How Do I Approach the Patient with Diarrhea? Key History, Physical Examination, and Diagnostic Considerations
Acute gastroenteritis accounts for 179 million outpatient visits, approximately 500,000 hospitalizations, and >5000 deaths in the United States each year. The evaluation of diarrhea begins with a thorough history to determine potential causes to customize initial diarrheal illness management, followed by a careful physical examination to assess the patient’s level of dehydration, determine supportive care requirements, and refine the diagnostic workup. Causative etiologies can be elucidated with a five-question approach. Labs and imaging are rarely required.
KeywordsDiarrhea Dehydration Abdominal pain Enteritis E. coli
- 5.Crawford C. Cryptosporidiosis outbreaks on the rise, CDC warns [document on the Internet]. AAFP News, American Academy of Family Physicians; 2015 July 1. Available from: https://www.aafp.org/news/health-of-the-public/20150701cryptooutbreaks.html.
- 7.Bardhan PK, Beltinger J, Beltinger RW, Hossain A, Mahalanabis D, Gyr K. Screening of patients with acute infectious diarrhoea: Evaluation of clinical features, faecal microscopy, and faecal occult blood testing. Scan J Gastroenterol. 2000;3591:54–60.Google Scholar
- 9.Churgay CA, Aflab Z. Gastroenteritis in children: part I. Diagn Am Fam Physician. 2012;85(11):11.Google Scholar