NCBI Bookshelf. Geneva: World Health Organization; Diarrhoea is probably the most common manifestation of HIV in children, especially in infancy. While most children have acute diarrhoea, some will present with persistent or chronic diarrhoea. Persistent diarrhoea is associated with an fold increase of risk of death in HIV-infected infants.
Diabetic ketoacidosis following pentamidine therapy in a patient with the acquired immunodeficiency syndrome. Therefore, the sexual hi are the highest cause of HIV transmission nowadays. Endoscopic biopsies are often positive when tumor is detectable by contrast studies. HIV disease and the gastroenterologist. Prolonged survival necessitates greater emphasis on maintaining adequate nutritional status and diagnosing and treating chronic co-morbid conditions including hepatitis C virus HCV.
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Some Blood in stool with hiv possibilities include:. Immune Deficiency Virus, Disease Syndrome. Walker, H. Views Read Edit View history. Mayo Clinic Proceedings. Although blood in the stool is considered a red-flag digestive symptomit doesn't automatically mean that you have a life-threatening illness. Slow bleeding, cancer, ulcer, peptobismol and iron use can be mimics . Blood in the stool due to an anal fissure is always brighter red or maroon, as it is at the end of the gastrointestinal tract. Supportive treatment may not be sufficient and the appropriate drugs directed at the cause is essential. Peptic ulcer disease alone can be Uniform probate code oklahoma into multiple causes, but is generally initially controlled primarily with a proton pump inhibitorwith the addition of an H 2 blockeror in serious cases, requiring surgical intervention.
HIV compromises the immune system and may result in opportunistic infections that cause many symptoms.
- Blood in the stool hematochezia can be a symptom of bleeding in the gastrointestinal tract.
- Like finding a lump in your breast, seeing blood in your stool can send you into a tailspin of panic.
- Chronic diarrhea may begin in the mildly symptomatic stage of the infection and persist through to the onset of AIDS.
- Blood in stool looks different depending on how early it enters the digestive tract —and thus how much digestive action it has been exposed to—and how much there is.
Some of them are accustomed to say AIDS infection that is wrong. The correct world is HIV Infection. Many people live for many years with HIV without symptoms. It attacks the immune system. The complications caused by AIDS may not result to death. People with HIV can enjoy a long life and control its by taking antiretroviral treatment which is effective and helps boost their immune system.
HIV cannot grow or reproduce on its own. Instead, the virus attached itself to white blood cell T-helper cell and fuses with it. Therefore, bodily fluids that contain white blood cell or blood have high concentration of the virus such as blood, vaginal fluids, leucorrhea, menstrual blood, pus.
On the other hand, bodily fluids that do not contain blood or white blood cell have low concentration of the virus such as urine, stools and sweat. Although HIV virus is a potent virus, it is very fragile. It does not service long outside the human body.
In general, HIV will be inactive from few hours to a day, depended on environment. High temperature, dried environment, acid-base condition or sunshine commonly damages the HIV virus. However, under suitable environment, appropriate humidity or cold temperature approximately 20 Celsius degree , HIV can survive for many days but not over a week.
Only human and monkey can be affected by HIV virus. HIV virus will not survive in animals such as dogs, cats, cows, buffalos or mosquitoes. In animals, HIV will be inactive in a short period. Therefore, if a mosquito bit HIV people, HIV virus will be inactive in a short time and will not transmit to other people. HIV is spread mainly by 3 major routes through: Blood, blood transfusion, sharing needles or syringes, using unsterile medical equipment with blood contaminated or open wound contact with blood or lymph of HIV infected people.
Sexual transmission between male and female or male and male; having vaginal or anal or oral sex especially fellatio on penis of HIV infected people. The transmission during pregnancy or breastfeeding is rare. Although blood transmission has very high risk of HIV transmission, it does not really the most possible cause of HIV transmission.
The transmissions of HIV caused by receiving blood are quite low, comparing with sexual activities. Moreover, all blood products are screened to ensure safety. Therefore, the sexual activities are the highest cause of HIV transmission nowadays. Yes, but it likely rare. The truth is that it is not nearly that easy to get HIV. It is not transmitted by contact with HIV-positivr people. There are many influenced factors include of HIV viral load. HIV viral load can range from high to low respectively i.
Our skin can protect our body from virus. If the skin is broken or torn, it may increases the greater risk of transmitting of HIV. The aphthous, conjunctiva, and virginal mucosa are easy getting wound. It is to be careful to prevent HIV viral load contact to these tissues In the European movies, people usually wear sun glasses and doctors usually wear mask.
