What is the differential diagnosis for diarrhea?

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Last updated: May 27, 2025View editorial policy

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Differential Diagnosis for Diarrhea

The differential diagnosis for diarrhea is extensive and can be categorized based on the likelihood and potential impact of missing a diagnosis.

  • Single Most Likely Diagnosis
    • Viral gastroenteritis: This is often the most common cause of diarrhea, especially in otherwise healthy individuals. It is usually self-limiting and caused by viruses such as norovirus or rotavirus.
  • Other Likely Diagnoses
    • Bacterial gastroenteritis: Caused by bacteria like Salmonella, Shigella, or Campylobacter, often related to food or water contamination.
    • Food intolerance: Lactose intolerance, fructose malabsorption, or gluten sensitivity (celiac disease) can lead to chronic or recurrent diarrhea.
    • Medication-induced diarrhea: Various medications, including antibiotics, can cause diarrhea as a side effect.
    • Irritable Bowel Syndrome (IBS): A chronic condition characterized by abdominal pain and changes in bowel movements, including diarrhea.
  • Do Not Miss Diagnoses
    • Inflammatory bowel disease (IBD): Conditions like Crohn's disease or ulcerative colitis can present with chronic diarrhea and require specific management to prevent complications.
    • Clostridioides difficile (C. diff) infection: A potentially life-threatening condition that can cause severe diarrhea, especially in individuals who have recently used antibiotics.
    • Giardiasis: An infection caused by the Giardia parasite, which can lead to severe and prolonged diarrhea if not treated.
    • Ischemic bowel disease: Reduced blood flow to the intestines can cause diarrhea among other symptoms, and is a medical emergency.
  • Rare Diagnoses
    • Microscopic colitis: A condition characterized by inflammation of the colon lining, which can cause chronic, watery diarrhea.
    • Whipple's disease: A rare, systemic bacterial infection that can cause diarrhea, among other symptoms.
    • Thyrotoxicosis: Hyperthyroidism can sometimes present with diarrhea as one of its symptoms.
    • Carcinoid syndrome: A rare condition caused by a neuroendocrine tumor that can lead to diarrhea, flushing, and other symptoms.

Each of these diagnoses has a different set of risk factors, symptoms, and treatment approaches, highlighting the importance of a thorough medical evaluation to determine the underlying cause of diarrhea.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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