Clinical findings

Limited data are available regarding the use of physical findings for making an etiological diagnosis in patients presenting with chronic diarrhea. Among HIV-infected patients, the history and physical examination have been reported not to be helpful in determining whether or not an enteropathogen will be identified, with the exception that abdominal tenderness was commoner in patients with CMV.107 The American Gastroenterological Association has recommended that complete evaluation of persons seeking care for chronic diarrhea include evaluation of fluid balance, nutritional status, presence of flushing or rashes, mouth ulcers, thyroid masses, wheezing, arthritis, cardiac murmurs, hepatomegaly, abdominal masses, ascites, and edema. Attention should be paid during anorectal examination to the anal sphincter tone and the presence of perianal fistula or abscess.100

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