Diarrhea
Medical Author: Jay W. Marks, MD
Medical Editors: Dennis Lee, MD and William C. Shiel, Jr., MD, FACP, FACR
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Hotel Hygiene: Is Your Hotel Making You Sick?
Medical Author: Melissa
Conrad Stöppler, MD
Medical Editor: William C. Shiel
Jr., MD, FACP, FACR
As a physician and pathologist, I have a pretty strong stomach. But even I
was overcome with a wave of nausea when I watched a hidden camera expose of
hotel hygiene practices by investigative reporters. In brief, for the report I
saw, teams of journalists placed hidden cameras in hotel rooms in a range of
randomly–chosen hotels in the Atlanta, Georgia area (the study, and similar observations,
have also been carried out in other locations). Hotels ranged from the
mid–priced business hotels to the top of the line luxury establishments (5 star). A
blatant disregard for hygienic practices that could lead to serious infection
was observed in numerous hotels when housekeeping staff cleaned (or didn't
clean, as the case may be) the drinking glasses in the hotel room.
Housekeeping staff was caught on film either rinsing the drinking glasses (in
preparation for a new guest) with water only, or washing them with industrial
cleaner labeled "do not drink." In other cases, dirty bath towels – from the
previous guest – were used to dry the glasses after their perfunctory rinse in
tap water. Another film clip showed a woman wearing latex gloves cleaning the
guest toilet and then proceeding to rinse the drinking glasses, without removing
or changing the gloves. We all know that some of the principal routes for spread of infections
include contact with infected persons or contact with articles of bedding or
clothing that have been contaminated by an infected source...
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What is diarrhea?
Diarrhea
is an increase in the frequency of bowel movements or a decrease in the form
of stool (greater looseness of stool). Although changes in frequency of
bowel movements and looseness of stools can vary independently of each other,
changes often occur in both.
Diarrhea needs to be distinguished from four other conditions. Although these conditions may accompany
diarrhea, they often have different causes and different treatments than
diarrhea. These other conditions are:
- incontinence of stool, which is the inability to
control (delay) bowel movements until an appropriate time, for example, until one can
get to the toilet
- rectal urgency, which is a sudden urge to have a
bowel movement that is so strong that if a toilet is not immediately available
there will be incontinence
- incomplete evacuation, which is a sensation that
another bowel movement is necessary soon after a bowel movement, yet there is
difficulty passing further stool the second time
- bowel movements immediately after eating a meal
How is diarrhea defined?Diarrhea can be defined in absolute or relative terms based on either the
frequency of bowel movements or the consistency (looseness) of stools.
Frequency of bowel movements.
Absolute diarrhea is having more
bowel movements than normal. Thus, since among healthy individuals the maximum
number of daily bowel movements is approximately three, diarrhea can be defined as
any number of stools greater than three. Relative diarrhea is having more
bowel movements than usual. Thus, if an individual who usually has one bowel
movement each day begins to have two bowel movements each day, then diarrhea is
present-even though there are not more than three bowel movements a day, that is,
there is not absolute diarrhea.
Consistency of stools. Absolute diarrhea is more difficult to
define on the basis of the consistency of stool because the consistency of stool
can vary considerably in healthy individuals depending on their diets. Thus,
individuals who eat large amounts of vegetables will have looser stools than
individuals who eat few vegetables. Stools that are liquid or watery are always
abnormal and considered diarrheal. Relative diarrhea is easier to define based
on the consistency of stool. Thus, an individual who develops looser stools than
usual has diarrhea--even though the stools may be within the range of normal with
respect to consistency.
Next: Why does diarrhea develop? »
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