Chronic diarrhea causes: Difference between revisions

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==Overview==
==Overview==
Depending on the socio economic status of the population, chronic diarrhea can be caused by several factors. In a developing nation, the most likely causes of chronic bacteria include; mycobacterial and parasitic infections and less likely to include functional disorders such as malabsorption and inflammatory bowel diseases. In a developed nation however, the most likely cause of diarrhea include; irritable bowel syndrome (IBS), inflammatory bowel disease, malabsorption syndromes (such as lactose intolerance and celiac disease), and chronic infections (particularly in patients who are immunocompromised).
Depending on the socioeconomic status of the [[population]], chronic [[diarrhea]] can be caused by several factors. In a developing nation, the most likely causes of chronic [[diarrhea]] are [[Mycobacterial infection|mycobacterial]] and [[parasitic infections]], while functional disorders such as [[malabsorption]] and [[Inflammatory bowel disease|inflammatory bowel diseases]] are less likely causes. In a developed nation, however, the most likely causes of [[diarrhea]] are [[irritable bowel syndrome]] (IBS), [[inflammatory bowel disease]], [[malabsorption]] syndromes (such as [[lactose intolerance]] and [[celiac disease]]), and chronic [[infections]] (particularly in patients who are [[immunocompromised]]).
 
==Causes==
==Causes==
'''Watery diarrhea'''
===Life threatening causes===
*Osmotic diarrhea
There are no life-threatening causes of chronic [[diarrhea]]; however, complications resulting from untreated chronic [[diarrhea]] are common.
**Mg2+, PO43-, SO42- ingestion
**Carbohydrate malabsorption
*Secretory diarrhea
**Laxative abuse (nonosmotic laxatives)
**Congenital syndromes
**Bacterial toxins
**Ileal bile acid malabsorption
**Inflammatory bowel disease
***Ulcerative colitis
***Crohn’s disease
***Microscopic (lymphocytic and collagenous) colitis
***Diverticulitis
**Vasculitis
**Drugs and poisons
**Disordered motility
***Postvagotomy diarrhea
***Postsympathectomy diarrhea
***Diabetic autonomic neuropathy
***Hyperthyroidism
***Irritable bowel syndrome
**Neuroendocrine tumors
***Gastrinoma
***VIPoma
***Somatostatinoma
***Mastocytosis
***Carcinoid syndrome
***Medullary carcinoma of thyroid
**Neoplasia
***Colon carcinoma
***Lymphoma
***Villous adenoma
**Addison’s disease
**Epidemic secretory diarrhea
**Idiopathic secretory diarrhea
 
'''Fatty diarrhea'''
*Malabsorption syndromes
**Mucosal diseases
**Short-bowel syndrome
**Postresection diarrhea
**Mesenteric ischemia
*Maldigestion
**Pancreatic insufficiency
**Bile acid deficiency


