Why gastrointestinal complaints are challenging

Abdominal pain, nausea, vomiting, and diarrhea are among the most common urgent-care presentations. They are also among the least anatomically specific. Myocardial infarction, lower-lobe pneumonia, diabetic ketoacidosis, testicular torsion, ectopic pregnancy, pyelonephritis, and medication toxicity can all present as “stomach problems.” Early appendicitis, bowel ischemia, or obstruction may initially have subtle examination findings.

The goal is not to prove that every patient has a benign diagnosis. The urgent-care clinician must determine whether outpatient management is reasonably safe, whether time-sensitive imaging or laboratory evaluation is required, and whether the patient needs a higher level of care.

Begin with stability and disposition

Obtain a complete set of vital signs and assess appearance, mental status, perfusion, hydration, respiratory effort, and ability to sit or walk comfortably. Repeat abnormal vital signs rather than dismissing them as pain or anxiety.

Emergency evaluation is generally appropriate for:

• Hemodynamic instability, syncope, altered mental status, sepsis, or shock
• Rigid abdomen, involuntary guarding, rebound, diffuse peritoneal findings, or rapidly progressive pain
• Severe pain out of proportion to the examination, especially with vascular risk
• Hematemesis, coffee-ground emesis, melena, maroon stool, or significant hematochezia with instability, anemia symptoms, anticoagulation, or ongoing bleeding
• Persistent bilious or feculent emesis, marked distention, obstipation, or suspected obstruction
• Sudden severe chest, epigastric, abdominal, back, or flank pain concerning for acute coronary syndrome, aortic catastrophe, perforation, pancreatitis, or ischemia
• Positive pregnancy test with pain, bleeding, syncope, shoulder pain, or ectopic-pregnancy concern
• Severe dehydration, acute kidney injury concern, major electrolyte disturbance, inability to tolerate oral fluids, or failed oral rehydration
• Jaundice with fever, right-upper-quadrant pain, hypotension, or altered mental status
• Severe focal pain with fever or progressive tenderness concerning for appendicitis, cholecystitis, diverticulitis, or another surgical process
• Toxic appearance, bloody diarrhea with severe pain, suspected hemolytic uremic syndrome, or severe disease in an immunocompromised patient
• Testicular pain, absent cremasteric reflex, high-riding testis, or torsion concern
• Significant abdominal trauma, pulsatile mass, or gastrointestinal foreign body with obstruction or perforation risk

Normal vital signs do not exclude serious disease. Older adults, pregnant patients, immunocompromised patients, and those taking beta blockers or antipyretics may have muted responses.

Use anatomy—but do not be trapped by it

Pain location helps organize the differential, but visceral pain may be poorly localized, migrate, or be referred.

• Epigastric: Gastritis, peptic ulcer disease, pancreatitis, biliary disease, acute coronary syndrome, aortic disease
• Right upper quadrant: Biliary colic, cholecystitis, cholangitis, hepatitis, hepatic congestion, lower-lobe pneumonia
• Left upper quadrant: Gastric disease, pancreatitis, splenic pathology, renal disease, lower-lobe pneumonia
• Periumbilical: Early appendicitis, gastroenteritis, small-bowel disease, mesenteric ischemia, aortic pathology
• Right lower quadrant: Appendicitis, ileitis, ovarian torsion, ectopic pregnancy, pelvic inflammatory disease, ureteral stone, hernia
• Left lower quadrant: Diverticulitis, colitis, constipation, ovarian or urinary pathology, hernia
• Suprapubic: Cystitis, retention, pelvic inflammatory disease, pregnancy-related disease, uterine or ovarian pathology
• Diffuse: Gastroenteritis, obstruction, peritonitis, metabolic disease, toxic ingestion, ischemia, constipation

Always consider extra-abdominal sources and diagnoses involving reproductive or genitourinary organs when anatomy and symptoms overlap.

Focused history

Pain analysis

Use onset, location, duration, character, aggravating and relieving factors, radiation, timing, severity, and associated symptoms. Ask whether pain began suddenly at maximal intensity, migrated, followed eating, worsens with movement, or is colicky versus constant. Pain severity alone does not determine acuity, but a sudden or disproportionate pattern changes risk.

Vomiting

Clarify frequency, volume, ability to retain liquids, and whether emesis is bloody, coffee-ground, bilious, feculent, or projectile. Ask whether pain preceded vomiting or followed it. Determine urine output and orthostatic symptoms. Consider pregnancy, cannabis use, migraine, medication effects, obstruction, metabolic disease, and intracranial pathology—not only gastroenteritis.

