Chronic diarrhea classification: Difference between revisions

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Revision as of 16:41, 7 June 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omodamola Aje B.Sc, M.D. [2]

Overview

Chronic diarrhea .^[1]^[2]^[3]^[4]

Classification

Chronic diarrhea may be classified into

Inflammatory diarrhea
Watery diarrhea
Fatty diarrhea

Inflammatory diarrhea

Diarrhea is said to be due to an inflammatory cause when stool analysis such as stool cultures, flexible sigmoidoscopy or colonoscopy with biopsies show evidence of the presence of fecal leukocytes. Causes of inflammatory diarrhea include;

Idiopathic inflammatory bowel disease such as Crohn’s disease or ulcerative colitis
Infectious diseases such as cytomegalovirus, herpes simplex, tuberculosis, strongyloidiasis, Aeromonas or Plesiomonas
Ischemic colitis,
Radiation colitis, and
Neoplasia.

Watery diarhea

Watery diarrhea can be classified as;

Osmotic diarrhea: this is the more common type however it has a limited differential diagnosis which includes;
- Ingestion of exogenous magnesium,
- Carbohydrate malabsorption, or
- consumption of poorly absorbable carbohydrates.

Secretory diarrhea : This is the less common type, the differential diagnosis of secretory diarrhea is quite vast. However, the incidence of these diseases is low. Some of the differentials include but are not limited to;
- Aeromonas
- Plesiomonas
- Microsporidia
- Giardia
- Coccidia
- Cryptosporidium,

Structural and Endocrine diseases should also be considered, including;

- Diabetes
- Hyperthyroidism
- Addison’s disease
- Peptide-secreting endocrine tumors

Fatty diarrhea

Fatty diarrhea can be described either due to malabsorption or maldigestion problems;

Malabsorption; 3 most common causes of malabsorption are
- Celiac sprue
- Pancreatic insufficiency
- Bacterial overgrowth
Maldigestion; Maldigestion results from pancreatic exocrine insufficiency

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.

Template:WH Template:WS

[FineSchiller1999-1] 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.

[2] "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.

[pmid15017602-3] Camilleri M (2004). "Chronic diarrhea: a review on pathophysiology and management for the clinical gastroenterologist". Clin Gastroenterol Hepatol. 2 (3): 198–206. PMID 15017602.

[pmid10699778-4] 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.

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@@ Line 4: / Line 4: @@
 ==Overview==
-Chronic diarrhea may be classified into 3 basic categories:.<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>
+Chronic diarrhea .<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>
-watery, fatty(malabsorption) and inflammatory (with blood and pus). It is important to note that not all chronic diarrhea falls into one category alone.
 ==Classification==