Chronic diarrhea differential diagnosis: Difference between revisions

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__NOTOC__
__NOTOC__
{{Chronic diarrhea}}
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Chronic_diarrhea]]
{{CMG}}; {{AE}} {{SSH}}
'''''To review the differential diagnosis of diarrhea, click [[Diarrhea#Differential Diagnosis of Diarrhea of other diseases|here]].'''''
 
{{CMG}}; {{AE}} {{SSH}}, {{SMP}}


==Overview==
==Overview==
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 a patient's [[chronic diarrhea]] into a subcategory such as [[Watery diarrhea|watery]], fatty and [[inflammatory]] helps to direct the [[diagnostic]] work-up. Some [[Watery diarrhea|watery]] causes of chronic diarrhea which should be differentiated from one another include [[crohn's disease]], [[hyperthyroidism]], [[VIPoma]], [[lactose intolerance]], [[celiac disease]] and [[irritable bowel syndrome]] (IBS). The causes of fatty diarrhea that should be differentiated from one another include [[celiac sprue]], [[pancreatic insufficiency]], [[bacterial overgrowth]] and [[maldigestion]] problems which results from [[Pancreatic insufficiency|pancreatic exocrine insufficiency]]. Finally, the [[inflammatory]] causes of chronic diarrhea such as [[ulcerative colitis]] and [[entamoeba histolytica]] must also be differentiated.
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 a patient's [[chronic diarrhea]] into a subcategory such as [[Watery diarrhea|watery]], fatty and [[inflammatory]] helps to direct the [[diagnostic]] work-up. Some [[Watery diarrhea|watery]] causes of chronic diarrhea which should be differentiated from one another include [[crohn's disease]], [[hyperthyroidism]], [[VIPoma]], [[lactose intolerance]], [[celiac disease]] and [[irritable bowel syndrome]] (IBS). The causes of fatty diarrhea that should be differentiated from one another include [[celiac sprue]], [[pancreatic insufficiency]], [[bacterial overgrowth]] and [[maldigestion]] problems which results from [[Pancreatic insufficiency|pancreatic exocrine insufficiency]]. Finally, the [[inflammatory]] causes of chronic diarrhea such as [[ulcerative colitis]] and [[entamoeba histolytica]] must also be differentiated.


==Differential Diagnosis of Chronic Diarrhea of other diseases==
==Differential Diagnosis of Chronic Diarrhea from other diseases==
'''The following table outlines the major differential diagnoses of chronic diarrhea.'''<ref name="Casburn-JonesFarthing2004">{{cite journal|last1=Casburn-Jones|first1=Anna C|last2=Farthing|first2=Michael Jg|title=Traveler's diarrhea|journal=Journal of Gastroenterology and Hepatology|volume=19|issue=6|year=2004|pages=610–618|issn=0815-9319|doi=10.1111/j.1440-1746.2003.03287.x}}</ref><ref name="KamatMathur2006">{{cite journal|last1=Kamat|first1=Deepak|last2=Mathur|first2=Ambika|title=Prevention and Management of Travelers’ Diarrhea|journal=Disease-a-Month|volume=52|issue=7|year=2006|pages=289–302|issn=00115029|doi=10.1016/j.disamonth.2006.08.003}}</ref><ref name="PfeifferDuPont2012">{{cite journal|last1=Pfeiffer|first1=Margaret L.|last2=DuPont|first2=Herbert L.|last3=Ochoa|first3=Theresa J.