Investigation of chronic diarrhoea

I congratulate the authors of the recently revised ‘‘BSG guidelines for the investigation of diarrhoea’’ for their excellent overview of this important clinical problem.(Gut 2003; 52(suppl V):v1–15). I would however take issue with the suggestion that measurement of stool volumes in outpatients is impractical. In my experience such measurement is readily achievable and cheap, merely requiring a suitable container and some weighing scales. A three day stool collection should be considered early in the investigation of chronic diarrhoea, particularly if a factitious aetiology is suspected which is unfortunately often underdiagnosed and over investigated.