Wounds from sexual diseases such as herpes, chancroid, and syphilis are easily affected the HIV virus. It is definitely not transmitted every time you have sex with someone that has HIV or needle puncture. It depends on various combination factors. Child is transmitted HIV from mother only. Sperm cell by themselves do not bear HIV Except semen. Without sexual activities, you can safely live in the same house with positive-HIV person, eating together, touching each other, sleeping on the same bed, using same toilet, and wearing same clothes without getting HIV transmission.
However, high risk does not truly mean be infected. The infection depends on various factors. Condoms are an effective barrier against HIV. So a single exposure with someone who is positive may or may not catch HIV. It is like buying a lottery, you may be lucky or unlucky But the possibility of HIV transmission is higher than winning lottery. There is no cure of HIV if you are infected, so do not neglect the risk. Absolutely, it does not matter.
Saliva carries minuscule traces of the virus, but this is not considered harmful. Thus, kissing will not transmit HIV. A researcher had ever calculated how much HIV virus in saliva that is enough for spreading; it is equaled to 1 liter of saliva. Actually HIV virus cannot survive in bath water.
Soap can inactivate HIV. Stool and urine contain very low concentration of the virus that is not enough for transmission. Toilet cleaner can also kill HIV. Seminal fluid or vaginal discharge dries out quickly when it is outside the body. Although your skin has touched with the fluid or discharge, it cannot transmit into your body. In fact, saliva carries very rare of the virus and it is not considered to be an HIV transmission risk. The virus is sensitive to heat. Normal temperatures used for cooking will kill the virus.
Although the HIV virus is swallowed, the stomach can be able to kill virus. If you are seriously worry, use serving spoon during meal.
Even if the food contained small amounts of HIV-infected blood, heat from cooking that is higher than 50 degree Celsius and longer than 15 minutes would destroy the virus.
However, you may get risk from eating the food contained small amounts of HIV-infected blood without re-cooking, but it is not much. If there are no mouth ulcers, bleeding gums, decayed tooth, you do not worry. Blood, lymph, semen, vaginal discharge, and urine will be diluted by swimming pool water so its concentration is very low and not enough for transmission. Although mosquitoes are carriers of various viruses such as Aedes are carriers of dengue, Anopheles are carriers of malaria, but they are not carriers of HIV.
HIV is not able to survive for a long period of time inside mosquitoes. When a mosquito bites HIV-positive people, it draws their blood into its gut. Although a mosquito just bites an HIV-positive person, its proboscis will not remain blood or remain only tiny droplets of blood.
The physical aspect of its proboscis is different from a needle that may remain some sightless blood. Even if a mosquito bites various people, it is never carried HIV to other humans. If a HIV-positive madman pierces himself with a needle contaminated with fresh blood, it has a chance of HIV transmission. If the needle had contaminated with blood for a period of time, HIV virus is mostly died and risk of HIV transmission is reduced.
Regardless of dirty or clean clothing, HIV cannot transmit from sharing them. Sweat including saliva is usually not much enough to cause HIV transmission even you have open wounds. HIV virus are commonly killed by detergent and washing.
How do you catch HIV? All bodily fluids contain dissimilar concentration of the virus: High concentration of the virus: blood, vaginal fluids, leucorrhea, menstrual blood, breast milk Low concentration of the virus: tear, saliva, snot, sputum Almost completely virus free: stools, urine, sweat Why does each bodily fluid contain dissimilar concentration of the virus?
Can HIV virus survive in animals? Which one takes a highest risk? Exactly, it is blood transfusion. However, all packs of blood are recently being certified and safe so it is no worry about HIV virus. The sexual activities have lower risk of HIV transmission than blood transfusion. However, it varies on various factors such as anal sex has higher risk than vaginal sex and oral sex, respectively.
A receptive partner is more risky for getting HIV than an insertive partner. The risk will likely decrease if no breastfeeding. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. N Entl J Med. Short-course zidovudine for perinatal HIV-1 transmission in Bangkok, Thailand: a randomized controlled trial.
Are there any possibilities of HIV transmission other than 3 major routes? If the father is infected with HIV but not mother, is the child infected? Recently, women with HIV should not breastfeed their babies but powered milk. Kissing, do you think it matter? If a madman uses a needle piercing other people, is it risk for HIV transmission?