Diarrhea

Define stool frequency, duration, volume, and whether stool is watery, greasy, bloody, mucoid, black, or pale. Ask about fever, tenesmus, severe cramps, vomiting, weight loss, nocturnal symptoms, travel, untreated water, sick contacts, restaurants, shared meals, animals, sexual exposures, childcare, healthcare work, institutional residence, and outbreaks.

Review antibiotics and healthcare exposure for Clostridioides difficile risk. Ask whether the patient works with food, patients, children, or vulnerable populations because infection-control and reporting requirements may affect work restrictions.

Bleeding

Clarify color, quantity, recurrence, clots, whether blood coats the stool or is mixed within it, and associated pain. Ask about melena, hematemesis, epistaxis, iron or bismuth use, anticoagulants, antiplatelets, NSAIDs, alcohol, liver disease, prior ulcer or varices, inflammatory bowel disease, diverticular disease, and previous endoscopy.

Do not assume bright red blood is hemorrhoidal or that dark stool is melena without examining the context. Brisk upper-GI bleeding can cause hematochezia.

Pregnancy and pelvic history

For patients with pregnancy potential, ask last menstrual period, contraception, pregnancy possibility, bleeding, discharge, pelvic pain, fertility treatment, and prior ectopic pregnancy. History alone cannot reliably exclude pregnancy. A pregnancy test is often a pivotal abdominal-pain test because it changes the differential, imaging, medications, and disposition.

Medical, surgical, and medication history

Prior abdominal surgery increases obstruction and adhesion risk. Review gallstones, pancreatitis, ulcers, GI bleeding, inflammatory bowel disease, diverticulitis, liver disease, vascular disease, diabetes, renal disease, malignancy, immune compromise, and abdominal aortic aneurysm risk.

Ask about GLP-1 receptor agonists, NSAIDs, anticoagulants, antibiotics, metformin, opioids, laxatives, iron, supplements, alcohol, cannabis, and possible toxic ingestion. Record the last dose and recent changes.

Focused physical examination

General and hydration assessment

Assess alertness, mucous membranes, tears in children, capillary refill, pulse quality, skin temperature, urine output, and orthostatic symptoms. Orthostatic measurements may support volume depletion but do not independently prove or exclude it.

Abdominal examination

Inspect for distention, scars, hernias, bruising, visible masses, and respiratory splinting. Auscultation may provide context, but bowel sounds are neither sensitive nor specific enough to rule in or out obstruction.

Palpate gently, beginning away from the painful area. Document location and severity of tenderness, guarding, rigidity, rebound when appropriate, mass, hepatosplenomegaly, and costovertebral-angle tenderness. Observe pain with movement, coughing, getting onto the table, or heel strike, but do not use a single maneuver to exclude appendicitis or peritonitis.

Named signs—Murphy, McBurney, Rovsing, psoas, obturator, and Carnett—can refine a differential but are not standalone diagnostic tests. A reassuring early examination may evolve; trajectory and follow-up matter.

Additional examinations

Examine the heart and lungs when upper-abdominal symptoms, dyspnea, fever, or older age make cardiopulmonary disease plausible. Inspect for jaundice, pallor, rash, bruising, and chronic liver-disease signs.

Rectal, pelvic, or testicular examination should be performed when it answers a relevant question and the setting permits privacy, consent, and chaperoning. Do not omit emergency referral merely because an intimate examination cannot be completed safely or comfortably in urgent care.

Abdominal pain: dangerous patterns and common mimics

Appendicitis

Appendicitis may begin as vague periumbilical discomfort and later localize to the right lower quadrant, but classic migration is not universal. Anorexia, nausea, fever, and focal tenderness support the diagnosis. Diarrhea, urinary symptoms, pregnancy, older age, or atypical appendix position can obscure it.

No isolated score, white count, or examination finding safely excludes appendicitis in every patient. Progressive focal pain, peritoneal findings, persistent vomiting, fever, or diagnostic uncertainty with limited imaging access should lower the threshold for emergency evaluation.

Biliary disease

Biliary colic typically causes episodic right-upper-quadrant or epigastric pain, often after food, without persistent systemic inflammation. Prolonged pain, fever, focal Murphy-type tenderness, leukocytosis, or worsening illness raises concern for acute cholecystitis. Jaundice, fever, and right-upper-quadrant pain suggest cholangitis; hypotension or altered mental status indicates severe disease.

