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Approach to the adult with acute diarrhea in resource-limited countries

Regina LaRocque, MD, MPH
Mark Pietroni, MA, MBBChir, FRCP, DTM&H
Section Editor
Stephen B Calderwood, MD
Deputy Editor
Allyson Bloom, MD


The Global Burden of Disease study estimated that there were 1.4 million deaths due to diarrheal diseases in 2010 [1]. 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 [2].

The World Health Organization (WHO) provides guidelines for the management of diarrheal illness in resource-limited countries in "The Treatment of Diarrhea: A Manual for Physicians and Other Senior Health Workers" [3]. Specific WHO guidelines for the management of epidemic shigellosis [4] and cholera [5] 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 resource-limited countries.

The clinical assessment and management of children with acute diarrhea in resource-limited countries and of individuals with diarrhea in resource-rich settings are discussed elsewhere. (See "Approach to the child with acute diarrhea in resource-limited countries" and "Epidemiology and causes of acute diarrhea in resource-rich countries" and "Approach to the adult with acute diarrhea in resource-rich settings" and "Approach to the adult with chronic diarrhea in resource-rich settings" and "Approach to diarrhea in children in resource-rich countries" and "Overview of the causes of chronic diarrhea in children in resource-rich countries".)


Diarrhea is defined as the passage of loose or watery stools, typically at least three times in a 24-hour period [6]. 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.


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Literature review current through: Jun 2017. | This topic last updated: May 24, 2017.
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