Chronic diarrhea other diagnostic studies
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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
An endoscopic evaluation should be considered if there are persistent symptoms, inconclusive diagnosis, or failure to respond to therapy. Guidelines for the role of endoscopy in the management of patients with diarrhea have been published by the American Society of Gastrointestinal Endoscopy.
Other diagnostic studies
Flexible sigmoidoscopy
Flexible sigmoidoscopy can be used as an initial diagnostic tool in patients with chronic diarrhea who are pregnant or have significant comorbidities where a colonoscopy is contraindicated. Flexible sigmoidoscopy may however be sufficient in the diagnosis as long as biopsy samples are obtained for histologic evaluation even when the mucosa appears normal to rule out causes of chronic diarrhea such as microscopic colitis.[1]
Colonoscopy
Chronic diarrhea can be diagnosed by colonoscopy with biopsy in patients with IBD, microscopic inflammatory disorders, and colorectal neoplasia.[2]
Esophagogastroduodenoscopy
Esophagogastroduodenoscopy (EGD) can be a useful in the evaluation of patients with IBD. Chron's disease can involve the esophagus,[3] stomach,[4] and duodenum.[5] Duodenal biopsies have been found to show more granulomas (40%-68%) than do colon biopsies.
References
- ↑ ASGE Standards of Practice Committee. Shen B, Khan K, Ikenberry SO, Anderson MA, Banerjee S; et al. (2010). "The role of endoscopy in the management of patients with diarrhea". Gastrointest Endosc. 71 (6): 887–92. doi:10.1016/j.gie.2009.11.025. PMID 20346452.
- ↑ Leighton JA, Shen B, Baron TH, Adler DG, Davila R, Egan JV; et al. (2006). "ASGE guideline: endoscopy in the diagnosis and treatment of inflammatory bowel disease". Gastrointest Endosc. 63 (4): 558–65. doi:10.1016/j.gie.2006.02.005. PMID 16564852.
- ↑ Decker GA, Loftus EV, Pasha TM, Tremaine WJ, Sandborn WJ (2001). "Crohn's disease of the esophagus: clinical features and outcomes". Inflamm Bowel Dis. 7 (2): 113–9. PMID 11383583.
- ↑ Kefalas CH (2003). "Gastroduodenal Crohn's disease". Proc (Bayl Univ Med Cent). 16 (2): 147–51. PMC 1201000. PMID 16278730.
- ↑ Wahab PJ, Crusius JB, Meijer JW, Mulder CJ (2001). "Gluten challenge in borderline gluten-sensitive enteropathy". Am J Gastroenterol. 96 (5): 1464–9. doi:10.1111/j.1572-0241.2001.03812.x. PMID 11374684.