'''Inflammatory diarrhea'''
===Common causes===
*Inflammatory bowel disease
There following are some of the common causes of chronic [[diarrhea]]:<ref name="pmid20417725">{{cite journal| author=Jamma S, Rubio-Tapia A, Kelly CP, Murray J, Najarian R, Sheth S et al.| title=Celiac crisis is a rare but serious complication of celiac disease in adults. | journal=Clin Gastroenterol Hepatol | year= 2010 | volume= 8 | issue= 7 | pages= 587-90 | pmid=20417725 | doi=10.1016/j.cgh.2010.04.009 | pmc=2900539 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20417725  }} </ref><ref name="pmid698649">{{cite journal| author=Manning AP, Thompson WG, Heaton KW, Morris AF| title=Towards positive diagnosis of the irritable bowel. | journal=Br Med J | year= 1978 | volume= 2 | issue= 6138 | pages= 653-4 | pmid=698649 | doi= | pmc=1607467 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=698649  }} </ref><ref name="pmid381094">{{cite journal| author=Mekhjian HS, Switz DM, Melnyk CS, Rankin GB, Brooks RK| title=Clinical features and natural history of Crohn's disease. | journal=Gastroenterology | year= 1979 | volume= 77 | issue= 4 Pt 2 | pages= 898-906 | pmid=381094 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=381094  }} </ref><ref name="pmid16151544">{{cite journal| author=Silverberg MS, Satsangi J, Ahmad T, Arnott ID, Bernstein CN, Brant SR et al.| title=Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a Working Party of the 2005 Montreal World Congress of Gastroenterology. | journal=Can J Gastroenterol | year= 2005 | volume= 19 Suppl A | issue=  | pages= 5A-36A | pmid=16151544 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16151544  }} </ref><ref name="pmid7615277">{{cite journal| author=Veress B, Löfberg R, Bergman L| title=Microscopic colitis syndrome. | journal=Gut | year= 1995 | volume= 36 | issue= 6 | pages= 880-6 | pmid=7615277 | doi= | pmc=1382626 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7615277  }} </ref> 
**Ulcerative colitis
*'''[[Celiac disease|Malabsorption]]'''
**Crohn’s disease
**[[Cystic fibrosis]]
**Diverticulitis
**[[celiac disease|Celiac disease]]
**Ulcerative jejunoileitis
**[[Disaccharidase|Disaccharidase deficiency]]
*Infectious diseases
*'''[[Irritable bowel syndrome]]'''
**Ulcerating viral infections
*[[Inflammatory bowel disease|'''Inflammatory bowel disease''']]
***Cytomegalovirus
**[[Crohn's disease|Crohn disease]]
***Herpes simplex
**[[ulcerative colitis|Ulcerative colitis]]
*Ischemic colitis
* '''[[Microscopic colitis]]'''
*Radiation colitis
*'''Anatomic abnormalities'''
*Neoplasia
**[[Intussusception]]
**Colon cancer
**[[Hirschsprung's disease]] (with and without toxic [[megacolon]])
**Lymphoma
**[[Partial bowel obstructions|Partial bowel obstruction]]
**[[Blind loop syndrome]] (also in patients with dysmotility)
**Intestinal lymphangiectasis
**[[Short gut syndrome]]


*[[Immunodeficiency|'''Immunodeficiency''']]
**[[Severe combined immunodeficiency disorder]] and other genetic disorders
**[[HIV]]


*'''Endocrine diarrhea'''
**[[Addison's disease]]
**[[Carcinoid tumors]]
**[[VIPoma|Vipoma]]
**[[Gastrinoma]] ([[Zollinger-Ellison syndrome]])
**[[Mastocytosis]]  or increased motility
**[[Hyperthyroidism]]


===Causes by organ system===
*'''Infectious enteritis or colitis (diarrhea not associated with ''C. difficile'')'''
**[[Bacterial gastroenteritis]]
**[[Viral gastroenteritis]]
**[[Amebic dysentery]]


{|style="width:80%; height:100px" border="1"
*'''[[Ischemic colitis]]'''
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
|-
|}


===Causes in Alphabetical Order===
*'''Miscellaneous'''
<code>List the causes of the disease in alphabetical order.</code>
**Antibiotic-associated diarrhea
{{columns-list|3|
**[[Pseudomembranous colitis]]
* Cause 1
**[[Hemolytic-uremic syndrome|Hemolytic uremic syndrome]]
* Cause 2
**[[Neonatal drug withdrawal]]
* Cause 3
* Cause 4
* Cause 5
* Cause 6
* Cause 7
* Cause 8
* Cause 9
* Cause 10
}}