Blood in stool with hiv. What is HIV Diarrhea?
If the origination point of the blood is higher up in the digestive tract, it is typically darker in color. Lower origination point yields a brighter, lighter, and richer color. The bloody stool may be discovered in a fecal test ordered by a physician, when wiping, or may be seen on the outside of the stool. The majority of individuals who experience this symptom will only observe mild rectal bleeding. Moderate and severe rectal bleeding may be accompanied by clots of blood and serious complications for the affected individual, including hypotension, anemia, weakness, dizziness, and syncope.
Blood in the stool can be caused by a common minor issue or could be a sign of a serious disease. Get to know the causes now. An individual with bloody stool may be affected by anal fissures. The anus is lined with mucosa or thin, moist tissue that can become injured. An anal fissure is a term used to describe a tear in this anal mucosa. It can occur due to trauma from childbirth, chronic diarrhea, passing hard stools, anal intercourse, and straining during bowel movements. Anal fissures typically present with sensations of pain, anal sphincter spasms, and rectal bleeding during bowel movements.
Blood in the stool due to an anal fissure is always brighter red or maroon, as it is at the end of the gastrointestinal tract. Fresh blood that does not sit in the intestines or stomach does not have the opportunity to form grains, clots, or turn to a darker tone. Uncover more causes behind blood in stool now. A colon polyp is a clump of cells that develops in the interior lining of the colon.
Hyperplastic polyps, hamartomatous polyps, and inflammatory polyps are non-neoplastic and usually do not form malignancy. Serrated polyp types and adenomas are neoplastic polyps that have a greater risk of carcinogenesis. Polyps occur when the cells in the lining of the colon or rectum experience a DNA mutation that causes them to grow and divide inappropriately. Polyps usually do not produce symptoms until they become large and or problematic enough to cause an obstruction, inflammation, or malignancy.
Due to repeated friction and irritation from passing stools, polyps may ulcerate and bleed, causing blood in the stool. While bleeding due to polyps can be associated with polyp malignancy, it does not always indicate cancer. Polyps only occur in the large intestine and rectum where the color of blood in the stool provides insight into the relative location of such polyps. Regular preventative colonoscopies can help an individual eradicate any problematic polyps before they result in serious complications like malignancy or those associated with excessive bleeding.
Read about another cause of blood in stool now. Repetitive attempts to have a bowel movement can lead to tearing around the exit of the rectum anal fissure.
This list of diagnoses include diseases in which the wall of the bowel is compromised by disease. Diseases causing inflammation in the GI tract can lead to blood in the stool. The tests that are considered to evaluate of the passage of blood in the stool are based on the characteristics of bleeding color, quantity and whether or not the person passing blood has a low blood pressure with elevated heart rate, as opposed to normal vital signs.
Melena is defined as dark, tarry stools, often black in color due to partial digestion of the RBCs. Hematochezia is defined as bright red blood seen in the toilet either inside of, or surrounding the stool.
Hematochezia is typically presumed to come from the lower portion of the GI tract, and the initial steps of diagnosis include a DRE with FOBT, which if positive, will lead to a colonoscopy. Mucus may also be found in stool. A texture described as tarry stool is generally associated with dark black stool seen in partially digested blood. A person's age is an important consideration when assessing the cause of the bleeding.
Treatment of bloody stool depends largely on the cause of the bleeding. Bleeding is commonly associated with symptoms of fatigue , dizziness , headaches , or even shortness of breath , and these associated symptoms also require treatment.
Anemia is a common complication of blood in the stool, especially when there is a large amount of blood or bleeding occurs over a long period of time. Diagnostic measures can be used as interventions to help stop bleeding in some cases. Bleeding that occurs due to a neoplasm cancer growth can be treated using colonoscopy and clipping, surgical intervention, or other measures, depending on the form and stage of cancer.
The treatment for motility issues, namely constipation, is typically to improve the movement of waste though the GI tract. This is done by using stool softeners which work by pulling water into the stool while in the colon , addition of fiber to the diet, and use of osmotic laxatives which help fluid movement through the colon, improving overall motility.
Improving a persons gut motility can reduce the straining during defection and decrease the risk of developing of anal fissures. Treatment options for hemorrhoids can be dependent on whether an underlying cause exists.
