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16 - Diarrhea in HIV-Infected Patients

from Part I - Systems

Published online by Cambridge University Press:  15 December 2009

By
George Beatty
Edited by
Rachel L. Chin
George Beatty
Affiliation:
Associate Clinical Professor of Medicine, University of California, San Francisco School of Medicine, Positive Health Program at San Francisco General Hospital, San Francisco, CA
Rachel L. Chin
Affiliation:
University of California, San Francisco
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Summary

INTRODUCTION

A useful initial approach to evaluating diarrhea in an individual infected with human immunodeficiency virus (HIV) is to distinguish acute from chronic diarrhea, and small from large bowel involvement. In addition, particular consideration should be given to the stage of HIV disease, current medications, and sexual history, as these factors help determine likely pathogens. Finally, evaluating the degree of systemic illness is essential to assessing the need for hospital admission.

Initial Approach

Acute diarrhea is defined as the presence of three or more loose or watery stools per day for less than 2 weeks. Diarrhea is defined as persistent if it has been present between 2 and 4 weeks and is considered chronic when present for 4 weeks or more. Pathogens infecting the small bowel affect the secretory and nutritional absorption functions of the gastrointestinal (GI) tract and typically present with large volumes of watery stool, often accompanied by cramps, bloating, and abdominal gas (Table 16.1). Severe or prolonged diarrhea may result in dehydration, malnutrition, and weight loss. Large bowel involvement primarily affects water resorptive capacity and typically causes frequent, small-volume diarrhea that may be bloody or mucoid and is often accompanied by pain.

EPIDEMIOLOGY

Overall, up to 40% of patients with HIV infection report at least one episode of diarrhea in any given month, and approximately one quarter of patients experience chronic diarrhea at some point.

Type
Chapter
Information
Emergency Management of Infectious Diseases , pp. 83 - 88
Publisher: Cambridge University Press
Print publication year: 2008

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  • Diarrhea in HIV-Infected Patients
    • By George Beatty, Associate Clinical Professor of Medicine, University of California, San Francisco School of Medicine, Positive Health Program at San Francisco General Hospital, San Francisco, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.017
Available formats
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Save book to Dropbox

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  • Diarrhea in HIV-Infected Patients
    • By George Beatty, Associate Clinical Professor of Medicine, University of California, San Francisco School of Medicine, Positive Health Program at San Francisco General Hospital, San Francisco, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.017
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Diarrhea in HIV-Infected Patients
    • By George Beatty, Associate Clinical Professor of Medicine, University of California, San Francisco School of Medicine, Positive Health Program at San Francisco General Hospital, San Francisco, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.017
Available formats
×