Diarrhea
Symptoms by Name     Gastroenterology    eMedicine
General Info
HPI/Physical
Acute diarrhea defined as three or more loose or watery stools per day; >10 mL/kg/d in the infant and young child, and >200 g/d in the teenager and adult. The increase in water in the stools is due to a change in the physiology of the small and large intestinal absorption of ions and other substrates.
Infectious is the most common cause  of acute diarrhea, but do not dismiss other noninfectious causes of diarrhea
History:
Characteristics of consistency, color, volume, and frequency: bloody, watery, mucous, large/small volume, increased flatulence, foul-smelling stools
Food history: Ingestion of raw or contaminated food, water exposure, a history of camping, or travel history may indicate a cause for diarrhea.
Symptoms:
Abdominal pain: usually nonspecific nontender with cramping, borborygmi, dehydration, failure to thrive, malnutrition, perianal erythema
Differential
Dysentary/Colitis
(Invasive Diarrhea)
Bacterial Enteritis
(Toxin/Food Poisoning)
Viral Gastroenteritis
Protozoan Gastroenteritis
Secondary to Medication/Disease
Secondary to Medication
Salmonella
Shigella
Campylobacter
Yersinia enterocolitica
EHEC
Clostridium Difficile

Staph Aureus
Bacillus Cereus
ETEC
Clostridium Perfringens
Scombroid
Ciguatera
Klebsiella
Vibrio Cholera
Rotavirus
Norwalk
Adenovirus
Entamoeba
Giardia
Cryptosporidium
Appendicitis
Carcinoid Tumor
Hyperthyroidism
Irritable Bowel Syndrome
Inflammatory Bowel:
    Crohn Disease
    Ulcerative Colitis
Malabsorption Syndromes
Lactose Intolerance
Short Gut Syndrome
Antibiotic Associated
Laxative
Opiate Withdrawal
Chemotherapy Induced
Radiation Induced



Tests/Diagnosis
Management
Disposition
Stool Guaiac Test
Fecal Leukocytes
Gram Stain
Stool Culture
Ova & Parasites
C. Diff Toxin
__________________
Cryptosporidium Ag
Rotavirus Ag
Stool Anion Gap
Oral Replacement Therapy/IV Fluids
+/- Antibiotics
+/- Antimotility Agents
Can be discharged home if tolerating PO and hemodynamically stable