Three or more loose or liquid stools per 24 hours, and/or
Stools that are more frequent than what is normal for the individual lasting <14 days, and/or
Stool weight greater than 200 g/day.
Acute (≤14 days)
Persistent (>14 days), or
Chronic (>4 weeks).
In 2016, diarrhea was the eighth leading cause of death among all ages and the fifth leading cause of death among children younger than 5 years.
Worldwide, it has been estimated that there are 2 billion episodes of diarrheal illness per year. Death due to diarrhea disproportionately affects postneonatal children <5 years. However, with implementation of improved access to oral rehydration therapy (ORT), vitamin supplementation, rotavirus vaccines, and education on feeding and weaning, it is estimated that mortality has dropped from 3.9 million deaths in 1967 to 526,000 in 2015. Additionally, new antisecretory agents have shown promise in conjunction with ORT to reduce diarrhea volume burden. Despite the improvement, diarrhea remains the third leading cause of death in postneonatal children <5 years, after pneumonia and preterm birth/neonatal disorders.
Normally, approximately 10 liters of fluid consisting of ingested food and drink, in addition to secretions from the salivary glands, stomach, pancreas, bile ducts, and duodenum, enters the gastrointestinal tract every day. The small intestine is the major site for reabsorption. Overall, about 99% of the fluid is reabsorbed, leaving 0.1 liter to be excreted in the feces. Diarrhea occurs when various factors interfere with this normal process, resulting in decreased absorption or increased secretion of fluid and electrolytes, or increase in bowel motility.
Improved understanding of the pathophysiology of infectious diarrhea, and the factors that promote the spread of causative infectious agents, will lead to practical approaches for preventing and responding to outbreaks.
- Enteric adenovirus
- Campylobacter enteritis (Campylobacter jejuni and Campylobacter coli)
- Escherichia coli (enterotoxigenic, enteropathogenic, enteroinvasive, enterohemorrhagic, enteroaggregative)
- Clostridium difficile
- Vibrio cholerae
- Staphylococcus aureus
- Bacillus cereus
- Clostridium perfringens
- Entamoeba histolytica
- Ulcerative colitis
- Crohn disease
- Irritable bowel syndrome
- Cystoisospora belli
- Klebsiella oxytoca
- Bowel ischemia
- Radiation injury
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