Often 2 or more mechanisms are present simultaneously. [ncbi.nlm.nih.gov]

Four weeks before presentation she started having diarrhea. She had no history of fever or night sweats. [archivesofrheumatology.org]

With this lower amount of "healthy" bacteria present, the overgrowth of C. diff is then responsible "for elaborating the enterotoxin ". [1] References [ edit ] ^ a b Allan B. Wolfson, ed. (2005). [en.wikipedia.org]

Diarrhea Tips to prevent diarrhea Diarrhea is most often caused by antibiotics, which affect bacteria normally present in the large intestine. [hopkinsmedicine.org]

• Fatigue

  C 17, 18 Testing for celiac disease should be considered in patients with irritable bowel syndrome, type 1 diabetes mellitus, thyroid disease, iron deficiency anemia, weight loss, infertility, elevated liver transaminase levels, and chronic fatigue. [aafp.org]

  […] by the World Health Organization as “the passage of 3 or more loose or liquid stools per day, or more frequently than normal for the individual.” 2 This disease is associated with several symptoms, including abdominal cramps, fever, nausea, vomiting, fatigue [pharmacytimes.com]

  Warning signs (for liver injury) Severe fatigue. Abdominal pain and swelling. Jaundice (yellow eyes and skin, dark urine). Fever. Nausea or vomiting. [healingwell.com]

• Diarrhea

  Abstract Many drugs have been known to cause diarrhea, although their mechanism of action has not been well described. [ncbi.nlm.nih.gov]

  What to Do When Diarrhea Appears? If diarrhea is due to a remedy, this should be discontinued until diarrhea stops. Next time the remedy can be tried in lower amount. [healthhype.com]

  Osmotic diarrhea Osmotic diarrheas can occur from intentional use of a drug as part of its mechanism of action, or unintentionally. [abdominalkey.com]

  Definition Drug-induced diarrhea is loose, watery stools that occurs when you take certain medicines. Alternative Names Diarrhea associated with medicines Causes Nearly all medicines may cause diarrhea as a side effect. [mclarenhealthplan.org]

  Drug-induced diarrhea is loose, watery stools that occurs when you take certain medicines. Nearly all medicines may cause diarrhea as a side effect. The drugs listed below, however, are more likely to cause diarrhea. [medlineplus.gov]

• Chronic Diarrhea

  Unfortunately, it is not only difficult to determine the true cause of chronic diarrhea, but is expensive as well. [empr.com]

  Moreover, identification of a drug as a cause of chronic diarrhea is a challenge in patients taking multiple medications. [journals.lww.com]

  Enlarge Print Diagnosis of Chronic Diarrhea Figure 1. Algorithm for the diagnosis of chronic diarrhea. Information from references 1 and 11. Diagnosis of Chronic Diarrhea Figure 1. Algorithm for the diagnosis of chronic diarrhea. [aafp.org]

  Complications Two potentially serious complications of diarrhea are: dehydration, with acute or chronic diarrhea malabsorption, with chronic diarrhea Diarrhea can also be a sign of a wide range of underlying chronic conditions. [medicalnewstoday.com]

• Nausea

  The most commonly reported adverse effects include abdominal cramps, mild nausea, injection site reactions and hypoglycemia (at high doses.) [healio.com]

  Other possible causes of diarrhea include: Radiation to abdomen or pelvis Anxiety or stress Surgery on the small or large bowel or pelvis Infection Antibiotics, Antacids containing magnesium, anti-nausea medicines, laxatives, or stool softeners Lactose [chemocare.com]

  Cleveland Clinic Journal of Medicine. 2015 October;82(10):671-676 A 56-year-old man presents to the emergency department with nausea, weakness, and exertional dyspnea, which have been going on for 1 week. [mdedge.com]

  Symptoms of viral gastroenteritis typically last only 48-72 hours and include: nausea, vomiting, abdominal cramps, and diarrhea. [medicinenet.com]

  In such conditions, you may experience: Foul smelling diarrhea Abdominal cramps Nausea and vomiting Low-grade fever Loss of appetite Pus or blood in the stools Antibiotic-associated diarrhea often begins about a week after you start taking an antibiotic [gleneaglesglobalhospitals.com]

• Abdominal Pain

  He has had diarrhea with intermittent abdominal pain over the past year, with 10 stools daily, including 3 or 4 at night. The stools are described as large, nonbloody, sticky, greasy, and occasionally watery. [mdedge.com]

  Diagnostic Criteria for Irritable Bowel Syndrome Manning criteria Onset of pain linked to more frequent bowel movements Looser stools associated with onset of pain Pain relieved by passage of stool Noticeable abdominal bloating Sensation of incomplete [aafp.org]

  Typical symptoms range from slightly loose stools to bloody diarrhea, abdominal pain, and fever. [msdmanuals.com]

  Motility related diarrhea is more likely to be associated with cramping abdominal pain. Inflammatory diarrhea often is associated with crampy abdominal pain as well as signs of inflammation, for example, fever, and abdominal tenderness. [medicinenet.com]

  Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders characterized by lower abdominal pain, disturbed defecation, and bloating. Many nongastrointestinal manifestations also exist with IBS. [accesspharmacy.mhmedical.com]

• Dyspepsia

  […] tablets; P = .01). 23 Diphenoxylate plus atropine can be used in combination with loperamide for the treatment of grade 1 or 2 diarrhea at a dosage of 1 to 2 tablets every 6 to 8 hours. 4 Side effects include dry mouth, blurred vision, insomnia, and dyspepsia [jhoponline.com]

• Arthritis

  Arthritis Rheum. 2001; 44: 1984-92. Strand V, Cohen S, Schiff M, Weaver A, Fleischmann R, Cannon G, et al. Treatment of active rheumatoid arthritis with leflunomide compared with placebo and methotrexate. [archivesofrheumatology.org]

  Nonsteroidal anti-inflammatory drugs (NSAIDs) used to treat pain and arthritis, such as ibuprofen and naproxen. Metformin used to treat diabetes. Some herbal teas contain senna or other "natural" laxatives that can cause diarrhea. [mclarenhealthplan.org]

  An orally administered organic gold compound for the treatment of rheumatoid arthritis. Pharmacotherapy 1983; 3: 284–98 PubMed Google Scholar 141. Wallin BA, McCafferty JP, Fox MJ, et al. [link.springer.com]

• Osteoporosis

  […] prescription drug that treats type 2 diabetes Colchicine (Colcrys, Mitigare), a medicine prescribed for people with gout Angiotensin-converting enzyme (ACE) inhibitors, a group of drugs prescribed for high blood pressure Bisphosphonates, prescribed for osteoporosis [webmd.com]

  However, in clinical practice, the use of salmon calcitonin for treatment of osteoporosis rarely causes diarrhea (Vassilopoulou-Sellin, R. personal communication) [27]. [abdominalkey.com]

  Fluoride treatment in osteoporosis. Postgrad Med J 1991; 67: 323–6 PubMed CrossRef Google Scholar 149. Pak CY, Sakhaee K, Gallagher C, et al. [link.springer.com]

• Ulcer

  MMF is a commonly used immunosuppressive agent that can induce ulcerating colitis [ 2,3 ]. MMF-induced ulcerating colitis is a diagnosis by exclusion. [academic.oup.com]

  This may cause ulcers, bleeding, perforation, and narrowing (strictures) of the esophagus. [hopkinsmedicine.org]

  Mucosal ulcerations induced by methotrexate occur in oral region by topical effect because of secretion of this drug in saliva[ 15 ]. However, methotrexate is not known to cause colonic ulceration. [archivesofrheumatology.org]

  […] history Ulcerating viral infections (e.g., cytomegalovirus, herpes simplex virus) Neoplasia Colon carcinoma Lymphoma Villous adenocarcinoma Radiation colitis Table 1. [aafp.org]

  The irritation may cause ulcers, bleeding, perforation (a hole or tear), and strictures (narrowing) of the esophagus. [healingwell.com]

• Withdrawn

  Since the first edition of this book was published in 2005, numerous drugs have been withdrawn from the market in the United States as a result of morbidity and/or mortality associated with drug-induced diseases. [books.google.com]

  Anthraquinones Diphenylmethane derivatives (bisacodyl) Oxyphenisatin – withdrawn for hepatotoxicity Phenolphthalein -withdrawn for carcinogenicity Ricinoleic acid (castor oil) Sodium picosulfate – available outside US Sodium dioctyl sulfosuccinate (docusate [abdominalkey.com]

  Because of a possible causative role, tacrolimus was also withdrawn, and 25 mg prednisolone was given intravenously b.i.d. as the sole immunosuppressive agent. [academic.oup.com]

  This type of diarrhea is watery and voluminous and resolves when the causative agent is withdrawn. [oncology.tv]

  Danthron was withdrawn from the US market in 1987 because of its association with development of hepatic and intestinal tumors in laboratory animals. [clinchem.aaccjnls.org]

• Headache

  Topiramate is approved for the treatment of seizure, as a migraine headache prophylaxis, and for weight loss, with off-label use for bipolar disorder, obesity, neuropathic pain, and smoking cessation 31. It inhibits CA II, IV, and XII 31. [f1000research.com]

This workup should include complete blood count, examination of stool for occult blood, metabolic panel to assess electrolyte levels, BUN/creatinine, albumin, stool cultures for enteric pathogens, C difficile, and ova and parasites, and a flat plate of [oncology.tv]

Workup for Suspected IBD Figure 2. Workup for suspected inflammatory bowel disease (IBD) in adults. Adapted with permission from van Rheenen PF, Van de Vijver E, Fidler V. [aafp.org]

• Colitis

  If they observe a specific type of inflammation called pseudomembranous colitis, Clostridium difficile –induced colitis is diagnosed. [msdmanuals.com]

