Diagnosis and Management of Acute Gastroenteritis in Adults in the Urgent Care Setting

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Publication Date: October 2024 (Volume 3, Number 10)

CME Credits: 4 AMA PRA Category 1 Credits™, 4 AAFP Prescribed credits, and 4 AOA Category 2-B CME credits. CME expires 10/01/2027.

Author

Peer Reviewer

Abstract

Acute gastroenteritis is a common condition frequently encountered in the urgent care setting. Although most cases are mild and self-limited, an important subgroup of patients will manifest severe disease that necessitates comprehensive diagnostic testing, empiric therapy, and escalation of care. This review provides evidence-based recommendations for the diagnosis, treatment, and disposition of adult patients with acute gastroenteritis. Guidance on management among special patient populations, including immunocompromised patients or patients with recent international travel, are discussed. Emerging issues in the field, such as evolving patterns of antimicrobial resistance and the impact of proton pump inhibitors on acute gastroenteritis, are also reviewed.

Case Presentations

A 32-year-old healthy woman presents to urgent care with a complaint of nonbloody diarrhea…

• She reports that she returned from a trip to Central America 3 days ago. The diarrhea began 1 day after she returned.
• The patient denies any fevers or abdominal pain and can tolerate oral hydration. She does report increased flatulence and multiple episodes of loose stools per day.
• She asks you if she needs antibiotics...

A 15-year-old healthy boy presents to urgent care with 2 to 3 days of fevers, decreased appetite and oral intake, and generalized weakness…

• He reports that he has diarrhea, which was initially watery and nonbloody, but has become mucous-like and bloody in the last 24 hours. He also reports a constant urge to defecate. He is able to maintain adequate hydration.
• He asks you if there is anything that can be done for his symptoms...

A 54-year-old man with a history of liver transplant presents to urgent care with nonbloody diarrhea for 1 week...

• He was initially able to adequately hydrate but reports feeling increasingly weak and has decreased urine output.
• He is concerned about the ongoing diarrhea and dehydration.
• You wonder if his symptoms could indicate a serious condition, given his transplant history...

Accreditation:

EB Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.