Ultrasound is generally the initial imaging modality for suspected gallbladder disease. Urgent care should not rely on a normal point-of-care urinalysis or transient response to analgesics to exclude biliary pathology.

Pancreatitis

Acute pancreatitis commonly causes persistent epigastric pain that may radiate to the back, with nausea and vomiting. Gallstones and alcohol are frequent causes, but medications, hypertriglyceridemia, procedures, and other etiologies occur. Diagnosis generally requires appropriate laboratory testing and sometimes imaging; severity cannot be determined by pain alone. Suspected pancreatitis usually warrants emergency or hospital-level evaluation for fluid status, organ dysfunction, biliary obstruction, and complications.

Obstruction and perforation

Prior surgery, hernia, malignancy, inflammatory disease, and severe constipation can predispose to obstruction. Colicky pain, distention, vomiting, and inability to pass stool or flatus are concerning. Bilious or feculent emesis, peritoneal signs, fever, tachycardia, or continuous pain may indicate strangulation, ischemia, or perforation.

Free air or obstruction may not be excluded by a single plain radiograph. The American College of Radiology lists CT abdomen and pelvis as usually appropriate for many adults with acute nonlocalized abdominal pain, while ultrasound or MRI may be preferred in selected populations and clinical questions.[1]

Mesenteric ischemia and vascular emergencies

Mesenteric ischemia should be considered when severe pain is disproportionate to early examination findings, especially with atrial fibrillation, diffuse atherosclerosis, low-flow states, hypercoagulability, or older age. Lactate can be normal early and should not be used as a rule-out test. Rapid emergency imaging and surgical or vascular consultation are required.

Sudden abdominal or back pain, syncope, hypotension, pulsatile mass, or known aneurysm raises concern for aortic catastrophe. Do not delay transfer for outpatient testing.

Extra-abdominal and metabolic causes

Lower-lobe pneumonia, acute coronary syndrome, pericarditis, pyelonephritis, renal colic, diabetic ketoacidosis, adrenal crisis, hypercalcemia, porphyria, sickle-cell complications, herpes zoster, abdominal wall pain, and medication toxicity may mimic primary GI disease.

Obtain glucose when vomiting, dehydration, altered mental status, polyuria, diabetes, or toxic appearance is present. Ketonuria can occur with fasting and does not by itself diagnose diabetic ketoacidosis; interpret it with glucose, acid-base status, electrolytes, and the clinical picture.

Nausea and vomiting

Symptom control is appropriate only after assessing the cause and disposition. An antiemetic response does not prove benign disease. Before prescribing, consider pregnancy, QT prolongation, electrolyte abnormalities, sedation, extrapyramidal effects, interactions, age, and renal or hepatic function.

Perform an oral-fluid challenge only when the patient is stable and obstruction, surgical abdomen, aspiration risk, and severe metabolic disease are not suspected. A successful challenge supports outpatient hydration but does not erase focal tenderness or another red flag.

Cannabinoid hyperemesis syndrome should be considered with recurrent stereotyped vomiting, frequent cannabis exposure, prior negative evaluations, and relief with hot bathing. It remains a diagnosis of pattern and exclusion; pregnancy, obstruction, pancreatitis, infection, and metabolic causes still require consideration. Sustained cannabis cessation is the definitive preventive intervention.

Acute diarrhea and suspected foodborne illness

Most acute watery diarrhea in otherwise healthy patients is self-limited. The priority is hydration, exposure assessment, and recognition of inflammatory or systemic illness.

IDSA recommends stool testing for pathogens including Salmonella, Shigella, Campylobacter, Yersinia, C. difficile, and Shiga toxin-producing Escherichia coli when diarrhea is accompanied by fever, bloody or mucoid stool, severe cramping or tenderness, or signs of sepsis.[2] Testing is usually unnecessary for uncomplicated short-duration watery diarrhea.

Rehydration

Reduced-osmolarity oral rehydration solution is first-line for mild-to-moderate dehydration across age groups. Oral rehydration works because sodium-glucose cotransport remains functional during most diarrheal illnesses. Severe dehydration, shock, altered mental status, ileus, or failed oral therapy requires isotonic intravenous fluids and a higher level of care.[2]

Encourage continued breastfeeding and age-appropriate nutrition after rehydration rather than prolonged fasting. Sports drinks, juice, and soda may contain excessive sugar and inadequate electrolyte composition for significant losses.

