Re Wilderness Diarrhea NRO Hope you don t mind this post taking up space here Just delete the quote if you like I recently posted a question on NRO notice board and you responded saying It seems to me that something along these lines should be included in the article and that the sources largely back it up However there may be a bit of a problem with conflation of general GI symptoms and diarrhea specifically especially in the MS SE ref In order to allay the concerns of the other editor and improve the article there will also need to be some information just a statement probably contextualizing the prevalence of diarrhea caused by strenuous activity relative to the prevalence of diarrhea caused by pathogens If we can improve it along these lines I ll be happy to help argue for its inclusion in the article Here s my re write which I haven t proposed as yet Does it do the job I m afraid it won t be accepted because it may imply that Wilderness Diarrhea is a non existent category which I think maybe it sortta is My larger problem is that I think the article is based on an overblown view of the subject even though it s got a couple of sources to the contrary Thing is I ve got like five good sources directly on the overblown side not the ones below but they get shunted into controversy section with the implication that they are fringe theories or simply deleted because they aren t peer reviewed or the source doesn t cite a source or etc things like that It s not that I m against telling people to treat suspect water but I think the preponderance of research apart from expert opinion suggests that the concern is highly over stated and to simply say that that would be unacceptable I ve been keeping away from the article for a week It s the domain currently of a single editor who seems to simply know what s best Any way here is re write of the bit along with some proposed context Causes The most common causes of wilderness diarrhea are Giardia and Cryptosporidium Backer Howard D 2007 Field Water Disinfection In Auerbach Paul S editor Wilderness Medicine 5th edition Philadelphia Pennsylvania Mosby Elsevier pg 1369 although several other organisms may play a larger role than generally believed Other infectious agents include Campylobacter hepatitis A virus hepatitis E virus enterotoxogenic E coli e coli 0157 H7 Shigella and various enteric viruses More rarely Yersinia enterocolitica Aeromonas hydrophila and Cyanobacterium may also cause disease The vectors for infectious diarrhea both within and outside wilderness are limited to contaminated food water and hand to mouth transmission It may be difficult to accurately associate a particular case with a recent wilderness visit because incubation can vary widely up to several weeks or more while infection outside the wilderness is common Giardia alone may infect up to 10 of Americans at any one time although most carriers are asymptomatic Within any given four week period as many as 7 2 of Americans may experience some form of diarrhea The most common causes are viruses followed by bacteria and parasites including Giardia Other important causes of diarrhea in the U S are non infectious and include medications stress or a change in eating or exercise patterns Non infectious gastrointestinal distress including diarrhea is common as a result of strenuous excercise A study of 155 men and women who walked an average of 26 miles a day for four days found 24 of the subjects experienced gastrointestinal symptoms No relationship was established between symptoms and age gender previous training or walking speed Factors in diarrhea related to exercise may include dehydration the diversion of blood from the bowel to the working muscles gut ischemia certain foo