Chronic diarrhea causes: Difference between revisions
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==Overview== | ==Overview== | ||
Depending on the | 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== | |||
===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]]:<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> | |||
*'''[[Celiac disease|Malabsorption]]''' | |||
**[[Cystic fibrosis]] | |||
**[[celiac disease|Celiac disease]] | |||
**[[Disaccharidase|Disaccharidase deficiency]] | |||
*'''[[Irritable bowel syndrome]]''' | |||
*[[Inflammatory bowel disease|'''Inflammatory bowel disease''']] | |||
**[[Crohn's disease|Crohn disease]] | |||
**[[ulcerative colitis|Ulcerative colitis]] | |||
* '''[[Microscopic colitis]]''' | |||
*'''Anatomic abnormalities''' | |||
**[[Intussusception]] | |||
**[[Hirschsprung's disease]] (with and without toxic [[megacolon]]) | |||
**[[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]] | |||
*'''Infectious enteritis or colitis (diarrhea not associated with ''C. difficile'')''' | |||
**[[Bacterial gastroenteritis]] | |||
**[[Viral gastroenteritis]] | |||
**[[Amebic dysentery]] | |||
*'''[[Ischemic colitis]]''' | |||
*'''Miscellaneous''' | |||
*''' | **Antibiotic-associated diarrhea | ||
**[[Pseudomembranous colitis]] | |||
**[[Hemolytic-uremic syndrome|Hemolytic uremic syndrome]] | |||
**[[Neonatal drug withdrawal]] | |||
===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>=== | ===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 | *'''Gastrointestinal drugs''' | ||
**Magnesium containing antacids | **[[Magnesium]] containing antacids | ||
**Laxatives | **[[Laxatives]] | ||
**Cisapride | **[[Cisapride]] | ||
**Olsalazine | **[[Olsalazine]] | ||
*Cardiac drugs | *'''Cardiac drugs''' | ||
**Digitalis | **[[Digitalis]] | ||
**Quinidine | **[[Quinidine]] | ||
**Procainamide | **[[Procainamide]] | ||
**Hydralazine | **[[Hydralazine]] | ||
**Beta-blockers | **[[Beta blockers|Beta-blockers]] | ||
**ACE inhibitors | **[[ACE inhibitor|ACE inhibitors]] | ||
**Diuretics | **[[Diuretics]] | ||
*Antibiotics | *'''Antibiotics''' | ||
**Clindamycin | **[[Clindamycin]] | ||
**Ampicillin | **[[Ampicillin]] | ||
**Amoxycillin | **[[Amoxycillin]] | ||
**Erythromycin | **[[Erythromycin]] | ||
**Cephalosporins | **[[Cephalosporin|Cephalosporins]] | ||
*Chemotherapeutic agents | *'''Chemotherapeutic agents''' | ||
*Hypolipidemic agents | *'''Hypolipidemic agents''' | ||
**Clofibrate | **[[Clofibrate]] | ||
**Gemfibrozil | **[[Gemfibrozil]] | ||
**Lovastatin | **[[Lovastatin]] | ||
*Neuropsychiatric drugs | *'''Neuropsychiatric drugs''' | ||
**Lithium | **[[Lithium]] | ||
**Fluoxetine | **[[Fluoxetine]] | ||
**Alprazolam | **[[Alprazolam]] | ||
*Others | *'''Others''' | ||
**Aminophylline | **[[Aminophylline]] | ||
**Salbutamol | **[[Salbutamol]] | ||
**Non-steroidal anti-inflammatory drugs | **[[Non-steroidal anti-inflammatory drug|Non-steroidal anti-inflammatory drugs]] | ||
**Thyroid hormones | **[[Thyroid hormones]] | ||
**Colchicine | **[[Colchicine]] | ||
==References== | ==References== | ||
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{{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
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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
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]
- Malabsorption
- Irritable bowel syndrome
- Inflammatory bowel disease
- Microscopic colitis
- Anatomic abnormalities
- Intussusception
- Hirschsprung's disease (with and without toxic megacolon)
- Partial bowel obstruction
- Blind loop syndrome (also in patients with dysmotility)
- Intestinal lymphangiectasis
- Short gut syndrome
- Immunodeficiency
- Severe combined immunodeficiency disorder and other genetic disorders
- HIV
- Endocrine diarrhea
- Addison's disease
- Carcinoid tumors
- Vipoma
- Gastrinoma (Zollinger-Ellison syndrome)
- Mastocytosis or increased motility
- Hyperthyroidism
- Infectious enteritis or colitis (diarrhea not associated with C. difficile)
- Miscellaneous
- Antibiotic-associated diarrhea
- Pseudomembranous colitis
- Hemolytic uremic syndrome
- Neonatal drug withdrawal
Drugs that commonly cause diarrhea[6][7][8]
- Gastrointestinal drugs
- Magnesium containing antacids
- Laxatives
- Cisapride
- Olsalazine
- Cardiac drugs
- Antibiotics
- Chemotherapeutic agents
- Hypolipidemic agents
- Neuropsychiatric drugs
- Others
References
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ Veress B, Löfberg R, Bergman L (1995). "Microscopic colitis syndrome". Gut. 36 (6): 880–6. PMC 1382626. PMID 7615277.
- ↑ Branski D, Lerner A, Lebenthal E (1996). "Chronic diarrhea and malabsorption". Pediatr Clin North Am. 43 (2): 307–31. PMID 8614603.
- ↑ 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.
- ↑ 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.