An anorectal varices related hemorrhoids caused by cirrhosis , however symptomatic treatment often involves removal. Colitis can be divided into infectious and drug induced, as can the treatment for these conditions. With infectious colitis, treatment is pathogen dependent, and generally requires the use of antibiotics. With drug-induced colitis, treatment typically involves removal of the offending agent, as is the case in NSAID induced PUD,  however, removing radiation from a cancer patient is not always practical within a treatment regimen, so medical treatment is the primary mode of treatment.
Structural compromise leading to blood in stool is caused by a variety of conditions, and therefore requires different treatment for each condition. Peptic ulcer disease alone can be divided into multiple causes, but is generally initially controlled primarily with a proton pump inhibitor , with the addition of an H 2 blocker , or in serious cases, requiring surgical intervention.
Inflammatory bowel disease is also divided into separate conditions, namely ulcerative colitis and Crohn's disease, which have different medical treatment regimens, and may require surgical intervention in more serious conditions. From Wikipedia, the free encyclopedia. This article needs more medical references for verification or relies too heavily on primary sources.
Please review the contents of the article and add the appropriate references if you can. Unsourced or poorly sourced material may be challenged and removed. April In Walker, H. Kenneth; Hall, W. Dallas; Hurst, J. Willis eds. Boston: Butterworths.
Mayo Clinic Proceedings. Retrieved Mar 29, PubMed Health. Dodd Walker, H. Watch out for Small Changes". Alexandria, Virginia: Fight Colorectal Cancer.
AIDS Signs and Symptoms | Conditions & Treatments | UCSF Medical Center
Gastrointestinal and hepatobiliary disorders are among the most frequent complaints in patients with HIV disease. Advances in antiretroviral therapy are changing the nature of HIV disease and affecting many of the gastrointestinal manifestations. Given fewer late-stage immunocompromised patients, clinicians must recognize the shifts in the spectrum of pathogens, recognize the need to maintain good nutrition, and facilitate outpatient management directed at identifying treatable causes and ameliorating symptoms.
Gastrointestinal GI manifestations of HIV disease include diarrhea, dysphagia and odynophagia, nausea, vomiting, weight loss, abdominal pain, anorectal disease, jaundice and hepatomegaly, GI bleeding, interactions of HIV and hepatotropic viruses, and GI tumors Kaposi's sarcoma and non-Hodgkin's lymphoma. The evaluation of specific gastrointestinal complaints must be based on an assessment of the degree of immunosuppression.
Progressive immunocompromise is associated with increasing prevalence of GI symptoms 3 and remains the common endpoint for most individuals infected with HIV.
The following general points should be considered when evaluating GI symptoms in HIV-infected patients:. Clinical signs and symptoms alone rarely suggest a specific etiology. Consequently, clinicians should investigate all significant GI complaints, using sufficiently objective studies to identify specific treatable infections or neoplasms associated with advanced HIV disease. A notable exception is esophageal disease, in which empiric therapy for Candida may precede invasive work-up.
Multiple GI infections are common, making it important to distinguish between true pathogens and secondary colonization, and to evaluate patients further when initial therapies fail. Evidence of tissue invasion by an infectious agent is the hallmark of true pathogenicity. Prolonged survival necessitates greater emphasis on maintaining adequate nutritional status and diagnosing and treating chronic co-morbid conditions including hepatitis C virus HCV. Among the more difficult management issues in the HIV-infected patient is deciding how extensively to investigate GI symptoms.
The clinician must always weigh the discomfort and invasiveness of a procedure against the severity of the patient's complaints and the likelihood of identifying a treatable condition. Thus, for example, patients who are incapacitated by abdominal pain or diarrhea should be evaluated more extensively with endoscopic or imaging studies than patients whose symptoms do not interfere with daily activities.
In outpatient studies, the prevalence of diarrhea ranged from 0. Prospective series have implicated a wide variety of protozoal, viral, and bacterial organisms as diarrheal pathogens Table 1. Others, like Cryptosporidium , cause self-limited diarrheal illness in healthy hosts but chronic diarrhea in immunosuppressed patients.
In earlier studies, pathogens were identified in over half of patients with advanced HIV disease and diarrhea. Two studies have reported a dramatic decrease in cryptosporidial diarrhea over the past 5 years. In patients with "early" HIV disease, medications are a common cause of diarrhea, especially protease inhibitors, including Nelfinavir and Saquinavir.
The diarrhea is often self-limited, lasting less than 2 to 4 weeks from initiation of medication use. Other etiologies of diarrhea include idiopathic colitis, enteropathogenic Escherichia coli , and small bowel bacterial overgrowth.
