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When and What to Test for Diarrhea: Focus on Stool Testing
1Division of Gastroenterology and Hepatology, Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Mayo Clinic, Rochester, Minnesota, USA .
The American Journal of Gastroenterology
|October 31, 2024
Summary
Stool diagnostic tests are crucial for identifying infectious causes of acute diarrhea and specific conditions in chronic diarrhea. Advanced fecal tests are recommended for improved gastroenterological diagnosis and treatment.
Area of Science:
- Gastroenterology
- Clinical Diagnostics
- Microbiology
Background:
- Diarrhea diagnosis relies on various stool tests.
- Acute and chronic diarrhea have distinct diagnostic approaches.
Purpose of the Study:
- To review stool diagnostic tests for acute and chronic diarrhea.
- To highlight the relevance of fecal testing in gastroenterology.
Main Methods:
- Narrative review of published literature.
- Analysis of diagnostic indications and available tests.
Main Results:
- Acute diarrhea: Stool tests indicated for suspected infections (e.g., Clostridioides difficile) or prolonged symptoms.
- Rapid tests offer quick results for bacterial, viral, or protozoal infections.
- Chronic diarrhea: Focus on inflammatory, fatty, osmotic, or secretory causes, including irritable bowel syndrome.
- Recommended tests for chronic diarrhea include Giardia, calprotectin, fecal immunochemical test, and bile acid diarrhea tests.
- Biochemical analyses differentiate diarrhea types and detect laxative abuse.
Conclusions:
- Fecal testing remains highly relevant in gastroenterology.
- Introduction of advanced microbiological and biochemical stool tests is warranted.
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