What is the clinical presentation of diarrhea in AIDS?
- When evaluating an HIV-infected patient with diarrhea, careful attention should be directed to the history and physical examination.
- Enteritis (small bowel diarrhea) is associated with voluminous, watery bowel movements, abdominal bloating, cramping, borborygmi, and nausea.
- Abdominal pain, if present, tends to be periumbilical or diffuse. Abdominal examination reveals an increase in number and frequency of bowel sounds, which may be high-pitched.
- Conversely, colitis (large bowel diarrhea) is characterized by frequent, small bowel movements, with the presence of mucus, pus, or blood (dysentery).
- Patients with prominent involvement of the distal colon also have proctitis symptoms, such as tenesmus, dyschezia (pain on defecation), and proctalgia (rectal pain).
