Diagnosing a cause of diarrhea is a challenging undertaking but can be
accomplished if a systematic approach is used for evaluation. Pathoph
ysiologic mechanisms of acute diarrhea (eg, Giardia Lamblia infection,
antibiotic use) are different from those of chronic diarrhea (eg, sec
retory dysfunction from thyrotoxicosis, lactose or fructose intoleranc
e), so adequate history taking and physical examination are essential
in narrowing the diagnosis. Laboratory investigation can then be direc
ted using the information obtained, and the cause of the diarrhea can
be established without subjecting the patient to extensive and expensi
ve testing. Undoubtedly, some functional entities that contribute to d
iarrhea await discovery.