HealthDay News — Persistent diarrhea is typically caused by parasites or bacteria and requires accurate diagnosis in order to determine appropriate treatment, according to a review published online in the Journal of the American Medical Association.

Herbert L. DuPont, MD, from the University of Texas School of Public Health and Medical School in Houston, reviewed the epidemiology, etiology, diagnosis, and management of persistent diarrhea caused by infectious agents among immunocompetent individuals.

Dr DuPont notes that much of the data on persistent diarrhea comes from studies of residents in or expatriates of developing countries or travelers to these regions. Approximately 3% of individuals traveling to developing countries develop persistent diarrhea. Intestinal infection with Schistosoma mansoni, and rarely Schistosoma haematobium, is also not very common and only occurs in endemic areas. Detectable parasitic and bacterial pathogens are among the microbiologic causes of protracted diarrhea. Available diagnostic tests for bacterial, viral, and protozoal infections include multiplex polymerase chain reaction. Patients returning from the undeveloped to the developed world can be given empirical antimicrobial therapy; in other cases, antibiotics should be given on the basis of laboratory test results.

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“Diagnosis is critical when treating persistent diarrhea,” Dr DuPont said in a news release. While antimicrobial therapy is appropriate for many patients with persistent diarrhea, a lab-established diagnosis is necessary for treatment, according to Dr DuPont.

The author disclosed financial ties to the pharmaceutical industry, including Romark Laboratories, which funded the study.


1. Dupont HL. Persistent Diarrhea: A Clinical Review. JAMA. 2016; doi:10.1001/jama.2016.7833.