Should endoscopy be considered to evaluate acute infectious diarrhea?
- Endoscopy should not be part of the routine evaluation of acute diarrhea, but can be considered in a select number of situations.
- Endoscopy may be useful to evaluate for IBD in patients with persistent bloody diarrhea and a negative infectious workup who do not respond to empiric therapy.
- When there is a strong suspicion for C. difficile and stool tests are negative or not available, flexible sigmoidoscopy may reveal characteristic pseudomembranes.
- Finally, endoscopy may also be useful for immunocompromised patients to evaluate for CMV colitis, which frequently requires a histologic diagnosis.
