Monitoring
Follow-up testing is not recommended in most patients after resolution of diarrhea. Clinical and laboratory reevaluation may be indicated in patients who did not respond to an initial course of therapy and should include consideration of non-infectious conditions. Non-infectious conditions (eg IBD and IBS) should be considered in patients with symptoms lasting ≥14 days and unidentified sources, and in those with a worsening clinical course unresponsive to management. Further work-up is required for traveler's diarrhea if there is fever or bloody stool. Evaluation for parasitic infection is recommended if diarrhea lasts >14 days. Reassessment of the patient's nutritional status, fluid and electrolyte balance, and optimal dose and duration of antimicrobial therapy is recommended in patients with persistent symptoms. Imaging (eg endoscopy or colonoscopy) may be indicated, and specialist consultation with a gastroenterologist may be beneficial in the evaluation of the patient's worsening status.