Antibiotic and antimotility safeguards

Empiric antibiotics are not appropriate for most uncomplicated watery diarrhea and can cause adverse effects, promote resistance, and increase C. difficile risk. In suspected Shiga toxin-producing infection, certain antibiotics may increase the risk of hemolytic uremic syndrome; obtain appropriate testing and use current specialist or public-health guidance.

Avoid antimotility agents in patients with bloody diarrhea, high fever, suspected invasive infection, toxic megacolon, or severe colitis. Medication decisions in children require age-specific guidance. Persistent diarrhea, immune compromise, recent antibiotics, travel, outbreak involvement, or occupational risk may require targeted testing and public-health coordination.

Gastrointestinal bleeding

Upper-GI patterns

Hematemesis, coffee-ground emesis, and melena suggest an upper source, but presentation varies. Assess airway, perfusion, orthostatic symptoms, ongoing bleeding, liver disease, anticoagulation, NSAIDs, prior ulcer, and variceal risk. A single normal hemoglobin early in acute blood loss can be misleading.

The Glasgow-Blatchford score can help identify very-low-risk upper-GI bleeding in appropriately evaluated emergency-department patients, but it requires laboratory and clinical data and is not a substitute for stabilization. ACG guidance suggests that patients with a score of 0–1 may be candidates for discharge with outpatient follow-up; other patients commonly require hospital evaluation and endoscopy.[3]

Lower-GI patterns

Hematochezia can result from hemorrhoids, fissures, diverticular bleeding, colitis, malignancy, ischemia, or brisk upper-GI bleeding. Painful bleeding after defecation with a visible fissure differs from painless large-volume bleeding, but benign anorectal findings do not automatically explain anemia, weight loss, altered bowel habits, older age, or ongoing blood loss.

The updated ACG lower-GI bleeding guideline emphasizes risk stratification, selective anticoagulant reversal for life-threatening bleeding, and CT angiography for selected severe ongoing bleeding.[4] These are hospital-level decisions. Urgent care should identify instability, quantify risk, avoid false reassurance, and arrange timely escalation.

Do not advise a patient to stop anticoagulant or antiplatelet therapy reflexively; balance bleeding and thrombosis risks with the prescribing or emergency team.

Anorectal complaints

Hemorrhoids and fissures

External thrombosed hemorrhoids may cause acute focal perianal pain and a tender bluish lump. Internal hemorrhoids more often cause painless bright-red bleeding. Anal fissures typically cause sharp pain during and after defecation with small-volume bleeding.

Conservative care may include stool-softening strategies, fiber, fluids, sitz baths, and appropriate analgesia. Procedure timing and selection for thrombosed hemorrhoids depend on symptom duration, severity, anticoagulation, pregnancy, clinician competence, and patient preference. Persistent bleeding, anemia, atypical lesions, weight loss, or altered bowel habits requires further evaluation.

Perirectal abscess and Fournier gangrene

Deep anorectal abscess may cause severe pain with few external findings. Fever, fluctuance, drainage, pain with sitting or defecation, diabetes, Crohn disease, and immune compromise increase concern. Perirectal abscess often needs surgical drainage beyond routine office incision.

Pain out of proportion, rapidly progressive perineal swelling, crepitus, bullae, ecchymosis, necrosis, or systemic toxicity suggests Fournier gangrene. This is a surgical emergency requiring immediate hospital care, broad-spectrum intravenous antibiotics, and debridement.

Diagnostic testing in urgent care

Order tests because the result can change management or disposition.

• Pregnancy test: Often essential in patients with pregnancy potential and abdominal, pelvic, vomiting, or bleeding complaints.
• Urinalysis: May identify urinary clues or dehydration, but pyuria, blood, ketones, bilirubin, or concentrated urine must be interpreted in context. Appendicitis can cause sterile pyuria.
• Glucose: Important in vomiting, dehydration, altered mental status, diabetes symptoms, and toxic appearance.
• CBC: May support anemia, infection, or hematologic complications but cannot independently exclude bleeding or surgical disease.
• Electrolytes, renal and hepatic tests: Useful for significant vomiting, diarrhea, dehydration, jaundice, medication safety, and systemic illness.
• Lipase: Appropriate when pancreatitis is clinically suspected; indiscriminate screening can produce confusing minor elevations.
• Stool testing: Reserve for inflammatory features, severe disease, immune compromise, prolonged illness, outbreak or public-health needs, recent antibiotics, or management-changing exposures.[2]
• ECG and troponin: Consider for epigastric or upper-abdominal symptoms when acute coronary syndrome is plausible.
• Imaging: Match to the suspected diagnosis, age, pregnancy, body habitus, and local capability. Limited urgent-care imaging should lower—not raise—the threshold for transfer when time-sensitive disease is possible.

