Chapter 76

### Definition

The definition of diarrhea varies within the medical literature, so it is not surprising that patient perception of diarrhea varies as well. Many patients come to the ED complaining of “diarrhea” when what they really have is soft stools or two stools per day compared with their usual one.

Acute diarrhea is the sudden onset of an increase in the normal water content of stool. In general, humans lose approximately 10 mL/kg/d of fluids in stool. The increased water content results in an increased frequency of stools from four to five times daily to >20 bowel movements in a 24-hour period. Strictly speaking, diarrhea is defined as an increased frequency of defecation, usually greater than three bowel movements per day for a daily stool weight exceeding 200 grams.1,2 Practically speaking, however, diarrhea is present when the patient is producing more stools of lesser consistency more frequently.

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