Small bowel bacterial overgrowth results in a clinical syndrome consisting of diarrhea and malabsorption of fat, vitamin B12, and carbohydrates. The morphologic changes reported in patients with small bowel overgrowth include villous atrophy and inflammatory infiltrates similar to the findings in "HIV enteropathy". Intestinal disturbances common in patients with HIV, including gastric hypoacidity, impaired intestinal immunity, or impaired intestinal motility are known to predispose to bacterial overgrowth.
Reported evidence suggests that HIV itself may be an indirect diarrheal pathogen because viral proteins have been found in the gut. Intestinal HIV infection may also affect local humoral immunity 22 and cause motility disturbances via effects on autonomic nerves. An "idiopathic AIDS enteropathy" has been proposed to account for the diarrhea in HIV-infected patients who lack an identifiable pathogen. This syndrome may result from indirect effects of HIV on enteric homeostasis. Although the precise features of the syndrome are not agreed on, 25 the term implies a chronic diarrheal illness with no identified etiology in patients with advanced HIV disease.
Unfortunately, the clinical history alone is not likely to establish a specific diagnosis when due to infection. A careful history can aid in localizing the segment of luminal GI tract most severely involved. For example, symptoms of cramps, bloating, and nausea suggest gastric or small-bowel involvement, or both, raising the possibility of infection with Cryptosporidium , Microsporidium , Isospora belli , or Giardia organisms.
Hematochezia and tenesmus imply large-bowel inflammation resulting from CMV, Shigella , Campylobacter , or Clostridium difficile infections. Tenesmus can occur as a result of herpes, Shigella , or Campylobacter infections. The character, frequency, color, and odor of the stool are relatively nonspecific in HIV-related GI syndromes and are therefore of little value in identifying specific infections.
A history that includes multiple sexual contacts or receptive anal sex increases the possibility of sexually transmitted diarrheal pathogens. Lymphadenopathy, hepatosplenomegaly, and abdominal tenderness have little diagnostic value.
The most important goal in evaluating diarrhea in patients with HIV disease is to identify treatable infections or neoplasms with the minimum work-up necessary.
Once dietary causes and medications are excluded, the initial evaluation should include stool culture for enteric bacteria, a specimen for Clostridium difficile toxin in the setting of antibiotic use , and at least three stool specimens for ova and parasite examination including acid-fast bacilli and trichrome stain.
The importance of obtaining multiple specimens was re-affirmed in a recent study of 30 patients with a confirmed diagnosis of cryptosporidiosis. If a diagnosis is not reached following careful stool analysis, sigmoidoscopy is appropriate to identify CMV infection. Biopsies should be obtained from abnormal regions or randomly from rectal mucosa if no abnormalities are apparent.
Although colonoscopy has been advocated instead of sigmoidoscopy for diagnosis of isolated right colonic CMV, 33 this approach is not likely to be as cost-effective as reserving the colonoscopy for patients in whom sigmoidoscopy is nondiagnostic.
If sigmoidoscopic evaluation is negative, upper endoscopy or colonoscopy with intubation and biopsy of the terminal ileum may occasionally uncover small-bowel infection by Cryptosporidium , Microsporidium , or M. Duodenal fluid can also be aspirated during endoscopy and examined for protozoal infection or small-bowel overgrowth. Compared with endoscopic procedures, the diagnostic value of radiographic contrast studies in evaluating diarrhea is very low and therefore these studies are not indicated.
When evaluation of diarrhea reveals an enteric pathogen, specific therapy should be administered if available Table 2. Chronic administration of alternating antibiotics may be necessary for recurrent Salmonella , Shigella , Campylobacter , or Isospora infections.
Sulfonamides, ciprofloxacin, tetracyclines, or metronidazole may be appropriate in this setting. HIV-infected patients with chronic diarrhea should be treated symptomatically. Antidiarrheals, including Imodium, Lomotil, or tincture of opium drops, are often required and should be titrated individually. Lactose-containing foods should be avoided as a diagnostic and therapeutic trial.
Bulk-forming agents, including effersyllium, bran, and pectin may be helpful. Nutritional repletion will increase the patient's sense of well-being, although a survival benefit has not been demonstrated. In cases of severe diarrhea, short- or long-term intravenous fluid repletion may be indicated. Numerous agents have been tested in patients with HIV-associated diarrhea, and controlled studies have failed to define a definitive treatment for cryptosporidiosis, microsporidiosis or pathogen-negative diarrhea.
