The Patient with Diarrhea

This chapter presents clinical presentation, differential diagnosis, management, and complications of diarrhea. The differential diagnosis of chronic diarrhea is more extensive and can be categorized into motility, inflammatory, secretory, or osmotic/malabsorption disorders. Patients with stools of normal daily volume may also complain of chronic diarrhea. The most common cause of chronic diarrhea in the United States is diarrhea-predominant irritable bowel syndrome (IBS). IBS is the most common etiology of chronic diarrhea in the United States. Most patients with chronic diarrhea require laboratory testing in addition to a thorough history and physical examination. Severe acute diarrhea as well as persistent and chronic diarrhea may require additional evaluation. Fecal fat is used to identify patients with malabsorption. The chapter also presents case scenarios, which are accompanied by discussions that will provide the context necessary to translate medical knowledge to clinical practice.