Important note: Information in this article was accurate in May 2000. The state of the art may have changed since the publication date.AIDSWEEKLY Plus; Monday, May 29, 2000
Prepared by AIDS Weekly editors from staff and other reports
The causes of this malady can sometimes be difficult to diagnose when normal, non-invasive procedures are used. Scientists at the National Taiwan University Hospital suggest that when there is no definitive reason for the diarrhea and it remains unresolved after a preliminary course of treatment, patients should undergo diagnostic endoscopy ("Endoscopy in acquired immune deficiency syndrome patients with diarrhea and negative stool studies," Gastrointest Endosc 2000 Apr;51(4 Pt 1):427-32.
In a one-year study of AIDS patients, investigators analyzed the sources and causes of diarrhea. The source of these patients' troubles had to date remained unknown, based on non-invasive testing methods, according to S.C. Wei et al.
"Etiologic diagnoses were made in 26 of 40 patients (65%) who underwent endoscopic studies. Amebic colitis and cytomegalovirus colitis were the two leading causes of prolonged diarrhea in patients with AIDS," Wei et al. said, noting that these diagnoses had not been made prior to endoscopy. The patients were subsequently treated and 87.5% of them recovered.
In looking at the morbidity and mortality in these patients, Wei et al. commented, "The difference in survival time after diarrhea between patients whose symptoms resolved after treatment and those who continued to have diarrhea was statistically significant (p<0.001)."
Endoscopy is an important tool for diagnosing those patients who encounter initial treatment failure, especially in those patients with negative stool cultures. Proceeding from failed preliminary treatment after two weeks of therapy to endoscopic examination may save patients' lives, Wei et al. concluded.
The corresponding author for this study is J.M. Wong, National Taiwan University Hospital, Department of Internal Medicine, 7 Chung Shan S Road, Taipei 100, Taiwan
Key points reported in this study are:
This article was prepared by AIDS Weekly editors from staff and other reports.
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