Brainerd diarrhea is characterized by 10-20 episodes of explosive, watery, non-bloody diarrhea with urgency and, in some cases, fecal incontinence each day. Gas, moderate stomach cramping, and weariness are some of the symptoms associated with the syndrome. A patient can also experience vomiting, nausea, and systemic symptoms such as fever and moderate weight loss. These symptoms may linger for a year or more, which usually progresses in a waxing and waning pattern. Long-term follow-up studies have indicated that almost all patients had fully recovered after three years.
Despite comprehensive clinical and laboratory studies and testing, the cause has not yet been determined. Although it is suspected to be infectious, extensive searches for bacterial, parasitic, and viral pathogens (disease agents) have yielded no results. There is a possibility that a chemical toxin causes Brainerd diarrhea, but no such toxin has been identified.
Currently, there is still no known treatment for the condition. Numerous antimicrobial drugs are administered, including trimethoprim-sulfamethoxazole, ciprofloxacin, doxycycline, ampicillin, metronidazole, and paromomycin, but none are compelling. Opioid antimotility drugs like loperamide, diphenoxylate, and paregoric have also helped improve the symptoms in about half of patients who take large doses of these drugs.
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