===Drugs that commonly cause diarrhea<ref name="pmid8614603">{{cite journal| author=Branski D, Lerner A, Lebenthal E| title=Chronic diarrhea and malabsorption. | journal=Pediatr Clin North Am | year= 1996 | volume= 43 | issue= 2 | pages= 307-31 | pmid=8614603 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8614603  }} </ref><ref name="pmid28407743">{{cite journal| author=Kroschinsky F, Stölzel F, von Bonin S, Beutel G, Kochanek M, Kiehl M et al.| title=New drugs, new toxicities: severe side effects of modern targeted and immunotherapy of cancer and their management. | journal=Crit Care | year= 2017 | volume= 21 | issue= 1 | pages= 89 | pmid=28407743 | doi=10.1186/s13054-017-1678-1 | pmc=5391608 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28407743  }} </ref><ref name="pmid28027072">{{cite journal| author=Philip NA, Ahmed N, Pitchumoni CS| title=Spectrum of Drug-induced Chronic Diarrhea. | journal=J Clin Gastroenterol | year= 2017 | volume= 51 | issue= 2 | pages= 111-117 | pmid=28027072 | doi=10.1097/MCG.0000000000000752 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28027072  }} </ref>===
*'''Gastrointestinal drugs'''
**[[Magnesium]] containing antacids
**[[Laxatives]]
**[[Cisapride]]
**[[Olsalazine]]
*'''Cardiac drugs'''
**[[Digitalis]]
**[[Quinidine]]
**[[Procainamide]]
**[[Hydralazine]]
**[[Beta blockers|Beta-blockers]]
**[[ACE inhibitor|ACE inhibitors]]
**[[Diuretics]]
*'''Antibiotics'''
**[[Clindamycin]]
**[[Ampicillin]]
**[[Amoxycillin]]
**[[Erythromycin]]
**[[Cephalosporin|Cephalosporins]]
*'''Chemotherapeutic agents'''
*'''Hypolipidemic agents'''
**[[Clofibrate]]
**[[Gemfibrozil]]
**[[Lovastatin]]
*'''Neuropsychiatric drugs'''
**[[Lithium]]
**[[Fluoxetine]]
**[[Alprazolam]]
*'''Others'''
**[[Aminophylline]]
**[[Salbutamol]]
**[[Non-steroidal anti-inflammatory drug|Non-steroidal anti-inflammatory drugs]]
**[[Thyroid hormones]]
**[[Colchicine]]


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


{{WH}}
{{WH}}
{{WS}}
{{WS}}
[[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

Chronic diarrhea Microchapters

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Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Chronic diarrhea from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

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Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

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

Overview

Depending on the socioeconomic status of the population, chronic diarrhea can be caused by several factors. In a developing nation, the most likely causes of chronic diarrhea are mycobacterial and parasitic infections, while functional disorders such as malabsorption and inflammatory bowel diseases are less likely causes. In a developed nation, however, the most likely causes of diarrhea are irritable bowel syndrome (IBS), inflammatory bowel disease, malabsorption syndromes (such as lactose intolerance and celiac disease), and chronic infections (particularly in patients who are immunocompromised).

Causes

Life threatening causes

There are no life-threatening causes of chronic diarrhea; however, complications resulting from untreated chronic diarrhea are common.

Common causes

There following are some of the common causes of chronic diarrhea:[1][2][3][4][5]

Drugs that commonly cause diarrhea[6][7][8]

References

  1. Jamma S, Rubio-Tapia A, Kelly CP, Murray J, Najarian R, Sheth S; et al. (2010). "Celiac crisis is a rare but serious complication of celiac disease in adults". Clin Gastroenterol Hepatol. 8 (7): 587–90. doi:10.1016/j.cgh.2010.04.009. PMC 2900539. PMID 20417725.
  2. Manning AP, Thompson WG, Heaton KW, Morris AF (1978). "Towards positive diagnosis of the irritable bowel". Br Med J. 2 (6138): 653–4. PMC 1607467. PMID 698649.
  3. Mekhjian HS, Switz DM, Melnyk CS, Rankin GB, Brooks RK (1979). "Clinical features and natural history of Crohn's disease". Gastroenterology. 77 (4 Pt 2): 898–906. PMID 381094.
  4. Silverberg MS, Satsangi J, Ahmad T, Arnott ID, Bernstein CN, Brant SR; et al. (2005). "Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a Working Party of the 2005 Montreal World Congress of Gastroenterology". Can J Gastroenterol. 19 Suppl A: 5A–36A. PMID 16151544.
  5. Veress B, Löfberg R, Bergman L (1995). "Microscopic colitis syndrome". Gut. 36 (6): 880–6. PMC 1382626. PMID 7615277.
  6. Branski D, Lerner A, Lebenthal E (1996). "Chronic diarrhea and malabsorption". Pediatr Clin North Am. 43 (2): 307–31. PMID 8614603.
  7. Kroschinsky F, Stölzel F, von Bonin S, Beutel G, Kochanek M, Kiehl M; et al. (2017). "New drugs, new toxicities: severe side effects of modern targeted and immunotherapy of cancer and their management". Crit Care. 21 (1): 89. doi:10.1186/s13054-017-1678-1. PMC 5391608. PMID 28407743.
  8. Philip NA, Ahmed N, Pitchumoni CS (2017). "Spectrum of Drug-induced Chronic Diarrhea". J Clin Gastroenterol. 51 (2): 111–117. doi:10.1097/MCG.0000000000000752. PMID 28027072.

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