Treatment principles and safeguards

Analgesia

Treat pain while continuing diagnostic evaluation. Analgesia does not reliably “mask” a surgical abdomen when the patient is reassessed appropriately. Avoid NSAIDs when GI bleeding, ulcer disease, kidney injury, significant dehydration, anticoagulation, or pregnancy-related contraindications are relevant.

Antiemetics

Choose based on patient-specific risks. Review QT-prolonging drugs and electrolyte disturbance, sedation, driving, extrapyramidal reactions, pregnancy considerations, and pediatric weight. A take-home antiemetic should accompany clear instructions that symptom suppression does not replace reevaluation for worsening or focal pain.

Acid suppression

An empiric acid-suppression trial may be reasonable for selected stable dyspeptic or reflux-like presentations without alarm features. It is not appropriate as reassurance for GI bleeding, progressive dysphagia, persistent vomiting, anemia, weight loss, palpable mass, jaundice, or concerning chest or abdominal pain.

Constipation

Before recommending laxatives, evaluate for obstruction, impaction, medication causes, neurologic disease, severe pain, vomiting, bleeding, weight loss, and new-onset symptoms in a high-risk patient. Avoid stimulant escalation in suspected obstruction. Long-term management typically emphasizes fiber when appropriate, hydration, activity, medication review, and osmotic therapy tailored to the patient.

Disposition and follow-up

Outpatient care is most defensible when the patient is stable, has no peritoneal signs or major red flags, can tolerate fluids, has a plausible low-risk diagnosis, can obtain medication, and has reliable reassessment.

Provide a specific follow-up interval rather than “as needed.” Uncertain abdominal pain often warrants reassessment within 12–24 hours, sooner if worsening. Vomiting, diarrhea, or presumed gastroenteritis may require review if oral intake declines, urine output falls, fever persists, blood appears, or symptoms fail to follow the expected course.

Immediate emergency precautions should include:

• Fainting, confusion, weakness, chest pain, dyspnea, or new instability
• Severe, localized, rapidly worsening, or disproportionate pain
• Rigid abdomen, pain with movement, or increasing distention
• Bloody or coffee-ground emesis, black stool, maroon stool, or significant rectal bleeding
• Inability to keep down fluids, minimal urination, or worsening dizziness
• Bilious or feculent vomiting or inability to pass stool and gas
• Fever with jaundice, severe focal tenderness, or toxic appearance
• Positive pregnancy test with pain, bleeding, syncope, or shoulder pain
• Testicular pain or swelling
• Bloody diarrhea with reduced urine, pallor, bruising, or marked fatigue

Documentation that demonstrates reasoning

Document:

• Onset, progression, location, migration, associated symptoms, exposures, medications, and surgical history
• Pregnancy possibility and testing when relevant
• Vital signs, appearance, hydration, perfusion, mental status, and oral tolerance
• Abdominal inspection and location-specific palpation findings
• Relevant cardiopulmonary, flank, skin, pelvic, rectal, or testicular findings
• Dangerous diagnoses considered and evidence for or against them
• Tests performed, limitations, and how results changed management
• Medication choices, contraindication screening, and response to treatment
• Repeat abdominal examination and repeat vital signs when performed
• Disposition rationale, follow-up interval, and exact return precautions

Example medical-decision-making language

Patient is hemodynamically stable, nontoxic, adequately perfused, and tolerating oral fluids. Abdomen is soft and nondistended with mild diffuse tenderness but no focal right-lower-quadrant or right-upper-quadrant tenderness, involuntary guarding, rigidity, rebound, or palpable mass. Current presentation favors an uncomplicated self-limited gastrointestinal illness. Appendicitis, cholecystitis, pancreatitis, obstruction, perforation, GI bleeding, pregnancy-related emergency, and metabolic disease were considered but are not supported by the present history, examination, and available testing. Because early abdominal disease can evolve, follow-up is arranged and emergency precautions were reviewed for focal or worsening pain, persistent vomiting, bleeding, fever, syncope, reduced urine output, or inability to hydrate.

