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5–8 | Clinical Manual for Management of the HIV-Infected Adult/2006
Patients with severe diarrhea must maintain adequate
hydration, by mouth if possible. In severe cases,
intravenous administration of fluids may be necessary.
Oral rehydration solutions include the World Health
Organization formula, Pedialyte, Rehydralyte, Rice-
Lyte, and Resol. Homemade alternatives include the
following:
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Combine 1/2 teaspoon of salt, 1 teaspoon of baking
soda, 8 teaspoons of sugar, and 8 ounces of orange
juice; add water to make l liter and drink.
Drink 1 glass containing 8 ounces of apple, orange,
or other juice; 1/2 teaspoon of corn syrup or honey;
and a pinch of salt; then drink 1 glass containing 8
ounces of water and 1/4 teaspoon of baking soda.
Mix 1/2 cup of dry, precooked baby rice cereal with
2 cups of water (boil first in areas with poor water
quality); add 1/4 teaspoon of salt and drink.
Patient Education
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Diarrhea can have many causes. Instruct patients to
notify their health care providers if they develop new
or worsening symptoms.
Instruct patients to take their medications exactly as
directed and to call their health care providers if they
experience worsening diarrhea, or other symptoms
such as fever, nausea, vomiting, or pain.
Patients must stay nourished and well hydrated even
if they are having diarrhea. Instruct patients to eat
small, frequent meals and to avoid dairy products,
greasy food, and high-fat meals.
References
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Bartlett JG, Cheever LW, Johnson MP, et al, eds.
A Guide to Primary Care of People with HIV/AIDS.
Rockville, MD: U.S. Department of Health and
Human Services, Health Resources and Services
Administration; 2004. Available at: http://hab.hrsa.
gov/tools/primarycareguide/. Accessed June 1, 2006.
Centers for Disease Control and Prevention.
Diagnosis and Management of Foodborne Illnesses.
Available at: http://www.cdc.gov/mmwr/preview/
mmwrhtml/rr5304a1.htm. Accessed June 1, 2006.
Centers for Disease Control and Prevention,
National Institutes of Health, Infectious Diseases
Society of America. Treating Opportunistic
Infections Among HIV-Exposed and Infected Children:
Recommendations from CDC, the National Institutes of
Health, and the Infectious Diseases Society of America.
December 3, 2004. Available at: http://aidsinfo.nih.
gov/Guidelines/GuidelineDetail.aspx?MenuItem=G
uidelines&GuidelineID=14. Accessed June 1, 2006.
Guerrant RL, Van Gilder T, Steiner TS, et al. Practice
guidelines for the management of infectious diarrhea.
Clin Infect Dis. 2001 Feb 1;32(3):331-51.
Sanaka M, Soffer E. Acute Diarrhea. Cleveland,
OH: The Cleveland Clinic; 2004. Available
at: http://www.clevelandclinicmeded.com/
diseasemanagement/gastro/diarrhea/diarrhea.htm.
Accessed June 1, 2006.
Scheidler MD, Giannella RA. Practical management
of acute diarrhea. Hosp Pract (Minneap). 2001 Jul
15;36(7):49-56.
Thielman NM, Guerrant RL. An algorithmic
approach to the workup and management of HIVrelated
diarrhea. J Clin Outcomes Management
1997;4:36-47.