Moderate or prolonged 3 weeks diarrhoea

Usually due to Giardia lamblia, Entamoeba histolytica, Campylobacter jejuni, salmonella, Yersinia enterocolitica or Cryptosporidium.

• stool examination (3 fresh specimens)

o microscopy o wet preparation o culture

• treat pathogen (click here for guidelines under diarrhoea)

Non-pathogens such as E.coli and Endolimax nana are often reported but do not treat specifically.

Note: Consider exotic causes such as schistosomiasis, strongyloidiasis and ciguatera in unusual chronic post-travel 'gastro-enteritis'. Persistent abdominal discomfort

This common syndrome includes bloating, intestinal hurry and borborygmi, and often follows an episode of diarrhoea. Usually no pathogens are found on stool examination. However, giardiasis can be difficult to detect and an empirical course of tinidazole (2 g statim) is worthwhile. Any persistent problem then is a type of postinfective bowel dysfunction or irritable bowel. Reassurance is important.

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