|title=The patient presenting with acute dysentery – A systematic review|journal=Journal of Infection|volume=64|issue=4|year=2012|pages=374–386|issn=01634453|doi=10.1016/j.jinf.2012.01.006}}</ref><ref name="pmid24506120">{{cite journal |vauthors=Barr W, Smith A |title=Acute diarrhea |journal=Am Fam Physician |volume=89 |issue=3 |pages=180–9 |year=2014 |pmid=24506120 |doi= |url=}}</ref><ref name="pmid29255768">{{cite journal |vauthors=Amil Dias J |title=Celiac Disease: What Do We Know in 2017? |journal=GE Port J Gastroenterol |volume=24 |issue=6 |pages=275–278 |year=2017 |pmid=29255768 |doi=10.1159/000479881 |url=}}</ref><ref name="pmid29254859">{{cite journal |vauthors=Kotloff KL, Riddle MS, Platts-Mills JA, Pavlinac P, Zaidi AKM |title=Shigellosis |journal=Lancet |volume= |issue= |pages= |year=2017 |pmid=29254859 |doi=10.1016/S0140-6736(17)33296-8 |url=}}</ref><ref name="Yamamoto-FurushoBosques-Padilla2017">{{cite journal|last1=Yamamoto-Furusho|first1=J.K.|last2=Bosques-Padilla|first2=F.|last3=de-Paula|first3=J.|last4=Galiano|first4=M.T.|last5=Ibañez|first5=P.|last6=Juliao|first6=F.|last7=Kotze|first7=P.G.|last8=Rocha|first8=J.L.|last9=Steinwurz|first9=F.|last10=Veitia|first10=G.|last11=Zaltman|first11=C.|title=Diagnóstico y tratamiento de la enfermedad inflamatoria intestinal: Primer Consenso Latinoamericano de la Pan American Crohn's and Colitis Organisation|journal=Revista de Gastroenterología de México|volume=82|issue=1|year=2017|pages=46–84|issn=03750906|doi=10.1016/j.rgmx.2016.07.003}}</ref><ref name="BorbélyOsterwalder2017">{{cite journal|last1=Borbély|first1=Yves M|last2=Osterwalder|first2=Alice|last3=Kröll|first3=Dino|last4=Nett|first4=Philipp C|last5=Inglin|first5=Roman A|title=Diarrhea after bariatric procedures: Diagnosis and therapy|journal=World Journal of Gastroenterology|volume=23|issue=26|year=2017|pages=4689|issn=1007-9327|doi=10.3748/wjg.v23.i26.4689}}</ref><ref name="CrawfordRamani2017">{{cite journal|last1=Crawford|first1=Sue E.|last2=Ramani|first2=Sasirekha|last3=Tate|first3=Jacqueline E.|last4=Parashar|first4=Umesh D.|last5=Svensson|first5=Lennart|last6=Hagbom|first6=Marie|last7=Franco|first7=Manuel A.|last8=Greenberg|first8=Harry B.|last9=O'Ryan|first9=Miguel|last10=Kang|first10=Gagandeep|last11=Desselberger|first11=Ulrich|last12=Estes|first12=Mary K.|title=Rotavirus infection|journal=Nature Reviews Disease Primers|volume=3|year=2017|pages=17083|issn=2056-676X|doi=10.1038/nrdp.2017.83}}</ref><ref name="pmid11068510">{{cite journal |vauthors=Kist M |title=[Chronic diarrhea: value of microbiology in diagnosis] |language=German |journal=Praxis (Bern 1994) |volume=89 |issue=39 |pages=1559–65 |year=2000 |pmid=11068510 |doi= |url=}}</ref><ref name="pmid4014291">{{cite journal |vauthors=Guerrant RL, Shields DS, Thorson SM, Schorling JB, Gröschel DH |title=Evaluation and diagnosis of acute infectious diarrhea |journal=Am. J. Med. |volume=78 |issue=6B |pages=91–8 |year=1985 |pmid=4014291 |doi= |url=}}</ref><ref name="pmid10575169">{{cite journal |vauthors=López-Vélez R, Turrientes MC, Garrón C, Montilla P, Navajas R, Fenoy S, del Aguila C |title=Microsporidiosis in travelers with diarrhea from the tropics |journal=J Travel Med |volume=6 |issue=4 |pages=223–7 |year=1999 |pmid=10575169 |doi= |url=}}</ref><ref name="WahnschaffeIgnatius2009">{{cite