Family practitioner's guide to patient self-treatment of acute diarrhea

The majority of cases of acute, nonspecific diarrhea are of short duration, can be treated symptomatically with nonprescription medications and adequate hydration, and do not require a visit to the physician's office. If the family practitioner can determine via telephone that the patient, or the caller's child, is not experiencing certain signs and symptoms often associated with diarrheal illness that may indicate a more severe condition (e.g., high fever, vomiting, persistent diarrhea, or diarrhea accompanied by blood or severe abdominal or rectal pain), self-treatment may be allowed without an office visit. In addition, if the physician determines that the patient is not suffering from diarrheal dehydration, indicated by dry mouth, excessive thirst (or for children, inadequate fluid intake), wrinkled skin, little or no urination, dizziness, or lightheadedness, the physician may also allow the patient to be treated without an office visit. If, however, the patient is experiencing any of these symptoms, an office visit is required to facilitate further evaluation by the physician.