CLINICAL PRESENTATION
Small bowel diarrheas
large, loose stools
periumbilical or RLQ pain
Large bowel diarrheas
frequent, small, loose stools
crampy, LLQ pain or tenesmus

ACUTE DIARRHEA
Viral gastroenteritis
Staphylococcus aureus
Clostridium perfringens
Salmonella
Shigella
Cryptosporidiosis
Drug-induced diarrhea
Clostridium difficile

TRAVELER’S DIARRHEA
Toxigenic E. coli
Entamoeba histolytica
Giardia lamblia
Choleria

CHRONIC & RECURRENT DIARRHEAS
Irritable bowel syndrome
Inflammatory bowel disease
Pseudomembranous colitis
Diabetic enteropathy
Dumping syndrome
Malabsorption of lactose
Chronic laxative use

HISTORY
Nature of bowel movements
Associated symptoms
Epidemiologic information
travel
food intake
personal contact
HIV status
Drug history

PHYSICAL
Vital sign
Skin
Lymph nodes
Abdomen
Rectal

LABORATORY TESTS
Gram’s stain for leukocytes
Stool for C&S
CBC
Electrolytes
Stool for O&P, C. difficile (if indicated)
LFTs & PT time
Amylase, glucose

MANAGEMENT
Acute diarrhea
maintain hydration
absorbent products
lomotil
immodium
antibiotics
Traveler’s diarrhea
prophylactic
treatment