Management of acute dyarrhea: current and future trends

F. Franceschi, F. Scaldaferri, M.E. Riccioni, I. Casagranda, E. Forte, V. Gerardi, C. Cordischi, S. Antonini, A. Tortora, T. Di Rienzo, G. D’angelo, G. Merra, G. Costamagna, G. Zuccalà, A. Gasbarrini

Emergency Department; 1Internal Medicine and Gastroenterology and 2Digestive Endoscopy Department, Catholic University of the Sacred Heart, School of Medicine, Rome, Italy. francesco.franceschi@rm.unicatt.it

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• Gastroenterology

Acute diarrhea is a very common symptom, which may recognize different causes and is basically the expression of an altered homeostasis of the bowel, which overcame current classifications. When approaching patients with acute diarrhea, we should firstly check body temperature and vital parameters and secondly provide a general medical examination mainly focused on the abdomen, in order to exclude surgical causes of diarrhea, such as acute appendicitis, diverticulitis, intestinal occlusion and others. Another important aspect is the assessment of the level of hydration in order to provide the right amount of fluids.

There is no current indication for the administration of loperamide in infectious diarrhea, but there is a strong rationale for new class of drugs, which may be defined as “mucous regenerators”, such as gelatin tannate. Further studies are needed on this matter in order to test the effect of gelatin tannate in adult patients with acute diarrhea.

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