Promising new data indicate that microsporidiosis and cryptosporidiosis infection may be cleared in patients receiving highly effective antiretroviral therapy. One recent study of the effects of an extract from a tropical plant showed promising declines in stool weight over 4 days of treatment in patients with AIDS and virtually no pathogens.
The somatostatin analogue octreotide administered subcutaneously appears to be particularly effective in patients with diarrhea who lack a specific infection. Involuntary weight loss is a common condition associated with advancing HIV disease and gastrointestinal symptoms. Involuntary weight loss can be classified into two different etiologies, caloric deficit and metabolic disturbance Table 3. Inadequate caloric intake and weight loss may be due to upper intestinal abnormalities anorexia, nausea, vomiting , psychosocial and economic factors, fatigue, mental status changes, and medications.
Patients frequently reduce their oral intake to decrease symptoms of diarrhea or abdominal pain. Caloric deficit results in a selective utilization of body fat stores for energy, an adaptive process to preserve lean body mass starvation model.
In contrast, metabolic derangements leading to increased energy expenditure or abnormal energy substrate utilization due to opportunistic infection or other disease state result in a disproportionate loss of lean body mass with relative preservation of body fat stores.
Pharmacologic side effects, opportunistic infections that result in lesions in the mouth or esophagus, and malabsorption of nutrients can be the underlying causes of reported symptoms. Abnormal resting energy expenditure REE has also been associated with abnormal weight loss. While REE increases throughout the course of disease, Macallan et al.
These investigators completed 51 assessments of energy metabolism on 27 men with HIV infection at different stages of their disease: rapid weight loss, slow weight loss, stable weight, or weight gain. In addition to finding an increased REE in all groups, the determinant of weight loss patterns was clearly caloric deficit and TEE. The rapid weight loss group had an average deficit of kcals, whereas the weight gain group was kcals above energy expenditure.
Macallan and associates have also recognized weight loss to be either rapid or slow in patients with stage IV HIV disease. In a study of 30 men, serial weight measurements were followed closely. An association was found between acute weight loss episodes and opportunistic infections, with weight loss preceding the infection; caloric deficit and increased REE was also noted. Weight regain without nutrition support is not uncommon in patients with acute weight loss, especially after the resolution of an infection.
Patients with chronic weight loss can regain weight, however, but most likely will require liquid nutrition supplements long-term. All patients infected with HIV should have a regular nutritional and functional assessment.
All patients who have lost weight should have a thorough evaluation for symptoms contributing to inadequate intake and interventions to promote weight gain should be initiated promptly. The clinical assessment should identify markers and predictors of malnutrition. In addition, conditions that increase energy requirements should also be noted, including: fever, tachypnea, systemic infections, increased physical activity.
A detailed review of medications and "alternative therapies" including herbal therapy and megadosing of vitamins and minerals may provide insight into potential side-effects.
A social history is also important to identify environmental or financial obstacles to obtaining, storing, and preparing food. The goal of nutrition therapy is to preserve lean body mass. Based on the evaluation of the patient, estimated caloric intake should be determined and 3-day food records should be administered to review patients actual intake. While guidelines for carbohydrate and fat have not been established, protein requirements should be at least 1. Appetite stimulants are often effective in treating anorexia, a major cause of involuntary weight loss.
Dronabinol Marinol , a synthetic derivative of marijuana, and Megastrol acetate Megace , a synthetic progestational drug, have been associated with increased appetite and weight. Diarrhea associated with malabsorption requires careful nutrition management. A balance must be found between controlling symptoms with a low-fat diet and maintaining caloric intake with fat-containing foods that offer caloric density.
Patients with diarrhea unable to meet caloric requirements may benefit from a liquid nutrition supplement containing medium-chain triglycerides. Dietary or supplemental soluble fiber may help bind water and improve diarrhea. If nonvolitional weight loss cannot be reduced or reversed by oral intake and oral liquid nutritional supplements, enteral alimentation should be initiated.
Unless otherwise indicated, the gastrointestinal tract should be used for nutrient absorption. Kotler et al. Parenteral nutrition should be reserved for severe intestinal dysfunction, such as large volume secretory diarrhea. A clinical trial that randomized participants to total parenteral nutrition TPN or nutrition counseling resulted in increased weight and body cell mass in patients who received TPN, however, rehospitalization and survival were the same in both groups.