Chronic diarrhea

Chronic diarrhea is a topic covered in the Diagnosaurus.

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DDx

Common

  • Irritable bowel syndrome, lactase deficiency, parasites, caffeine, alcohol, laxative abuse
Osmotic
  • Lactase deficiency
  • Medications: antacids, lactulose, sorbitol, Olestra
  • Factitious: magnesium-containing antacids or laxatives
Secretory
  • Hormonal: Zollinger-Ellison syndrome (gastrinoma), carcinoid, VIPoma, medullary thyroid carcinoma
  • Laxative abuse: phenolphthalein, cascara, senna
  • Villous adenoma
  • Medications
Inflammatory conditions
  • Inflammatory bowel disease
  • Microscopic colitis (lymphocytic or collagenous)
  • Cancer with obstruction and pseudodiarrhea
  • Radiation colitis
Malabsorption
  • Small bowel: celiac sprue, Whipple's disease, tropical sprue, eosinophilic gastroenteritis, small bowel resection, Crohn's disease
  • Lymphatic obstruction: lymphoma, carcinoid, tuberculosis, Mycobacterium avium complex (MAC), Kaposi's sarcoma, sarcoidosis, retroperitoneal fibrosis
  • Pancreatic insufficiency: chronic pancreatitis, cystic fibrosis, pancreatic cancer
  • Bacterial overgrowth, eg, diabetes
  • Reduced bile salts: ileal resection, Crohn's disease, postcholecystectomy
Motility disorders
  • Irritable bowel syndrome
  • Postsurgical: vagotomy, partial gastrectomy, blind loop with bacterial overgrowth
  • Systemic disease: diabetes mellitus, hyperthyroidism, scleroderma
  • Caffeine or alcohol use
Chronic infections
  • Parasites: giardiasis, amebiasis, strongyloidiasis
Other
  • Ischemic colitis
  • Adrenal insufficiency

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Last updated: December 1, 2014

Citation

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TY - ELEC T1 - Chronic diarrhea ID - 114453 A1 - Zeiger,Roni F, Y1 - 2014/12/01/ BT - Diagnosaurus UR - https://emergency.unboundmedicine.com/emergency/view/Diagnosaurus/114453/all/Chronic_diarrhea PB - McGraw-Hill Education ET - 4 DB - Emergency Central DP - Unbound Medicine ER -