How Do I Approach the Patient with Diarrhea? Key History, Physical Examination, and Diagnostic Considerations

Abstract

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.