Sandbox

Chronic Diarrhea

Start altered diet: ❑ Stop lactose products ❑ Avoid alcohol and high osmolar supplements ❑ Drink 8-10 large glasses of clear fluids (Fruit juices, soft drinks etc) ❑ Eat frequent small meals (Rice, potato, banana, pastas etc) Start oral rehydration therapy OR intravenous fluids: Based upon the volume status and severity of dehydration

Clostridium Difficile

Fecal glutamate dehydrogenase (GDH) screening tests for C. difficile

Positive

Negative

Enzyme immunoassay (EIA) for toxins A + B

Evalute for other acute diarrhea causes

Negative

Positive

Fecal nucleic acid amplification tests: ❑ Polymerase chain reaction (PCR): Most preferred ❑ Isothermal amplification tests

Negative

Positive

Evalute for other acute diarrhea causes

No strong clinical suspicion of CDI

Strong clinical suspicion of CDI

Rx for CDI