AIDS-Related diarrhea – pathogenesis, evaluation and treatment

Abstract

SUMMARY
As the AIDS epidemic continues to spread and involve all
segments of society, more and more internists and gastroenterologists
are called upon to evaluate and treat patients
with disabling diarrhea, the most common clinical manifestation
of AIDS. It is often asked: Does it make sense to
initiate an extensive workup if no specific etiologic agent is
identified in many patients? Should we look for organisms
when there is no specific therapy for many of them? We
will try to answer both questions and outline a rational approach
to the patient with AIDS-related diarrhea, on the
basis of small-bowel versus large-bowel diarrhea and
severity of symptoms. Isolation of one or more organisms
is common if a proper search is conducted, and specific as
well as symptomatic therapy can have a significant impact
on the patients quality of life.