Adapt this language to the actual encounter; never document findings that were not assessed.

Coding considerations

Common ICD-10-CM examples include:

• R10.9 — Unspecified abdominal pain
• R10.31 — Right lower-quadrant pain
• R10.11 — Right upper-quadrant pain
• R11.2 — Nausea with vomiting, unspecified
• R19.7 — Diarrhea, unspecified
• K52.9 — Noninfective gastroenteritis and colitis, unspecified
• K92.0 — Hematemesis
• K92.1 — Melena
• K62.5 — Hemorrhage of anus and rectum
• K64.9 — Hemorrhoids, unspecified
• K59.00 — Constipation, unspecified

Code the diagnosis supported at the conclusion of the encounter rather than an unconfirmed high-risk differential. Greater specificity for location, cause, acuity, complications, and infectious organism should be used when supported. Verify the current ICD-10-CM set.

Potential CPT reporting may include evaluation-and-management services, point-of-care urinalysis or pregnancy testing, glucose, selected laboratory testing, ECG, hydration, and procedures actually performed. Coding depends on medical necessity, documentation, supervision, bundling, supplies, and payer policy. Verify current descriptors rather than relying on a short educational list.

Clinical pearls

• “Gastroenteritis” is a conclusion, not a substitute for an abdominal differential.
• Repeat abnormal vital signs and repeat the abdominal examination after treatment.
• A normal early examination does not eliminate evolving appendicitis.
• Pain out of proportion is a vascular warning.
• A normal early hemoglobin does not exclude acute GI bleeding.
• Bright-red rectal bleeding can still come from a brisk upper-GI source.
• Pregnancy testing changes the diagnostic map.
• Ketones in urine may reflect fasting; interpret them with glucose and acid-base status.
• A successful oral challenge does not erase focal tenderness or peritoneal findings.
• Colored diarrhea, odor, or a suspected meal rarely identifies the pathogen reliably.
• Oral rehydration solution is treatment, not simply “drink more water.”
• Avoid antimotility drugs in bloody or inflammatory diarrhea.
• Antibiotics are unnecessary—and sometimes harmful—in many diarrheal illnesses.
• Benign anorectal findings should not automatically explain anemia or persistent bleeding.
• When urgent care cannot obtain the time-sensitive imaging the differential requires, transfer is part of the diagnostic plan.

Conclusion

Safe urgent-care gastrointestinal care is built on pattern recognition plus disciplined uncertainty. First assess stability, hydration, bleeding, pregnancy possibility, obstruction, peritoneal irritation, and vascular risk. Then localize the complaint, use targeted testing, treat symptoms without allowing improvement to create false reassurance, and define the reassessment plan.

Most uncomplicated vomiting and diarrhea improve with oral rehydration, nutrition, and time. The central skill is identifying the patient who does not fit that pathway: the patient with evolving focal tenderness, ongoing bleeding, inability to hydrate, severe metabolic disturbance, pregnancy-related risk, obstruction, ischemia, sepsis, or another threat that requires emergency imaging, consultation, or hospital care.

References

1. American College of Radiology. ACR Appropriateness Criteria: acute nonlocalized abdominal pain [Internet]. Reston (VA): American College of Radiology [cited 2026 Aug 14]. Available from: https://acsearch.acr.org/docs/69467/Narrative/
2. Shane AL, Mody RK, Crump JA, Tarr PI, Steiner TS, Kotloff K, et al. 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea. Clin Infect Dis. 2017;65(12). doi:10.1093/cid/cix669. Available from: https://www.idsociety.org/practice-guideline/infectious-diarrhea/
3. Laine L, Barkun AN, Saltzman JR, Martel M, Leontiadis GI. ACG clinical guideline: upper gastrointestinal and ulcer bleeding. Am J Gastroenterol. 2021;116(5):899-917. doi:10.14309/ajg.0000000000001245. Available from: https://pubmed.ncbi.nlm.nih.gov/33929377/
4. Sengupta N, Feuerstein JD, Jairath V, Shergill AK, Strate LL, Wong RJ, et al. Management of patients with acute lower gastrointestinal bleeding: an updated ACG guideline. Am J Gastroenterol. 2023;118(2):208-231. doi:10.14309/ajg.0000000000002130. Available from: https://pubmed.ncbi.nlm.nih.gov/36735555/