An approach to diarrhea with emphasis on the irritable bowel syndrome.

Diarrhea is a symptom of a large number of serious organic illnesses, but it is also a cardinal symptom of the irritable bowel syndrome (IBS). A complete history and physical examination will narrow the etiologic possibilities greatly, as will a few routine screening tests. If the symptom seems to be caused by IBS, a combination of dietary manipulation and advice about psychologic factors should be tried, prior to the use of medications. Particularly refractory cases or those in which there is doubt concerning the diagnosis should be referred to a specialist for further assessment and management.