia, and nausea and vomiting. Keep emergency resuscitation equipment handy.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Diarrhea:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Administer an analgesic for pain and an opiate to decrease intestinal motility, unless the patient has a possible or confirmed stool infection.
▪ Ensure the patient's privacy during defecation, and empty bedpans promptly.
▪ Clean the perineum thoroughly, and apply ointment to prevent skin breakdown.
▪ Note the amount and characteristics of the patient's stool.
▪ Monitor intake and output.
▪ Obtain serum samples for electrolytes and treat imbalances.
▪ Provide fluid replacement orally or I.V., as appropriate.
Patient teaching
▪ Stress the need for medical follow-up to patients with inflammatory bowel disease (particularly ulcerative colitis) who have an increased risk of developing colon cancer.
▪ Emphasize the importance of maintaining adequate hydration.
▪ Explain food or fluids that should be avoided.
▪ Discuss stress reduction techniques.
▪ Explain the diagnosis and treatment plan.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Fecal incontinence:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Maintain proper hygienic care, including control of foul odors.
▪ Provide meticulous skin care.
▪ For the neurologically capable patient with chronic incontinence, provide bowel retraining.
▪ Take measures to allay the patient's embarrassment.
▪ Provide emotional support for the patient.
Patient teaching
▪ Teach the patient to perform Kegel exercises to strengthen abdominal and perirectal muscles.
▪ Discuss how to maintain proper hygiene.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Diarrhea - Case 17-1: 2-Month-Old Boy:
VI. Treatment
(Pediatric Complaints and Diagnostic Dilemmas)
In cases of incarcerated hernia, time is of the essence. Compromised blood flow
to the affected loop of bowel can result in strangulation and bowel necrosis
within 2 hours, so medical intervention is necessary. Reduction of the
incarcerated hernia by experienced pediatric surgical staff is optimal. A
gentle attempt at reduction using pressure on the scrotum with simultaneous
counterpressure above the external inguinal ring is indicated but should never
be forcefully done. Intravenous hydration and nasogastric tube decompression,
in anticipation of definitive surgical management, are also indicated.
Emergency surgery is sometimes required if the incarcerated hernia is not
reducible. If the incarcerated loop of bowel is reduced, surgery may be
postponed 12 to 36 hours so that the bowel edema can resolve.
Elective repair of an asymptomatic inguinal hernia should be performed as soon
as possible after diagnosis, to avoid complications such as incarceration. All
inguinal hernias require surgical intervention, because they do not resolve
spontaneously. In boys, undescended testes may be associated with inguinal
hernia, requiring orchiopexy. There is still some debate as to the importance
of surgical exploration of the contralateral side in search of an occult
inguinal hernia not detected by physical examination, as was the case in this
patient. This decision is left to the individual surgeon, but contralateral
exploration is commonly performed.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Diarrhea - Case 17-4: 15-Month-Old Boy:
VI. Treatment
(Pediatric Complaints and Diagnostic Dilemmas)
Surgical resection is usually performed. Low-risk patients may not need any
additional therapy. Radiotherapy and chemotherapy are used, depending on the
stage of the disease. Patients with high-risk disease may have some improvement
in short-term survival with autologous bone marrow transplantation, but
longer-term outcome is still poor. Surgical removal of the tumor usually cures
the secretory diarrhea. The use of somatostatin analogues also has a
therapeutic effect on the secretory diarrhea, but the definitive therapy for
the diarrhea remains surgical.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
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