Complaints may range from occasional stool that is not well formed to acute, copious diarrhea that produces profound dehydration and shock. Patients with inflammatory or infectious diarrhea often present with fever, tenesmus (the frequent urge to defecate), abdominal pain, and hemoccult-positive stool. These conditions usually cause a more severe form of diarrhea and require more careful assessment and more aggressive treatment. Noninflammatory diarrhea is usually watery, milder, without significant fever, with only mild abdominal cramping, and without blood or leukocytes in the stool. Nausea and vomiting can occur with both forms of diarrhea (see Chapter 76).