Rationale

Acute diarrhea (lasting less than 1 week) is defined as a disturbance of stool frequency and/or consistency. Diarrheal diseases are extremely common worldwide, including in North America, where morbidity and mortality are significant.

Causal Conditions

(list not exhaustive)

1. Infection

   1. Viruses

   2. Bacteria

   3. Parasites

2. Drugs or toxins

3. Ischemic

4. Inflammatory bowel disease

5. Metabolic disease (e.g., hyperthyroidism)

Key Objectives

Given a patient with acute diarrhea (lasting less than 1 week), the candidate will diagnose the cause, severity, and complications, and will initiate an appropriate management plan. Particular attention should be paid to the history of risk factors associated with specific causes and the assessment for complications, such as volume loss or electrolyte abnormalities.

Enabling Objectives

Given a patient with acute diarrhea, the candidate will

1. list and interpret critical clinical findings, including those based on

   1. differentiation between small-bowel diarrhea and large-bowel diarrhea;

   2. identification of potential risk factors for specific infections (e.g., travel); and

   3. results of an appropriate history and physical examination aimed at determining severity and complications (e.g., volume depletion, comorbidities);

2. list and interpret critical investigations, including appropriate laboratory investigations and other tests (e.g., stool cultures, electrolytes); and

3. construct an effective initial management plan, including

   1. initiating dietary interventions if appropriate;

   2. initiating rehydration if appropriate;

   3. initiating specific therapy if indicated;

   4. referring to specialized care if indicated by the possible diagnosis or by the case severity; and

   5. alerting the public health authorities if required.