You are currently viewing Acute Diarrhea Evaluation & Diagnosis – Mnemonic

Here is a quick mnemonic “DIAGNOSE DIARRHEA to remember about Acute Diarrhea Evaluation & Diagnosis

This can be valuable for patients as well as medical doctors, nurses & students doing their clinical rounds. You can also find it very useful for med exams like USMLE, NExT Medical Step 1&2, MBBS, NEET PG, INI-CET, FMGE,MCAT & NCLEX exams

Acute Diarrhea Evaluation & Diagnosis : How To Remember Easily ?

  • D – Duration and Severity: Evaluate acute diarrhea based on its severity and duration.
  • I – Indications for Evaluation: Consider evaluation if the patient has:
    • Profuse diarrhea with dehydration
    • Grossly bloody stools
    • Fever ≥38.5°C (≥101°F)
    • Duration >48 h without improvement
    • Recent antibiotic use
    • New community outbreaks
    • Severe abdominal pain in patients aged >50 years
    • Elderly (≥70 years) or immunocompromised patients
  • A – Antibiotic Trial: In cases of moderately severe febrile diarrhea with fecal leukocytes or gross blood, consider an empirical antibiotic trial.
  • G – Giardia and More: Persistent diarrhea may be due to Giardia, but also consider C. difficile, E. histolytica, Cryptosporidium, Campylobacter, and others.
  • N – Notable Associations: Microbiologic analysis of stool is crucial for severe acute infectious diarrhea. Consider specific cultures and immunoassays for certain pathogens.
  • O – Other Imaging Approaches: Consider structural examination through sigmoidoscopy, colonoscopy, or abdominal CT scanning for uncharacterized persistent diarrhea to exclude IBD or other causes.
  • S – Special Cultures: In some cases, special cultures may be appropriate for specific pathogens like enterohemorrhagic E. coli, Vibrio species, and Yersinia.
  • E – Evolving Microarray Technologies: Molecular diagnosis of pathogens in stool can be done by identifying unique DNA sequences using evolving microarray technologies.
  • D – Distinct Diarrhea Entity: Brainerd diarrhea is an entity characterized by an abrupt-onset diarrhea that persists for at least 4 weeks, potentially of infectious origin.
  • I – Initial Approach: Imaging approaches such as CT scanning may be suitable for suspected noninfectious acute diarrhea caused by conditions like ischemic colitis, diverticulitis, or partial bowel obstruction.
  • A – Additional Causative Organisms: Consider other causative organisms like C. difficile, E. histolytica, Cryptosporidium, Campylobacter, etc., if stool studies are unrevealing.
  • R – Rapid, Specific, and Cost-effective Diagnosis: Evolving microarray technologies have led to more rapid, sensitive, specific, and cost-effective diagnosis of pathogens in stool.
  • R – Routine Studies: If a particular pathogen is implicated, the whole panel of routine studies may not be necessary.
  • H – Host Factors: The decision to evaluate acute diarrhea also depends on various host factors.
  • E – Empirical Antibiotic Trial: In cases of moderately severe febrile diarrhea with fecal leukocytes or gross blood, consider an empirical antibiotic trial.
  • A – Associated Symptoms: Pay attention to associated symptoms like fever and severe abdominal pain.


Dr. Arin Nandi

Passionate About Medical Science & Helping Future Doctors Achieve Top Ranks In Medical Exams. He is professionally a dentist as well as a public health expert from JIPMER (1), (2)working in health department