Diarrhea With Generalized Weakness: The Body’s Electrolyte Balance Gone Haywire
Upon admission, the main management consists of addressing the fluid and electrolyte alterations. Appropriate fluid replacement is the primary goal of treatment, which resolves imminent problems that may arise due to the presence of diarrhea. It generally depends on the patient's condition, and whether severe dehydration and possible electrolyte imbalance are already present. Fluid resuscitation may initially start with oral rehydration, and intravenous crystalloids (75ml/kg) to maintain the cardiac output.
If the diarrhea has continued to be watery, and without any blood or accompanied fever, symptomatic treatment may be done to decrease the fluid losses. Loperamide may be administered to control of symptoms.
Since the etiologic agent is likely infectious, antibiotics may be administered if the pathogen has been isolated via microscopy or culture. This can help reduce the bacterial load, and may help decrease the uncontrolled passage of water and electrolytes outside the body if the diarrhea has persisted even after admission.
The generalized body weakness should be addressed by initially isolating the cause of the electrolyte imbalance. The specific electrolytes should be replenished. In this case, potassium is the most likely electrolyte that may have caused the current symptoms. The target level is between 3.5- 5 mEqs. Administration of potassium may be done orally and intravenously (20 meQs diluted in 1 L PNSS). Continuous assessment of and monitoring of potassium level should be done to avoid overcorrection.