---
tags: OME, PGY1,
---
# Diarrhea

In the united states, most of the time diarrhea is going to be viral and self-limiting. You should look for nausea, vomitting and diarrhea. If there's "vomitting from both ends" it's going to be gastroenteritis

## Differential

%%{ init: { 'flowchart': { 'curve': 'basis'}} }%%
flowchart TD
    origin[Diarrhea] --- dur((Duration))
    dur -->|<2wks| acute[Acute]
    dur -->|4+ weeks| chronic[Chronic]
    acute -->|"#8853;WBC\n#8853;Fever\n#8853;Blood\n#8853;Pain"| Invasive
    acute -->|"#8861;WBC\n#8861;Fever\n#8861;Blood\n#8861;Pain"| Enterotoxic
    chronic --> Secretory & Osmotic
    chronic -->|"#8853;Blood\n#8853;Mucous"| Inflammatory
    style dur fill:#03fc3d
    

**Chronic diarrhea** can be, but rarely is, infectious. The key is to seperated it into secretory, osmotic, and inflammatory. If at any time there are blood or white cells in the stool, its inflammtory. THe lactoferrin has become the preferred method/lab test for assessing for inflammatory causes of diarrhea.

:::warning
Irritable Bowel Syndrome (IBS) has traditionally been a diagnosis of exclusion
:::

**Acute diarrhea** unless it has high risk features can be managed with supportive care.