Evaluation of Patients with Chronic Diarrhea

Patients who report having diarrhea for more than four weeks should be evaluated for chronic diarrheal diseases, since most infectious enteritides and other causes of acute diarrhea generally resolve spontaneously within this period.13 We suggest a two-stage outpatient evaluation, which relies initially on the history and physical examination to direct studies and then on a systematic outpatient evaluation, followed, if necessary, by a third-stage inpatient evaluation. This approach should lead to a diagnosis in approximately 90 percent of patients. Patients with diarrhea experience a change in the consistency or frequency of their bowel movements. Diarrheal diseases are almost always . . .