History

Symptom profile

Diarrhea characterization

OPQRST

Onset

Provocation and palliation

Quality

Region and radiation

Severity

Timing

Associated symptoms

GI associated symptoms

Systemic associated symptoms

Dehydration symptoms

Exposures and timeline

Infectious exposure history

Food and water exposures

Travel exposures

Antibiotic exposure timing

Prior episodes and baseline

Baseline bowel pattern

Prior similar episodes

Functional impact

Alarm Features

Immediate escalation triggers

Unstable features

High risk GI features

High risk infection features

Dehydration and metabolic danger

Severe dehydration signs

Electrolyte risk features

High risk populations

Special populations

Medications

Medication contributors

Diarrhea associated medications

Recent medication changes

Change history

OTC and supplements

Non prescription exposures

Therapy constraints

Contraindications and interaction traps

Diet

Recent intake and triggers

Intake pattern

Lactose exposure

Gluten exposure

Hydration indicators

Hydration status indicators

Alcohol and recreational exposures

Substance exposures

Review of Systems

Constitutional

Systemic symptoms

GI

GI symptom cluster

GU and gyn

GU and reproductive symptoms

Cardiorespiratory and neuro

Danger associated symptoms

Collateral History and Family History

Collateral and reliability

Source and reliability

Family history

Familial conditions

Household and community exposures

Shared exposure risks

Risk Factors

Infectious and exposure risks

Enteric infection risk factors

Comorbidity risks

Host susceptibility

Procedure and device risks

Iatrogenic risks

Pregnancy and postpartum risks

Pregnancy related considerations

Differential Diagnosis

Life threatening

Cannot miss causes

Common

High probability causes

Less common and zebras

Broader causes

Mimics and pitfalls

Alternative explanations

Past Medical History

GI and systemic conditions

Relevant conditions

Prior procedures and anatomy

Surgical history

Prior endoscopy

Baseline function and supports

Baseline status

Physical Exam

General and vitals

Overall status

Vital sign patterns

Volume status and perfusion

Hemodynamic assessment

Abdominal exam

Abdominal findings

Peritoneal signs

Rectal and skin

Targeted exam

Skin findings

Extraintestinal findings

Clues to systemic disease

Lab Studies

Basic labs for risk stratification

Core labs

Inflammation and sepsis evaluation

Inflammatory markers

Sepsis adjuncts

Stool studies

Stool testing selection

Ova and parasite testing

Special labs by phenotype

Chronic diarrhea workup

Pregnancy and high risk labs

Pregnancy related

Imaging

Scoring Systems

Imaging decision tools

MRI

MRI considerations

CT

CT abdomen and pelvis considerations

Ultrasound

Ultrasound use cases

Special Tests

Bedside and procedural tests

Point of care options

Endoscopy related testing

Specialist tests

Stool phenotype aids

Pattern classification aids

ECG

When ECG matters

ECG indications

High risk patterns

Electrolyte associated patterns

Rate and rhythm patterns

Assessment

Syndrome classification

Diarrhea phenotype

Severity tier

Working diagnosis framing

Leading diagnosis candidates

Complications to rule out

High risk complications

Diagnostic uncertainty

Alternative diagnoses

Plan

First 5 minutes

Critical patient workflow

Rehydration and electrolyte management

Volume repletion

Electrolyte repletion

Symptom control

Antiemetics

Antidiarrheals

Analgesia

Antimicrobials when indicated

Targeted antibiotic principles

C difficile treatment triggers

Diagnostic sequencing

Test selection logic

Reassessment loop

Reassessment timing

Disposition

ICU criteria

ICU level care indicators

Inpatient admission criteria

Admission indications

Observation pathway criteria

Short stay criteria

Discharge criteria

Safe discharge features

Discharge Instructions

Copy discharge instructions

Condition summary

Hydration

Diet

Medications

Return to ED now

Follow up

References

Guidelines and core sources

Key references