Diagnosis and treatment of acute or persistent diarrhea

Gastroenterology. 2009 May;136(6):1874-86. doi: 10.1053/j.gastro.2009.02.072. Epub 2009 May 7.


Studies of microbial pathogens and the toxins they produce are important for determining the mechanisms by which they cause disease and spread throughout a population. Some bacteria produce secretory enterotoxins (such as cholera toxin or the heat-labile or stable enterotoxins produced by Escherichia coli) that invade cells directly. Others invade cells or produce cytotoxins (such as those produced by Shigella, enteroinvasive E coli, or Clostridium difficile) that damage cells or trigger host responses that cause small or large bowel diseases (such as enteroaggregative or enteropathogenic E coli or Salmonella). Viruses (such as noroviruses and rotaviruses) and protozoa (such as Cryptosporidium, Giardia, or Entamoeba histolytica) disrupt cell functions and cause short- or long-term disease. Much epidemiologic data about these pathogens have been collected from community- and hospital-acquired settings, as well as from patients with traveler's or persistent diarrhea. These studies have led to practical approaches for prevention, diagnosis, and treatment.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Anti-Bacterial Agents / therapeutic use*
  • Antibodies, Bacterial / analysis
  • Bacteria* / genetics
  • Bacteria* / immunology
  • Bacteria* / isolation & purification
  • DNA, Bacterial / analysis
  • Diagnosis, Differential
  • Diarrhea* / diagnosis
  • Diarrhea* / drug therapy
  • Diarrhea* / microbiology
  • Enzyme-Linked Immunosorbent Assay
  • Humans
  • Polymerase Chain Reaction


  • Anti-Bacterial Agents
  • Antibodies, Bacterial
  • DNA, Bacterial