  Because the role of TNF-α in MMF-induced colitis and the histopathologic resemblance of MMF-induced colitis to Crohn’s colitis, we decided to treat our patient with infliximab. [academic.oup.com]

  Early ulcerative colitis, distal colitis, and proctitis result in episodes of rectal bleeding, diarrhea, pain, and tenesmus. Moderate (left-sided) and severe (extensive) colitis are associated with bloody diarrhea, weight loss, fever, and anemia. [aafp.org]

  Acute colitis related to spiramycin. Lancet 1978; II: 993 CrossRef Google Scholar 50. David XR, Pierrugues R, Michel H. Acute hemorrhagic colitis related to oral administration of cephalosporin. [link.springer.com]

  One case had developed ulcerative and haemorrhagic colitis eighteen months after starting leflunomide treatment and the other case had developed microscopic colitis two years after starting treatment. [archivesofrheumatology.org]

Diarrhea can easily be managed by loperamide, dose reduction or treatment interruptions [41]. [abdominalkey.com]

For this reason, the depot form is not usually used for treatment of CID, although it may be useful in secondary prophylaxis of CID. [healio.com]

One case had developed ulcerative and haemorrhagic colitis eighteen months after starting leflunomide treatment and the other case had developed microscopic colitis two years after starting treatment. [archivesofrheumatology.org]

Treatment may vary depending on this classification and usually includes withdrawal of the offending drug. [ncbi.nlm.nih.gov]

Benson, AB III, Ajani, JA, Catalano, RB, et al.: Recommended guidelines for the treatment of cancer treatment-induced diarrhea. J Clin Oncol 2004, 22: 2918–2926. PubMed CrossRef Google Scholar 35. [link.springer.com]

Etiology Each case of diarrhea has either an infectious or noninfectious etiology. Infectious causes include the transmission of viral, bacterial, or parasitic pathogens (Table 2 1 ). [pharmacytimes.com]

Sensor, a population-based cohort study on gastroenteritis in the Netherlands: Incidence and etiology. Am J Epidemiol 2001;154:666-74. Dial S, Alrasadi K, Manoukian C, et al. [wikidoc.org]

Celiac Disease: Etiology, Diagnosis, and Treatment. New York, NY: Nova Biomedical Books; 2009: 95–146. 25. Volta U, Granito A, Parisi C, et al. Deamidated gliadin peptide antibodies as a routine test for celiac disease: a prospective analysis. [aafp.org]

An often unrecognized etiology? Therapie 1993; 48: 494–5 PubMed Google Scholar 213. Talal AH, Murray JA. Acute and chronic diarrhea. How to keep laboratory testing to a minimum. Postgrad Med 1994; 96: 30–8 PubMed Google Scholar 214. [link.springer.com]

He is a specialist in Internal Medicine with training in Clinical Epidemiology and Gastroenterology who has been the lead investigator in the design and implementation of randomized controlled trials since 1986. [books.google.com]

Epidemiology, risk factors and treatments for antibiotic-associated diarrhea. Dig Dis 1998;16:292-307. McInnes GT, Lawson DH, Jick H. Acute adverse reactions attributed to allopurinol in hospitalized patients. Ann Rheum Dis 1981;40:245-9. [wikidoc.org]

Visceral hypersensitivity is a major culprit in the pathophysiology of the disease. [accesspharmacy.mhmedical.com]

This article aims to review drug-induced diarrhea to (a) understand known pathophysiological mechanisms; (b) assess the risk associated with frequently prescribed medications, and discuss the pathogenesis; and (c) provide easily retrievable data in tables [journals.lww.com]

Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 16. Seller RH, Symons AB. Diarrhea. In: Seller RH, Symons AB, eds. [mclarenhealthplan.org]

Several pathophysiological mechanisms are involved in drug-induced diarrhoea: osmotic diarrhoea, secretory diarrhoea, shortened transit time, exudative diarrhoea and protein-losing enteropathy, and malabsorption or maldigestion of fat and carbohydrates [ncbi.nlm.nih.gov]

"We think it's possible that probiotics act to prevent the symptoms of C. difficile infection rather than to prevent the infection itself," said Johnston. [medicaldaily.com]

Prevention To prevent diarrhea due to antibiotic use, talk to your health care provider about taking supplements containing healthy bacteria (probiotics) and/or eating yogurt. Some of these products may reduce the risk for diarrhea. [mclarenhealthplan.org]

Prevention As mentioned previously, diarrhea is a preventable disease. [pharmacytimes.com]

Diarrhea Tips to prevent diarrhea Diarrhea is most often caused by antibiotics, which affect bacteria normally present in the large intestine. [hopkinsmedicine.org]

"Probiotics for Prevention of Antibiotic-associated Diarrhea". Journal of Clinical Gastroenterology. 42 : S58–S63. doi : 10.1097/MCG.0b013e3181618ab7. PMID 18542041. ^ Surawicz, C. M. (2008). [en.wikipedia.org]