The evaluation and management of diarrhea can be a challenging problem for primary care physicians. The differential diagnosis is large and the multiplicity of diagnostic tests makes the evaluation complex. A strategy of taking a thorough history and performing simple objective tests can make the diagnostic process easier. This strategy will often lead to a specific diagnosis that can be treated specifically. When a diagnosis is not proven, however, diarrhea can be managed symptomatically with antidiarrheals such as loperamide. Such an approach improves the quality of life of patients with diarrhea and may mitigate associated symptoms, such as fecal incontinence.