The physical examination in acute diarrhea is helpful in determining the severity of disease and hydration status. A directed physical examination may lead to a more focused evaluation. Vital signs (including temperature and orthostatic evaluation of pulse and blood pressure) and signs of volume depletion (including dry mucous membranes, decreased skin turgor, and confusion) should be carefully evaluated. A careful abdominal examination, to evaluate for tenderness and distention, and a stool examination to evaluate for grossly bloody stools are warranted. Nonbloody stools should be evaluated for heme positivity.