Acute Diarrhea: An Overview

Jarrod Beachum, PA-C

Diarrhea is a frequently seen complaint for most urgent care and primary care clinics. Today I wanted to discuss some common causes, symptoms, treatments, and when to come see a provider.

Acute diarrhea is defined as stool with increased water content/volume or frequency that lasts <14 days. It can be divided first into infections or non-infectious diarrhea. Infectious causes are more common and include viruses, bacteria, and parasites. Viral diarrhea is by far the most common cause of infectious diarrhea. Non-infectious causes include medication side effects, acute abdominal processes, gastrointestinal disease, and endocrine disease.

When we evaluate diarrhea complaints, we will ask you many questions. We are trying to determine how many days you have had it, any associated symptoms (such as vomiting, fever, thirst, dizziness, etc.), appearance of the stool, severity of the symptoms, medication history, travel and food history, and recent illness history. These questions are important for determining the most likely cause of your specific diarrhea so it can be properly treated. While it may be unsettling to look at your stool in the toilet, it can have especially important clues for us, such as color, blood, types of food eaten, etc.

A physical exam is useful mostly in determining the level of dehydration. Signs of dehydration include ill appearance, dry mucous membranes (nose, mouth), delayed capillary refill time, increased heart rate, abnormal vital signs. Fever suggests an inflammatory cause, most likely viral.

We typically don’t do any testing for diarrhea because it is of little value. Testing is warranted in cases of severe dehydration, persistent fever, bloody stool, or suspected infection outbreaks.

Treatment of diarrhea is straight forward. Step one if oral rehydration. IV hydration is reserved for severe dehydration and not likely to be completed in an urgent care setting. Most diarrhea is self-limiting and will resolve in a matter of 1-3 days. Imodium with simethicone may help relieve the frequency of bowel movements and gas discomfort. If we suspect a bacterial cause, such as C. diff or E. coli, then antibiotics can be prescribed after proper testing. Other non-infectious causes have different treatment plans and may include more special testing.

Again, most cases of diarrhea will run their course in a couple of days without treatment and significant problems for people. Come and see us if you have any of the following: diarrhea >2 days, fever of 102°F or higher, 6 or more stools in 24 hours, severe abdominal or rectal pain, bloody/black/purulent stools, diarrhea with frequent vomiting, and dehydration signs mentioned above. We would be glad to examine you and help you get back to normal quicker.

Jarrod Beachum, PA-C