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  • Causes of Chronic Diarrhea

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    Julita Yanti
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    This document summarizes various causes of chronic diarrhea categorized into osmotic diarrhea, secretory diarrhea, inflammatory conditions, malabsorption syndromes, motility disorders, chronic infections, and factitious diarrhea. Osmotic diarrhea is caused by medications, disaccharidase deficiency, and magnesium while secretory diarrhea results in large stool volumes and is caused by hormonal imbalances, medications, and structural issues. Inflammatory conditions present with symptoms like fever and bleeding and are due to conditions such as colitis, Crohn's disease, and malignancies. Malabsorption syndromes cause weight loss and abnormal labs through damage to the small intestine, lymphatic issues, pancreatic problems, and bacterial overgrowth. Motility disorders follow

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    Causes of chronic diarrhea

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    This document summarizes various causes of chronic diarrhea categorized into osmotic diarrhea, secretory diarrhea, inflammatory conditions, malabsorption syndromes, motility disorders, chronic infections, and factitious diarrhea. Osmotic diarrhea is caused by medications, disaccharidase deficiency, and magnesium while secretory diarrhea results in large stool volumes and is caused by hormonal imbalances, medications, and structural issues. Inflammatory conditions present with symptoms like fever and bleeding and are due to conditions such as colitis, Crohn's disease, and malignancies. Malabsorption syndromes cause weight loss and abnormal labs through damage to the small intestine, lymphatic issues, pancreatic problems, and bacterial overgrowth. Motility disorders follow

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    47 views2 pages

    Causes of Chronic Diarrhea

    Uploaded by

    Julita Yanti
    This document summarizes various causes of chronic diarrhea categorized into osmotic diarrhea, secretory diarrhea, inflammatory conditions, malabsorption syndromes, motility disorders, chronic infections, and factitious diarrhea. Osmotic diarrhea is caused by medications, disaccharidase deficiency, and magnesium while secretory diarrhea results in large stool volumes and is caused by hormonal imbalances, medications, and structural issues. Inflammatory conditions present with symptoms like fever and bleeding and are due to conditions such as colitis, Crohn's disease, and malignancies. Malabsorption syndromes cause weight loss and abnormal labs through damage to the small intestine, lymphatic issues, pancreatic problems, and bacterial overgrowth. Motility disorders follow

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    of 2

    Causes of chronic diarrhea.

    Osmotic diarrhea
      CLUES: Stool volume decreases with fasting; increased stool osmotic gap
        1. Medications: antacids, lactulose, sorbitol
        2. Disaccharidase deficiency: lactose intolerance
        3. Factitious diarrhea: magnesium (antacids, laxatives)
    Secretory diarrhea
      CLUES: Large volume (> 1 L/d); little change with fasting; normal stool osmotic gap
        1. Hormonally mediated: VIPoma, carcinoid, medullary carcinoma of thyroid (calcitonin),
    Zollinger-Ellison syndrome (gastrin)
        2. Factitious diarrhea (laxative abuse); phenolphthalein, cascara, senna
        3. Villous adenoma
        4. Bile salt malabsorption (ileal resection; Crohn's ileitis; postcholecystectomy)
        5. Medications

    Inflammatory conditions
      CLUES: Fever, hematochezia, abdominal pain
        1. Ulcerative colitis
        2. Crohn's disease
        3. Microscopic colitis
        4. Malignancy: lymphoma, adenocarcinoma (with obstruction and pseudodiarrhea)
        5. Radiation enteritis
    Malabsorption syndromes
      CLUES: Weight loss, abnormal laboratory values; fecal fat > 10 g/24h
        1. Small bowel mucosal disorders: celiac sprue, tropical sprue, Whipple's disease,
    eosinophilic gastroenteritis, small bowel resection (short bowel syndrome), Crohn's disease
        2. Lymphatic obstruction: lymphoma, carcinoid, infectious (tuberculosis, MAI), Kaposi's
    sarcoma, sarcoidosis, retroperitoneal fibrosis
        3. Pancreatic disease: chronic pancreatitis, pancreatic carcinoma
        4. Bacterial overgrowth: motility disorders (diabetes, vagotomy), scleroderma, fistulas, small
    intestinal diverticula
    Motility disorders
      CLUES: Systemic disease or prior abdominal surgery
        1. Postsurgical: vagotomy, partial gastrectomy, blind loop with bacterial overgrowth
        2. Systemic disorders: scleroderma, diabetes mellitus, hyperthyroidism
        3. Irritable bowel syndrome
    Chronic infections
        1. Parasites: Giardia lamblia, Entamoeba histolytica 
        2. AIDS-related:
           Viral: Cytomegalovirus, HIV infection (?)
           Bacterial: Clostridium difficile, Mycobacterium avium complex 
           Protozoal: Microsporida (Enterocytozoon bieneusi), Cryptosporidium, Isospora belli 
    Factitious
      See Osmotic and Secretory diarrhea above.
    MAI, Mycobacterium avium-intracellulare.

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