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A useful clinical classification of chronic diarrhea is based on the character of the stool--watery, fatty or bloody. Pathophysiologic mechanisms include osmotic and secretory diarrheas, bacterial overgrowth leading to excess colonic bile acids and fatty acids, defective anion exchange systems, mucosal damage and abnormal motility and transit. Evaluation may require hospitalization. Antidiarrheal agents are not used. Antibiotics are generally not indicated. Parenteral hydration and feedings of special formulas are carefully monitored.