How to evaluate a patient with Diarrhea. Outline of the presentation: 1. Questions to ask the patient presenting with Diarrhea 2. Diarrhea, pathophysiology, classification 3. Walk-through UpToDate Algorithm for Acute and Chronic Diarrhea

1. Approach to Diarrhea
Benazir Bhutto Hospital
Dr. Khubaib Samdani
Medical Unit - 1
Evaluating the Patient With Diarrhea

2. Outline Of My Presentation
Benazir Bhutto Hospital
Medical Unit - 1
Questions to ask the patient presenting with Diarrhea
Diarrhea, pathophysiology, classification
Walk-through UpToDate Algorithm for Acute and Chronic Diarrhea
1.
2.
3.

3. What is Diarrhea
Benazir Bhutto Hospital Medical Unit - 1
Diarrhea is a symptom or sign, not a disease, and can be
caused by numerous conditions.
Diarrhea can be defined by increased stool frequency,
liquidity, or volume.
Diarrhea is objectively defined as passing a stool weight
or volume greater than 200 g or 200 mL per 24 hours.

4. Medical Unit - 1 Benazir Bhutto Hospital
Talley &
O'Connor's
Clinical
Examination
- 8th Edition
Source:

5. Osmotic Diarrhea: unabsorbed substance draws water from the
plasma into the intestinal lumen along osmotic gradients.
Secretory Diarrhea: disordered electrolyte transport and, despite the
term, is more commonly caused by decreased absorption rather than
net secretion.
Inflammatory Diseases: cause diarrhea with exudative, secretory, or
osmotic components.
Altered Motility: of the intestine or colon may alter fluid absorption
by increasing or decreasing the exposure of luminal content to
intestinal absorptive surface.
Benazir Bhutto Hospital
Medical Unit - 1

6. Medical Unit - 1 Benazir Bhutto Hospital
Classification and Pathophysiology of Diarrhea

7. Evaluation of acute diarrhea in adults

13. Evaluation of Chronic Diarrhea in Adults

17. Benazir Bhutto Hospital
Medical Unit - 1
Source: Davidson's Principles and Practices of Medicine - 23rd Edition

18. Benazir Bhutto Hospital
Medical Unit - 1
Important Points
- Rule out fecal incontinence and fecal impaction.
- Rule out medications as a cause of diarrhea (drug-induced diarrhea)
- Consider factitious diarrhea.

19. Benazir Bhutto Hospital
Medical Unit - 1
Categorization of Diarrhea

20. Thank you for your attention

21. References
Sweetser S. Evaluating the patient with diarrhea: a case-based approach.
Mayo Clin Proc. 2012;87(6):596-602. doi:10.1016/j.mayocp.2012.02.015
https://www.uptodate.com/contents/image?imageKey=ID%2F68348
Davidson's Principles and Practices of Medicine - 23rd Edition
Talley & O'Connor's Clinical Examination - 8th Edition