Fast Five Quiz: Hygiene-Related Diseases

Richard H. Sinert, DO


May 04, 2021

The best way to prevent food poisoning caused by infectious agents is to practice strict personal hygiene, cook all foods adequately, avoid cross-contamination of raw and cooked foods, and keep all foods at appropriate temperatures.

Because most cases of acute gastroenteritis are self-limited, specific treatment is not necessary. Strict personal hygiene should be practiced during the illness. The main objective is adequate rehydration and electrolyte supplementation. This can be achieved with either an oral rehydration solution or intravenous solutions (eg, isotonic sodium chloride solution, lactated Ringer solution).

Absorbents (eg, bismuth subsalicylate [Kaopectate], aluminum hydroxide) help patients have more control over the timing of defecation. However, they do not alter the course of the disease or reduce fluid loss. Note the following:

  • An interval of at least 1-2 hours should elapse between administration of absorbents and other medications.

  • Antisecretory agents, such as bismuth subsalicylate (Pepto-Bismol), may be useful. The dose is 30 mL every 30 minutes, not to exceed 8-10 doses.

  • Antiperistaltics (opiate derivatives) should not be used in patients with fever, systemic toxicity, or bloody diarrhea or in patients whose condition either shows no improvement or deteriorates.

  • Diphenoxylate with atropine (Lomotil) is available in tablets (2.5 mg of diphenoxylate) and liquid (2.5 mg of diphenoxylate/5 mL). The initial dose for adults is two tablets four times a day (ie, 20 mg/d). The dose is tapered as diarrhea improves.

  • Loperamide (Imodium) is available over the counter as 2-mg capsules and as a liquid (1 mg/5 mL). It increases the intestinal absorption of electrolytes and water and decreases intestinal motility and secretion. The dose in adults is 4 mg initially, followed by 2 mg after each diarrhea stool, not to exceed 16 mg in a 24-hour period.

If symptoms persist beyond 3-4 days, the specific etiology should be determined by performing stool cultures. If symptoms persist and the pathogen is isolated, specific treatment should be initiated.

During episodes of acute diarrhea, patients often develop an acquired disaccharidase deficiency due to washout of the brush border enzymes. For this reason, avoiding milk, dairy products, and other lactose-containing foods is advisable.

Read more about the treatment of food poisoning.

This Fast Five Quiz was excerpted and adapted from the Medscape Drugs & Diseases articles Tinea Pedis, Dental Infections in Emergency Medicine, Pediculosis and Pthiriasis (Lice Infestation), Tinea in Emergency Medicine, and Food Poisoning.

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