Acute diarrhea outpatient triage
Primary care triage for acute diarrhea with dehydration, infection severity, and escalation boundaries.
Last reviewed February 7, 2026
Red flags
- Severe dehydration, hypotension, confusion, or inability to maintain oral intake.
- Bloody diarrhea with systemic toxicity or severe persistent abdominal pain.
- Immunocompromised status with rapidly progressive symptoms.
Assessment priorities
- Define stool frequency/severity, blood presence, fever, and dehydration burden.
- Review travel, food exposure, recent antibiotics, and immunocompromise.
- Identify high-risk host factors requiring lower threshold for escalation.
Initial management
- Prioritize oral rehydration, electrolyte replacement, and supportive care.
- Use selective stool testing for severe illness, immunocompromise or symptoms lasting more than 7 days; confirm available testing with the local laboratory.
- Avoid routine empiric antibiotics; suspected/confirmed Shiga toxin-producing E. coli requires prompt assessment and avoidance of antibiotics and antimotility medicines.
Follow-up and escalation
- Reassess early if symptoms fail to improve within expected interval.
- Escalate for worsening dehydration, bleeding, or signs of systemic instability.
- Provide explicit return precautions and infection-control counseling.
References
- BC Guidelines Infectious diarrhea investigation (2022) (opens in a new tab)
- Emergency Care BC Oral rehydration for adults (2020) (opens in a new tab)
- IDSA Infectious diarrhea guideline (2017; US guidance) (opens in a new tab)
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