The Global Burden of Disease study estimated that there were 1.4 million deaths due to diarrheal diseases in 2010 . According to this report, diarrheal diseases represent one of the five leading causes of death worldwide and are the second leading cause of death in children under five years of age (behind acute respiratory infections). Most cases of diarrhea are associated with contaminated food and water sources, and around 2.4 billion people globally have no access to basic sanitation .
The World Health Organization (WHO) provides guidelines for the management of diarrheal illness in developing countries in "The Treatment of Diarrhea: A Manual for Physicians and Other Senior Health Workers" . Specific WHO guidelines for the management of epidemic shigellosis  and cholera  are also available. The recommendations in this topic are consistent with those guidelines.
This topic reviews the clinical assessment, treatment, and prevention of acute diarrhea, including watery diarrhea and dysentery, in adults in developing countries.
The clinical assessment and management of children with acute diarrhea in developing countries and of individuals with diarrhea in resource-rich settings are discussed elsewhere. (See "Approach to the child with acute diarrhea in developing countries" and "Epidemiology and causes of acute diarrhea in developed countries" and "Approach to the adult with acute diarrhea in developed countries" and "Approach to the adult with chronic diarrhea in developed countries" and "Evaluation of diarrhea in children" and "Overview of the causes of chronic diarrhea in children".)
CLASSIFICATION OF DIARRHEA
Diarrhea is defined as the passage of loose or watery stools, typically at least three times in a 24-hour period . Acute diarrhea is defined as diarrhea of ≤14 days in duration, in contrast to persistent (>14 days and ≤30 days) or chronic (>30 days) diarrhea. Invasive diarrhea, or dysentery, is defined as diarrhea with visible blood, in contrast to watery diarrhea. Dysentery is commonly associated with fever and abdominal pain.