Overview

• Diarrhoea ⇒ ≥3 loose or watery stools per day or more frequent passage than is normal for the individual
  • Viral Causes (most commonn) → norovirus, rotavirus, adenovirus
  • Bacterial Causes → campylobacter jejuni (after exposure to poultry), shigella, salmonella, e.coli (travellers diarrhoea), c.diff (antibiotic and PPI associated diarrhoea)
  • Parasitic → giardiasis, enterobiasis, amebiasis
• Risk Factors → recent travel (traveller’s diarrhoea), exposure to outbreak, recent hospitilisation (c.diff), medication use
• Acute Diarrhoea <14 days, Chronic Diarrhoea >14 days

Making Diagnosis

Clinical Features:

• Watery/Fatty/Bloody Stool → Sudden Onset
• Fever
• Abdominal Pain & Cramping
• N&V
• Presentation of Infections (PassMed)
• Presentation of Infections (MedEd)
• Campylobacter Jejuni ⇒ most common cause of food poisoning commonly due to raw or undercooked meat, gram negative rods, bloody diarrhoea.
• Salmonella ⇒ eggs, poultry or contaminated food.
• Bacillus Cereus ⇒ symptoms start 30 mins to 6 hrs after exposure, rice and pasta.
• S.Aureus (short incubation period + severe vomiting) ⇒ starts 1-6hrs after exposure, profuse vomiting (only mild diarrhoea).
• Norovirus ⇒ projectile vomiting, highly infective, incubation period 12-24hrs.