journal|last1=Wahnschaffe|first1=Ulrich|last2=Ignatius|first2=Ralf|last3=Loddenkemper|first3=Christoph|last4=Liesenfeld|first4=Oliver|last5=Muehlen|first5=Marion|last6=Jelinek|first6=Thomas|last7=Burchard|first7=Gerd Dieter|last8=Weinke|first8=Thomas|last9=Harms|first9=Gundel|last10=Stein|first10=Harald|last11=Zeitz|first11=Martin|last12=Ullrich|first12=Reiner|last13=Schneider|first13=Thomas|title=Diagnostic value of endoscopy for the diagnosis of giardiasis and other intestinal diseases in patients with persistent diarrhea from tropical or subtropical areas|journal=Scandinavian Journal of Gastroenterology|volume=42|issue=3|year=2009|pages=391–396|issn=0036-5521|doi=10.1080/00365520600881193}}</ref><ref name="pmid27765536">{{cite journal |vauthors=Mena Bares LM, Carmona Asenjo E, García Sánchez MV, Moreno Ortega E, Maza Muret FR, Guiote Moreno MV, Santos Bueno AM, Iglesias Flores E, Benítez Cantero JM, Vallejo Casas JA |title=75SeHCAT scan in bile acid malabsorption in chronic diarrhoea |journal=Rev Esp Med Nucl Imagen Mol |volume=36 |issue=1 |pages=37–47 |year=2017 |pmid=27765536 |doi=10.1016/j.remn.2016.08.005 |url=}}</ref><ref name="pmid19365159">{{cite journal |vauthors=Gibson RJ, Stringer AM |title=Chemotherapy-induced diarrhoea |journal=Curr Opin Support Palliat Care |volume=3 |issue=1 |pages=31–5 |year=2009 |pmid=19365159 |doi=10.1097/SPC.0b013e32832531bb |url=}}</ref><ref name="pmid23384808">{{cite journal |vauthors=Abraham BP, Sellin JH |title=Drug-induced, factitious, & idiopathic diarrhoea |journal=Best Pract Res Clin Gastroenterol |volume=26 |issue=5 |pages=633–48 |year=2012 |pmid=23384808 |doi=10.1016/j.bpg.2012.11.007 |url=}}</ref><ref name="pmid25692805">{{cite journal |vauthors=Reintam Blaser A, Deane AM, Fruhwald S |title=Diarrhoea in the critically ill |journal=Curr Opin Crit Care |volume=21 |issue=2 |pages=142–53 |year=2015 |pmid=25692805 |doi=10.1097/MCC.0000000000000188 |url=}}</ref><ref name="pmid17373914">{{cite journal |vauthors=McMahan ZH, DuPont HL |title=Review article: the history of acute infectious diarrhoea management--from poorly focused empiricism to fluid therapy and modern pharmacotherapy |journal=Aliment. Pharmacol. Ther. |volume=25 |issue=7 |pages=759–69 |year=2007 |pmid=17373914 |doi=10.1111/j.1365-2036.2007.03261.x |url=}}</ref><ref name="pmid23384801">{{cite journal |vauthors=Schiller LR |title=Definitions, pathophysiology, and evaluation of chronic diarrhoea |journal=Best Pract Res Clin Gastroenterol |volume=26 |issue=5 |pages=551–62 |year=2012 |pmid=23384801 |doi=10.1016/j.bpg.2012.11.011 |url=}}</ref><ref name="pmid3523719">{{cite journal |vauthors=Giannella RA |title=Chronic diarrhea in travelers: diagnostic and therapeutic considerations |journal=Rev. Infect. Dis. |volume=8 Suppl 2 |issue= |pages=S223–6 |year=1986 |pmid=3523719 |doi= |url=}}</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="pmid12135027">{{cite journal| author=Sauter GH, Moussavian AC, Meyer G, Steitz HO, Parhofer KG, Jüngst D| title=Bowel habits and bile acid malabsorption in the months after cholecystectomy. | journal=Am J Gastroenterol | year= 2002 | volume= 97 | issue= 7 | pages= 1732-5 | pmid=12135027 | doi=10.1111/j.1572-0241.2002.05779.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12135027  }}</ref><ref name="pmid1702075">{{cite journal| author=Maiuri L, Raia V, Potter J, Swallow D, Ho MW, Fiocca R et al.