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Harrison's Principles of Internal Medicine, 18e
| Part 2. Cardinal Manifestations and Presentation of Diseases > Section 6. Alterations in Gastrointestinal Function > |
Chapter 40. Diarrhea and Constipation
Sections: Diarrhea and Constipation: Introduction, Normal Physiology, Diarrhea, Constipation, Further Readings.
Topics Discussed: constipation; diarrhea; diarrhea, constipation, and irritable bowel syndrome.
Excerpt:"Diarrhea and constipation are exceedingly common and, together, exact an enormous toll in terms of mortality, morbidity, social inconvenience, loss of work productivity, and consumption of medical resources. Worldwide, >1 billion individuals suffer one or more episodes of acute diarrhea each year. Among the 100 million persons affected annually by acute diarrhea in the United States, nearly half must restrict activities, 10% consult physicians,  250,000 require hospitalization, and 5000 die (primarily the elderly). The annual economic burden to society may exceed $20 billion. Acute infectious diarrhea remains one of the most common causes of mortality in developing countries, particularly among children, accounting for 2–3 million deaths per year. Constipation, by contrast, is rarely associated with mortality and is exceedingly common in developed countries, leading to frequent self-medication and, in a third of those, to medical consultation. Population statistics on chronic diarrhea and constipation are more uncertain, perhaps due to variable definitions and reporting, but the frequency of these conditions is also high. United States population surveys put prevalence rates for chronic diarrhea at 2–7%..."
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