Gastrointestinal Emergencies pp 335-338 | Cite as
How Do I Approach the Patient with Diarrhea? Key History, Physical Examination, and Diagnostic Considerations
Chapter
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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.
Keywords
Diarrhea Dehydration Abdominal pain Enteritis E. coliReferences
- 1.Scallan E, Griffin PM, Angulo FJ, Tauxe RV, Hoekstra R. Foodborne illness acquired in the United States – unspecified agents. Emerg Infect Dis. 2011;17:16–22.CrossRefGoogle Scholar
- 2.Sweetser S. Evaluating the patient with diarrhea: a case based approach. Mayo Clin Proc. 2012;87(6):596–602.CrossRefGoogle Scholar
- 3.Thielman NM, Guerrant RL. Acute infectious diarrhea. N Engl J Med. 2004;350:38–47.CrossRefGoogle Scholar
- 4.Guerrant RL, Van Gilder T, Steiner TS, Thielman NM, Slutsker L, Tauxe RV, et al. Practice guidelines for the management of infectious diarrhea. Clin Infect Dis. 2001;32:331–50.CrossRefGoogle Scholar
- 5.Crawford C. Cryptosporidiosis outbreaks on the rise, CDC warns [document on the Internet]. AAFP News, American Academy of Family Physicians; 2015 July 1. Available from: https://www.aafp.org/news/health-of-the-public/20150701cryptooutbreaks.html.
- 6.Schiller LR, Sellin JH. Diarrhea. In: Feldman M, Friedman LS, Brandt LJ, editors. Sleisenger and Fordtran’s gastrointestinal and liver disease. Philadelphia: Saunders Elsevier; 2010. p. 211–32.CrossRefGoogle Scholar
- 7.Bardhan PK, Beltinger J, Beltinger RW, Hossain A, Mahalanabis D, Gyr K. Screening of patients with acute infectious diarrhoea: Evaluation of clinical features, faecal microscopy, and faecal occult blood testing. Scan J Gastroenterol. 2000;3591:54–60.Google Scholar
- 8.Rhodes F, Carty E. Laxatives: a rational approach to prescribing. Br J Hospital Med. 2014;75(8):C114–8.CrossRefGoogle Scholar
- 9.Churgay CA, Aflab Z. Gastroenteritis in children: part I. Diagn Am Fam Physician. 2012;85(11):11.Google Scholar
- 10.Steiner MJ, DeWalt DA, Byerley JS. Is this child dehydrated? JAMA. 2004;291(22):2746–54.CrossRefGoogle Scholar
- 11.Teach SJ, Yates EW, Feld LG. Laboratory predictors of fluid deficit in acutely dehydrated children. Clin Pediatr (Phila). 1997;36(7):395–400.CrossRefGoogle Scholar
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