General Principles of Management - Enteric Infections and Food Poisoning

GENERAL PRINCIPLES OF MANAGEMENT

In most gastrointestinal infections, the primary goal of treatment is relief of symptoms, with particular attention to maintaining fluid and electrolyte balance. The effects of common antidiarrheal medications such as subsalicylate-containing compounds (Pepto-Bismol) or antispasmodics (loperamide) are variable, depending on the etiology. In general, they may be helpful for the watery diarrhea caused by enterotoxins, but not for dysentery caused by mucosal invasion, and antispasmodics may be harmful in the latter instance. Antimicrobial agents are usually not indicated for self-limited watery diarrhea but are required for more severe dysenteric infections. Some enteric infections, such as typhoid fever, are always treated with antimicrobics. Prophylactic regimens for traveler’s diarrhea have been effective if it is recognized they do not cover all potential causes.