Disposition

Patients with diarrhea who appear severely ill, toxic, or dehydrated; those who cannot tolerate anything by mouth; and those with organ system involvement (e.g., lung, blood, or CNS) should be admitted for intravenous hydration, further diagnostic evaluation, and antiparasitic drug treatment as indicated. Patients who do not require hospitalization can be treated with antiparasitic agents if a specific diagnosis has been made and should be referred for follow-up. Those who can tolerate oral fluids can be reliably rehydrated with the World Health Organization oral rehydration solution. Such a solution can be prepared by adding 3.5 g sodium chloride (or % teaspoon of table salt), 2.5 g sodium bicarbonate (or 2.9 g sodium citrate or 1 teaspoon of baking soda, 1.5 g potassium chloride (or 1 cup of orange juice or two bananas), and 20 g glucose (or 40 g sucrose or 4 tablespoons of sugar) to a liter (1.05 quart) of clean water. This makes a solution of approximately 90 mmol sodium, 20 mmol potassium, 80 mmol chloride, 30 mmol bicarbonate, and 111 mmol glucose per liter.

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