| title=Mosaic pattern of lactase expression by villous enterocytes in human adult-type hypolactasia. | journal=Gastroenterology | year= 1991 | volume= 100 | issue= 2 | pages= 359-69 | pmid=1702075 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1702075  }}</ref><ref name="pmid14439871">{{cite journal| author=RUBIN CE, BRANDBORG LL, PHELPS PC, TAYLOR HC| title=Studies of celiac disease. 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'''The following table outlines the major differential diagnoses of chronic diarrhea.'''<ref name="Casburn-JonesFarthing2004">{{cite journal|last1=Casburn-Jones|first1=Anna C|last2=Farthing|first2=Michael Jg|title=Traveler's diarrhea|journal=Journal of Gastroenterology and Hepatology|volume=19|issue=6|year=2004|pages=610–618|issn=0815-9319|doi=10.1111/j.1440-1746.2003.03287.x}}</ref><ref name="KamatMathur2006">{{cite journal|last1=Kamat|first1=Deepak|last2=Mathur|first2=Ambika|title=Prevention and Management of Travelers’ Diarrhea|journal=Disease-a-Month|volume=52|issue=7|year=2006|pages=289–302|issn=00115029|doi=10.1016/j.disamonth.2006.08.003}}</ref><ref name="PfeifferDuPont2012">{{cite journal|last1=Pfeiffer|first1=Margaret L.|last2=DuPont|first2=Herbert L.|last3=Ochoa|first3=Theresa J.|title=The patient presenting with acute dysentery – A systematic review|journal=Journal of Infection|volume=64|issue=4|year=2012|pages=374–386|issn=01634453|doi=10.1016/j.jinf.2012.01.006}}</ref><ref name="pmid24506120">{{cite journal |vauthors=Barr W, Smith A |title=Acute diarrhea |journal=Am Fam Physician |volume=89 |issue=3 |pages=180–9 |year=2014 |pmid=24506120 |doi= |url=}}</ref><ref name="pmid29255768">{{cite journal |vauthors=Amil Dias J |title=Celiac Disease: What Do We Know in 2017? |journal=GE Port J Gastroenterol |volume=24 |issue=6 |pages=275–278 |year=2017 |pmid=29255768 |doi=10.1159/000479881 |url=}}</ref><ref name="pmid29254859">{{cite journal |vauthors=Kotloff KL, Riddle MS, Platts-Mills JA, Pavlinac P, Zaidi AKM |title=Shigellosis |journal=Lancet |volume= |issue= |pages= |year=2017 |pmid=29254859 |doi=10.1016/S0140-6736(17)33296-8 |url=}}</ref><ref name="Yamamoto-FurushoBosques-Padilla2017">{{cite journal|last1=Yamamoto-Furusho|first1=J.K.|last2=Bosques-Padilla|first2=F.|last3=de-Paula|first3=J.|last4=Galiano|first4=M.T.|last5=Ibañez|first5=P.|last6=Juliao|first6=F.|last7=Kotze|first7=P.G.|last8=Rocha|first8=J.L.|last9=Steinwurz|first9=F.|last10=Veitia|first10=G.|last11=Zaltman|first11=C.|title=Diagnóstico y tratamiento de la enfermedad inflamatoria intestinal: Primer Consenso Latinoamericano de la Pan American Crohn's and Colitis Organisation|journal=Revista de Gastroenterología de México|volume=82|issue=1|year=2017|pages=46–84|issn=03750906|doi=10.1016/j.rgmx.2016.07.003}}</ref><ref name="BorbélyOsterwalder2017">{{cite journal|last1=Borbély|first1=Yves M|last2=Osterwalder|first2=Alice|last3=Kröll|first3=Dino|last4=Nett|first4=Philipp C|last5=Inglin|first5=Roman A|title=Diarrhea after bariatric procedures: Diagnosis and therapy|journal=World Journal of Gastroenterology|volume=23|issue=26|year=2017|pages=4689|issn=1007-9327|doi=10.3748/wjg.v23.i26.4689}}</ref><ref name="CrawfordRamani2017">{{cite journal|last1=Crawford|first1=Sue E.|last2=Ramani|first2=Sasirekha|last3=Tate|first3=Jacqueline E.