Protocolo diagnóstico de la diarrea en el anciano y en el paciente ingresado

  1. I. Tinoco Racero 1
  2. E. Ruiz Blasco 1
  3. A. de los Santos Moreno 1
  4. J.A. Girón González 2
  1. 1 Hospital Universitario Puerta del Mar. Cádiz. España.
  2. 2 Universidad de Cádiz. Cádiz. España.
Revue:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Année de publication: 2016

Titre de la publication: Enfermedades del aparato digestivo (VII) Enfermedades del tubo digestivo. Intestino delgado y grueso

Serie: 12

Número: 7

Pages: 398-405

Type: Article

DOI: 10.1016/J.MED.2016.03.016 DIALNET GOOGLE SCHOLAR

D'autres publications dans: Medicine: Programa de Formación Médica Continuada Acreditado

Résumé

Diarrhea in elderly patients Diarrhoeal syndrome in elderly patients is a significant cause of morbidity and mortality and is influenced by numerous factors commonly present in this age group. Depending on its chronology, we differentiate between acute and chronic diarrhoea, which require different diagnostic approaches. In both cases, the medical history and physical examination are considered essential. Additional tests will be determined by the suspected diagnosis, symptom severity, functional condition and concomitant disease. Nosocomial diarrhoea Nosocomial diarrhoea is defined as 3 or more stools of reduced consistency, starting on the third day of hospitalization. The incidence of this condition is high and increases morbidity, mortality, length of stay and costs. Its pathogenesis varies, especially with infections associated with the use of antibiotics, in which those caused by Clostridium difficile predominate. An appropriate systematic assessment is essential to diagnosing this condition, as is the measurement of Clostridium toxin, reserving other tests according to the patient's symptoms and characteristics.

Références bibliographiques

  • Mounts AW, Holman RC, Clarke MJ, Bresee JS, Glass RI. Trends in hospitalizations associated with gastroenteritis among adults in the United States, 1979–1995. Epidemiol Infect. 1999;123:1-8.
  • Trinh C, Prabhakar K. Diarrheal diseases in the elderly. Clin Geriatr Med. 2007;23:833-56.
  • Fernández-Bañares F, Esteve M. Diarrea crónica. En: Montoro MA, García JC, editores. Problemas comunes en la práctica clínica-gastroenterología y hepatología. 2ª ed. Madrid: Jarpyo ed; 2012. p. 125-46.
  • Holt PR. Diarrhoea and malabsorption in the elderly. Gas-troenterol Clin North Am. 2001;30:427-44.
  • Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology. 2006;130:1480-91.
  • Philips S, Donaldson L, Geisler K, Pera A, Kochar R. Stool composition in factitial diarrhea: A 6-year experience with stool analysis. Ann Intern Med. 1995;123:97-100.
  • Polage CR, Solnick JV, Cohen SH. nosocomial diarrhea: evaluation and treatment of causes other than Clostridium difficile. Clin Infect Dis. 2012;982-9.
  • Gorkiewicz G. Nosocomial and antibiotic-associated diarrhoea caused by organisms other than Clostridium difficile. Int J Antimi-crob Agent.2009;33:S37-41.
  • Rodríguez Ramos C, Rivas Rivas M, Abraldes Bechiarelli A, Girón Gonzalez JA. Protocolo diagnóstico y terapéutico de la diarrea aguda en el entorno hospitalario. Medicine. 2014;11:3304-8.
  • Ghose C. Clostridium difficile infection in the twenty-first century. Emerg Microbes Infect. 2013;2(9):e62.
  • Pawloski SW, Warren CA, and Guerrant R. Diagnosis and Treatment of Acute or Persistent Diarrhea. Gastroenterology. 2009;136:1874-86.