Assessment of acute diarrhoea

Last reviewed: 2 Aug 2025
Last updated: 29 Aug 2025

Summary

Differentials

Common

  • Rotavirus
  • Norovirus
  • Enteric adenovirus
  • Campylobacter enteritis (Campylobacter jejuni and Campylobacter coli)
  • Shigella
  • Salmonella
  • Escherichia coli (enterotoxigenic, enteropathogenic, enteroinvasive, enterohaemorrhagic, enteroaggregative)
  • Clostridioides difficile
  • Vibrio cholerae
  • Staphylococcus aureus
  • Bacillus cereus
  • Clostridium perfringens
  • Listeria
  • Giardia
  • Entamoeba histolytica
  • Microsporidiosis
  • Drugs
  • Ulcerative colitis
  • Crohn's disease
  • Irritable bowel syndrome
Full details

Uncommon

  • Astrovirus
  • Yersinia
  • Aeromonas
  • Plesiomonas
  • Cryptosporidium
  • Cyclospora
  • Cystoisospora belli
  • Klebsiella oxytoca
  • Bowel ischaemia
  • Radiation injury
Full details

Contributors

Authors

Tisha N. Lunsford, MD FACGl AGAF

Director (Motility Section)

Consultant (Division of Gastroenterology)

Department of Internal Medicine

Mayo Clinic Arizona

Phoenix

AZ

Disclosures

TL declares that she has no competing interests.

Acknowledgements

Dr Tisha Lunsford would like to gratefully acknowledge Dr Sean Pawlowski, Dr Mamoon Elbedawi, Dr Peter Draganov, and Dr Cirle A. Warren, previous contributors to this topic. SP, ME, PD, and CAW declare that they have no competing interests.

Peer reviewers

George E. Reese, MBBS, MRCS

Honorary Clinical Research Fellow

Department of Biosurgery and Surgical Technology

Imperial College

St Mary's Hospital

London

UK

Disclosures

GER declares that he has no competing interests.

Daniel A. Leffler, MD, MS

Senior Medical Resident and Clinical Fellow in Nutrition and Gastroenterology

Department of Gastroenterology

Beth Israel Deaconess Medical Center

Boston

MA

Disclosures

DAL declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

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Key articles

Riddle MS, DuPont HL, Connor BA. ACG clinical guideline: diagnosis, treatment, and prevention of acute diarrheal infections in adults. Am J Gastroenterol. 2016 May;111(5):602-22.Full text  Abstract

World Gastroenterology Organisation. Acute diarrhea in adults and children: a global perspective. 2012 [internet publication].Full text

Shane AL, Mody RK, Crump JA, et al. 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea. Clin Infect Dis. 2017 Nov 29;65(12):e45-80.Full text  Abstract

McDonald LC, Gerding DN, Johnson S, et al. Clinical practice guidelines for clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis. 2018 Mar 19;66(7):e1-48.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Guidelines

    • CDC Yellow Book 2026: health information for international travel - post-travel diarrhea
    • Guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2024 update by IDSA/ASM
    More Guidelines
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