|last4=Parashar|first4=Umesh D.|last5=Svensson|first5=Lennart|last6=Hagbom|first6=Marie|last7=Franco|first7=Manuel A.|last8=Greenberg|first8=Harry B.|last9=O'Ryan|first9=Miguel|last10=Kang|first10=Gagandeep|last11=Desselberger|first11=Ulrich|last12=Estes|first12=Mary K.|title=Rotavirus infection|journal=Nature Reviews Disease Primers|volume=3|year=2017|pages=17083|issn=2056-676X|doi=10.1038/nrdp.2017.83}}</ref><ref name="pmid11068510">{{cite journal |vauthors=Kist M |title=[Chronic diarrhea: value of microbiology in diagnosis] |language=German |journal=Praxis (Bern 1994) |volume=89 |issue=39 |pages=1559–65 |year=2000 |pmid=11068510 |doi= |url=}}</ref><ref name="pmid4014291">{{cite journal |vauthors=Guerrant RL, Shields DS, Thorson SM, Schorling JB, Gröschel DH |title=Evaluation and diagnosis of acute infectious diarrhea |journal=Am. J. Med. |volume=78 |issue=6B |pages=91–8 |year=1985 |pmid=4014291 |doi= |url=}}</ref><ref name="pmid10575169">{{cite journal |vauthors=López-Vélez R, Turrientes MC, Garrón C, Montilla P, Navajas R, Fenoy S, del Aguila C |title=Microsporidiosis in travelers with diarrhea from the tropics |journal=J Travel Med |volume=6 |issue=4 |pages=223–7 |year=1999 |pmid=10575169 |doi= |url=}}</ref><ref name="WahnschaffeIgnatius2009">{{cite journal|last1=Wahnschaffe|first1=Ulrich|last2=Ignatius|first2=Ralf|last3=Loddenkemper|first3=Christoph|last4=Liesenfeld|first4=Oliver|last5=Muehlen|first5=Marion|last6=Jelinek|first6=Thomas|last7=Burchard|first7=Gerd Dieter|last8=Weinke|first8=Thomas|last9=Harms|first9=Gundel|last10=Stein|first10=Harald|last11=Zeitz|first11=Martin|last12=Ullrich|first12=Reiner|last13=Schneider|first13=Thomas|title=Diagnostic value of endoscopy for the diagnosis of giardiasis and other intestinal diseases in patients with persistent diarrhea from tropical or subtropical areas|journal=Scandinavian Journal of Gastroenterology|volume=42|issue=3|year=2009|pages=391–396|issn=0036-5521|doi=10.1080/00365520600881193}}</ref><ref name="pmid27765536">{{cite journal |vauthors=Mena Bares LM, Carmona Asenjo E, García Sánchez MV, Moreno Ortega E, Maza Muret FR, Guiote Moreno MV, Santos Bueno AM, Iglesias Flores E, Benítez Cantero JM, Vallejo Casas JA |title=75SeHCAT scan in bile acid malabsorption in chronic diarrhoea |journal=Rev Esp Med Nucl Imagen Mol |volume=36 |issue=1 |pages=37–47 |year=2017 |pmid=27765536 |doi=10.1016/j.remn.2016.08.005 |url=}}</ref><ref name="pmid19365159">{{cite journal |vauthors=Gibson RJ, Stringer AM |title=Chemotherapy-induced diarrhoea |journal=Curr Opin Support Palliat Care |volume=3 |issue=1 |pages=31–5 |year=2009 |pmid=19365159 |doi=10.1097/SPC.0b013e32832531bb |url=}}</ref><ref name="pmid23384808">{{cite journal |vauthors=Abraham BP, Sellin JH |title=Drug-induced, factitious, & idiopathic diarrhoea |journal=Best Pract Res Clin Gastroenterol |volume=26 |issue=5 |pages=633–48 |year=2012 |pmid=23384808 |doi=10.1016/j.bpg.2012.11.007 |url=}}</ref><ref name="pmid25692805">{{cite journal |vauthors=Reintam Blaser A, Deane AM, Fruhwald S |title=Diarrhoea in the critically ill |journal=Curr Opin Crit Care |volume=21 |issue=2 |pages=142–53 |year=2015 |pmid=25692805 |doi=10.1097/MCC.0000000000000188 |url=}}</ref><ref name="pmid17373914">{{cite journal |vauthors=McMahan