Chronic diarrhea laboratory findings: Difference between revisions
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==Overview== | ==Overview== | ||
The laboratory findings in chronic [[diarrhea]] include [[complete blood count]] to evaluate for [[anemia]] and abnormal [[white blood cell count]], [[Electrolyte|electrolytes]], [[Thyroid function tests|thyroid function tests,]] [[Serological testing|serology testing]] for [[celiac disease]], and [[Stool examination|stool analysis]] for [[Fecal occult blood|fecal leukocytes]], fecal [[lactoferrin]], and [[Fecal occult blood|fecal occult blood.]] | |||
==Laboratory Findings== | ==Laboratory Findings== | ||
===Blood Tests=== | ===Blood Tests=== | ||
Initial laboratory tests should include a complete blood count to evaluate for anemia and an abnormal white blood cell | Initial laboratory tests should include a [[complete blood count]] to evaluate for [[anemia]] and an abnormal [[White blood cell count|white blood cell coun]]<nowiki/>t, as well as [[Electrolyte|electrolytes]], [[thyroid function tests]], and [[Serology|serology testing]] for [[Celiac disease|celiac disease.]]<ref name="FineSchiller1999">{{cite journal|last1=Fine|first1=K|last2=Schiller|first2=L|title=AGA Technical Review on the Evaluation and Management of Chronic Diarrhea☆|journal=Gastroenterology|volume=116|issue=6|year=1999|pages=1464–1486|issn=00165085|doi=10.1016/S0016-5085(99)70513-5}}</ref><ref>{{cite journal|title=American Gastroenterological Association medical position statement: Guidelines for the evaluation and management of chronic diarrhea☆, ☆☆|journal=Gastroenterology|volume=116|issue=6|year=1999|pages=1461–1463|issn=00165085|doi=10.1016/S0016-5085(99)70512-3}}</ref><ref name="pmid15017602">{{cite journal| author=Camilleri M| title=Chronic diarrhea: a review on pathophysiology and management for the clinical gastroenterologist. | journal=Clin Gastroenterol Hepatol | year= 2004 | volume= 2 | issue= 3 | pages= 198-206 | pmid=15017602 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15017602 }} </ref><ref name="pmid10699778">{{cite journal| author=Fine KD, Seidel RH, Do K| title=The prevalence, anatomic distribution, and diagnosis of colonic causes of chronic diarrhea. | journal=Gastrointest Endosc | year= 2000 | volume= 51 | issue= 3 | pages= 318-26 | pmid=10699778 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10699778 }} </ref> | ||
===Stool Analysis=== | ===Stool Analysis=== | ||
*Fecal leukocytes | *'''Fecal leukocytes''': The presence of [[white blood cells]] in the stool has a [[Sensitivity (tests)|sensitivity]] of 70% and a [[Specificity (tests)|specificity]] of 50% for detecting [[inflammation]] in studies of [[infectious]] diarrhea. Fecal [[white blood cells]] can be present in both [[infectious colitis]] and [[Inflammatory bowel disease|inflammatory bowel diseases]] such as [[ulcerative colitis]], [[Crohn's disease]], and [[microscopic colitis]]. | ||
* | *'''Fecal occult blood''': The [[Sensitivity (tests)|sensitivity]] and [[Specificity (tests)|specificity]] of [[Stool guaiac test|stool guaiac]] cards for detecting [[inflammatory]] or [[neoplastic]] causes of [[diarrhea]] have not been studied. | ||
*'''Osmotic gap''': Measuring stool [[potassium]] and [[Sodium|sodium concentrations]] can determine the [[Osmotic|stool osmotic gap]]. For secretory [[diarrhea]], the osmotic gap is less than 50 mOsm/kg. In osmotic [[diarrhea]], the osmotic gap is greater than 50 mOsm/kg. | |||
* | |||
Measuring stool potassium and sodium concentrations can determine the stool osmotic gap. For secretory diarrhea, the osmotic gap is less than 50 mOsm/kg. In osmotic diarrhea, the osmotic gap is greater than 50 mOsm/kg | |||
==References== | ==References== | ||
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[[Category:Emergency medicine]] | |||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | |||
[[Category:Gastroenterology]] | |||
[[Category:Pediatrics]] | |||
Latest revision as of 20:57, 29 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omodamola Aje B.Sc, M.D. [2]
Overview
The laboratory findings in chronic diarrhea include complete blood count to evaluate for anemia and abnormal white blood cell count, electrolytes, thyroid function tests, serology testing for celiac disease, and stool analysis for fecal leukocytes, fecal lactoferrin, and fecal occult blood.
Laboratory Findings
Blood Tests
Initial laboratory tests should include a complete blood count to evaluate for anemia and an abnormal white blood cell count, as well as electrolytes, thyroid function tests, and serology testing for celiac disease.[1][2][3][4]
Stool Analysis
- Fecal leukocytes: The presence of white blood cells in the stool has a sensitivity of 70% and a specificity of 50% for detecting inflammation in studies of infectious diarrhea. Fecal white blood cells can be present in both infectious colitis and inflammatory bowel diseases such as ulcerative colitis, Crohn's disease, and microscopic colitis.
- Fecal occult blood: The sensitivity and specificity of stool guaiac cards for detecting inflammatory or neoplastic causes of diarrhea have not been studied.
- Osmotic gap: Measuring stool potassium and sodium concentrations can determine the stool osmotic gap. For secretory diarrhea, the osmotic gap is less than 50 mOsm/kg. In osmotic diarrhea, the osmotic gap is greater than 50 mOsm/kg.
References
- ↑ Fine, K; Schiller, L (1999). "AGA Technical Review on the Evaluation and Management of Chronic Diarrhea☆". Gastroenterology. 116 (6): 1464–1486. doi:10.1016/S0016-5085(99)70513-5. ISSN 0016-5085.
- ↑ "American Gastroenterological Association medical position statement: Guidelines for the evaluation and management of chronic diarrhea☆, ☆☆". Gastroenterology. 116 (6): 1461–1463. 1999. doi:10.1016/S0016-5085(99)70512-3. ISSN 0016-5085.
- ↑ Camilleri M (2004). "Chronic diarrhea: a review on pathophysiology and management for the clinical gastroenterologist". Clin Gastroenterol Hepatol. 2 (3): 198–206. PMID 15017602.
- ↑ Fine KD, Seidel RH, Do K (2000). "The prevalence, anatomic distribution, and diagnosis of colonic causes of chronic diarrhea". Gastrointest Endosc. 51 (3): 318–26. PMID 10699778.