Management of Diarrhoea

Diarrhoea is a relatively common phenomenon that has a myriad of presentations and causes. In the elderly, diarrhoea can be confused with incontinence, but the incontinence often represents a failed challenge to gastrointestinal function. Despite its common occurrence, there can be serious consequences for the elderly with undiagnosed underlying pathology and if left untreated. It is important to consider the causative factors for the most common causes of diarrhoea in the elderly before approaching diagnosis and treatment. One unique factor in older adults that affects susceptibility to diarrhoeal illness is declining immune competence secondary to mechanisms inherent to ageing or underlying pathology. The second factor is exposure which can be secondary to healthcare-associated contacts or residential contacts. In addition to factors unique to ageing adults, many diarrhoeal causes of illness present, cause illness and have morbidity and mortality similar to those in other age groups. The underlying complexity of many diarrhoeal illnesses means that a strategic approach to diagnosis and treatment is necessary. Factors such as the setting of the illness, type of onset, diarrhoea physical and chemical characteristics and comorbid disease serve as cues to categorizing the cause of diarrhoea correctly and instituting treatment in an efficient manner. Clearly, acute and chronic causes of diarrhoea represent a varied group of medical illnesses and represent a challenge in the care of ageing adults.