Chronic diarrhea classification: Difference between revisions
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*Idiopathic [[inflammatory bowel disease]] such as [[Crohn’s disease]] or [[ulcerative colitis]] | *Idiopathic [[inflammatory bowel disease]] such as [[Crohn’s disease]] or [[ulcerative colitis]] | ||
*Infectious diseases such as [[cytomegalovirus]], [[herpes simplex]], [[tuberculosis]], [[strongyloidiasis]], [[Aeromonas]] or [[Plesiomonas shigelloides|Plesiomonas]] | *Infectious diseases such as [[cytomegalovirus]], [[herpes simplex]], [[tuberculosis]], [[strongyloidiasis]], [[Aeromonas]] or [[Plesiomonas shigelloides|Plesiomonas]] | ||
*[[Ischemic colitis]] | *[[Ischemic colitis]] | ||
*[[Radiation colitis]] | *[[Radiation colitis]] | ||
*[[Neoplasia]] | *[[Neoplasia]] | ||
===Watery diarhea=== | ===Watery diarhea=== | ||
Watery diarrhea can be classified as; | Watery diarrhea can be classified as; | ||
*Osmotic diarrhea: this is the more common type however it has a limited differential diagnosis which includes; | *Osmotic diarrhea: this is the more common type however it has a limited differential diagnosis which includes; | ||
**Ingestion of exogenous [[magnesium]] | **Ingestion of exogenous [[magnesium]] | ||
**Carbohydrate [[malabsorption]] | **Carbohydrate [[malabsorption]] | ||
** | **Consumption of poorly absorbable carbohydrates. | ||
*Secretory diarrhea : This is the less common type | *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]] | **[[Aeromonas]] | ||
**[[Plesiomonas shigelloides|Plesiomonas]] | **[[Plesiomonas shigelloides|Plesiomonas]] | ||
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**[[Cryptosporidium]], | **[[Cryptosporidium]], | ||
* Structural and Endocrine diseases should also be considered | * Structural and Endocrine diseases should also be considered. These diseases include the following: | ||
** [[Diabetes]] | ** [[Diabetes]] | ||
** [[Hyperthyroidism]] | ** [[Hyperthyroidism]] | ||
** [[Addison's disease]] | ** [[Addison's disease]] | ||
** Peptide secreting [[endocrine tumors]] | ** Peptide secreting [[endocrine tumors]] | ||
===Fatty diarrhea=== | ===Fatty diarrhea=== | ||
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**[[Pancreatic insufficiency]] | **[[Pancreatic insufficiency]] | ||
**[[Bacterial overgrowth]] | **[[Bacterial overgrowth]] | ||
*Maldigestion; | *Maldigestion; It results from pancreatic exocrine insufficiency. | ||
==References== | ==References== | ||
Revision as of 21:05, 28 June 2017
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Chronic diarrhea Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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 may be classified into 3 basic categories: watery, fatty(malabsorption) and inflammatory (with blood and pus). It is important to note that not all chronic diarrhea falls into one category alone. The differential diagnosis for chronic diarrhea is enormous, with a large number of diagnostic tests available that can be used to evaluate these patients. Classifying the patient with chronic diarrhea into a subcategory helps to direct the diagnostic work-up.
Classification
Chronic diarrhea may be classified into:[1][2][3][4]
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
- 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
- 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;
- Structural and Endocrine diseases should also be considered. These diseases include the following:
- 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
- Maldigestion; It 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.