Approach to diarrhea

Diarrhea is the second most common presenting complaint in the practice of gastroenterology, and results from a very wide variety of conditions and exogenous factors, making definitive diagnosis a challenge. Diagnosing the cause of diarrhea is assisted by considering first the duration of diarrhea (acute or chronic). Chronic diarrhea is diagnosed by characterizing the stools as watery, fatty, or inflammatory. Careful history is essential to home in on the correct diagnosis. The treatment of diarrhea should focus first on the need for fluid repletion, then on treatment of the specific underlying condition. If no specific or treatable condition can be identified, empiric treatment with antimotility agents may be effective.