THERAPEUTIC CHOICES IN ACUTE GASTROENTERITIS IN ADULTS

Acute diarrhea is a very common illness among populations of all ages. Infective diarrhea accounts for most episodes of acute gastroenteritis in adults, and viruses are the most common etiologic agents. In developing countries, acute diarrhea is still cause of mortality, while in developed countries it impacts importantly the quality of life and may worsen underlying diseases such as nephropathies, cardiac diseases or diabetes. Therefore, the optimization of the treatment of acute gastroenteritis is essential all over the world. Acute diarrhea may be managed in hospitalization or with home medication, based on the severity of the disease and eventual comorbidities of the patient or complications. Therapy of acute diarrhea is based generally on the correction of fluid and electrolytes loss, on symptoms control and on the use of specific medications depending on etiology. Dehydration management should always be prompt and adapted to the severity of dehydration; oral rehydration is usually preferred, by using oral rehydration solutions; nonspecific antidiarrheal drugs are mainly used for symptoms controls and include antimotility drugs loperamide and dyphenoxylate, and antisecretory drugs bismuth subsalicylate and racecadotril; adsorbent agents as diosmectite may be applied as adjunctive treatments; antimicrobial therapy is indicated in case of acute infectious diarrhea, although it is not necessary for all etiologies; specific probiotic strains may be also applied in diarrhea’s treatment as they help in the reestablishment of a balanced intestinal microbiota.