From the Guidelines
Brown-colored stool in a patient with cholera is typically caused by the presence of blood in the stool, a condition known as melena, which occurs due to severe mucosal damage from the Vibrio cholerae toxin and profound dehydration and electrolyte imbalances. This condition can lead to intense inflammation and erosion of the intestinal lining, resulting in upper gastrointestinal bleeding, which is then digested as it passes through the intestinal tract, giving the stool a brown or black, tarry appearance 1. The most recent and highest quality study, published in 2024, recommends azithromycin as the first-choice treatment for cholera, with doxycycline as an alternative second-choice 1. Key points to consider in the management of cholera include:
- Aggressive rehydration to prevent fluid overload, especially in children 1
- Administration of oral rehydration solution (ORS) to replace fluid losses 1
- Use of antibiotics, such as azithromycin or doxycycline, to treat the underlying infection 1
- Possible need for blood transfusion and electrolyte replacement in severe cases 1 It is essential to prioritize the patient's morbidity, mortality, and quality of life when managing cholera, and to seek immediate medical attention if brown stools or other complications develop.
From the Research
Causes of Brown-Colored Stool in Cholera
- The provided studies do not directly address the cause of brown-colored stool in patients with cholera 2, 3, 4, 5, 6.
- The studies focus on the treatment and management of cholera, including oral rehydration therapy and antibiotic treatment, but do not discuss the color of stool as a symptom or indicator of the disease.
- Cholera is characterized by acute, secretory diarrhea, which is typically described as watery and pale in color, not brown 2.
- The color of stool can be influenced by various factors, including diet, digestive health, and the presence of blood or other substances, but the specific cause of brown-colored stool in cholera patients is not addressed in the available evidence.
Related Findings
- The studies provide information on the treatment and management of cholera, including the use of oral rehydration solutions and antibiotics to reduce stool output and duration of diarrhea 3, 4, 5, 6.
- The efficacy of different oral rehydration solutions, including those containing glucose, alanine, and rice, has been evaluated in clinical trials 5, 6.
- However, the color of stool is not a primary outcome measure in these studies, and the available evidence does not provide a clear explanation for brown-colored stool in patients with cholera.