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Chronic unexplained diarrhea: a logical and cost-effective approach to assessment

Dosanjh, Grace; Pardi, Darrell S.

Current Opinion in Gastroenterology: January 2016 - Volume 32 - Issue 1 - p 55–60
doi: 10.1097/MOG.0000000000000232
LARGE INTESTINE: Edited by Eamonn M.M. Quigley

Purpose of review The workup of chronic unexplained diarrhea can be equally frustrating for care providers and patients. It carries a physical, financial, and social toll. In this review we provide a sensible approach to evaluating and managing chronic diarrhea.

Recent findings Bile acid diarrhea is becoming increasingly recognized as a potential cause behind some cases of chronic diarrhea.

Summary A detailed history and physical examination can provide clues that guide a logical approach to the evaluation. We suggest a cost-effective approach to the workup and management of chronic diarrhea based on individual patient factors related to clinical history and physical exam. We find that this approach leads to initiation of treatment in a time-efficient fashion and avoids unnecessary testing.

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, USA

Correspondence to Grace Dosanjh, MD, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55902, USA. Tel: +1 507 266 4347; fax: +1 507 284 0538; e-mail:

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