Summary
Definition
History and exam
Key diagnostic factors
- diarrhoea
- frequent belching
Other diagnostic factors
- abdominal bloating and discomfort
- malaise
- weight loss
- nausea and vomiting
Risk factors
- contaminated water/food
- domestic animals living in or around the house
- hypogammaglobulinaemia
- young age
- male sex
- day-care centre attendance
- oral-anal sexual contact
- recent antibiotic use
Diagnostic investigations
1st investigations to order
- direct fluorescence antibody (DFA) test or enzyme-linked immunosorbent assay
- nucleic acid amplification test, polymerase chain reaction of stool sample
- stool microscopy
- FBC
Investigations to consider
- Lateral flow immunoassay (e.g., ImmunoCard STAT!)
- duodenal aspirates and biopsies
- string test (EnteroTest)
Treatment algorithm
non-pregnant adult or child
pregnant; first trimester
pregnant; second or third trimester
treatment failure or resistance
Contributors
Authors
Luther A. Bartelt, MD
Assistant Professor of Medicine
University of North Carolina School of Medicine
Division of Infectious Diseases
Chapel Hill
NC
Disclosures
LAB is an editorial board member for PLOS Neglected Tropical Diseases and an author for Elsevier and UpToDate. LAB has received funding from the National Institutes of Health. LAB is the author of two articles cited in this topic.
Acknowledgements
Dr Luther Bartelt would like to gratefully acknowledge Dr Fida Khan and Dr Musaddiq Waheed, previous contributors to this topic.
Disclosures
FK and MW declared that they had no competing interests.
Peer reviewers
Zana Nikolla, MD
Faculty of Medicine
University of Tirana
Tirana
Albania
Disclosures
ZN declares that she has no competing interests.
Rodney Adam, MD
Professor of Medicine and Immunobiology
University of Arizona
Tucson
AZ
Disclosures
RA declares that he has no competing interests.
Differentials
- Rotavirus or other viral gastroenteritis
- Functional diarrhoea
- Coeliac disease
More DifferentialsGuidelines
- CDC Yellow Book: health information for international travel - giardiasis
- Infectious diarrhea: guideline for investigation
More GuidelinesPatient information
Diarrhoea in adults
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