ZH, DuPont HL |title=Review article: the history of acute infectious diarrhoea management--from poorly focused empiricism to fluid therapy and modern pharmacotherapy |journal=Aliment. Pharmacol. Ther. |volume=25 |issue=7 |pages=759–69 |year=2007 |pmid=17373914 |doi=10.1111/j.1365-2036.2007.03261.x |url=}}</ref><ref name="pmid23384801">{{cite journal |vauthors=Schiller LR |title=Definitions, pathophysiology, and evaluation of chronic diarrhoea |journal=Best Pract Res Clin Gastroenterol |volume=26 |issue=5 |pages=551–62 |year=2012 |pmid=23384801 |doi=10.1016/j.bpg.2012.11.011 |url=}}</ref><ref name="pmid3523719">{{cite journal |vauthors=Giannella RA |title=Chronic diarrhea in travelers: diagnostic and therapeutic considerations |journal=Rev. Infect. Dis. |volume=8 Suppl 2 |issue= |pages=S223–6 |year=1986 |pmid=3523719 |doi= |url=}}</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="pmid12135027">{{cite journal| author=Sauter GH, Moussavian AC, Meyer G, Steitz HO, Parhofer KG, Jüngst D| title=Bowel habits and bile acid malabsorption in the months after cholecystectomy. | journal=Am J Gastroenterol | year= 2002 | volume= 97 | issue= 7 | pages= 1732-5 | pmid=12135027 | doi=10.1111/j.1572-0241.2002.05779.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12135027  }}</ref><ref name="pmid1702075">{{cite journal| author=Maiuri L, Raia V, Potter J, Swallow D, Ho MW, Fiocca R et al.| title=Mosaic pattern of lactase expression by villous enterocytes in human adult-type hypolactasia. | journal=Gastroenterology | year= 1991 | volume= 100 | issue= 2 | pages= 359-69 | pmid=1702075 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1702075  }}</ref><ref name="pmid14439871">{{cite journal| author=RUBIN CE, BRANDBORG LL, PHELPS PC, TAYLOR HC| title=Studies of celiac disease. I. The apparent identical and specific nature of the duodenal and proximal jejunal lesion in celiac disease and idiopathic sprue. | journal=Gastroenterology | year= 1960 | volume= 38 | issue=  | pages= 28-49 | pmid=14439871 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14439871  }}</ref><ref name="pmid8209928">{{cite journal| author=Konvolinka CW| title=Acute diverticulitis under age forty. | journal=Am J Surg | year= 1994 | volume= 167 | issue= 6 | pages= 562-5 | pmid=8209928 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8209928  }} </ref><ref name="pmid16698746">{{cite journal| author=Satsangi J, Silverberg MS, Vermeire S, Colombel JF| title=The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. | journal=Gut | year= 2006 | volume= 55 | issue= 6 | pages= 749-53 | pmid=16698746 | doi=10.1136/gut.2005.082909 | pmc=1856208 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16698746  }} </ref><ref name="pmid12700377">{{cite journal| author=Haque R, Huston CD, Hughes M, Houpt E, Petri WA| title=Amebiasis. | journal=N Engl J Med | year= 2003 | volume= 348 | issue= 16 | pages= 1565-73 | pmid=12700377 | doi=10.1056/NEJMra022710 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12700377  }} </ref><ref name="pmid8694025">{{cite journal| author=Hertzler SR, Savaiano DA| title=Colonic adaptation to daily lactose feeding in lactose maldigesters reduces lactose intolerance. | journal=Am J Clin Nutr | year= 1996 | volume= 64 | issue= 2 | pages= 232-6 | pmid=8694025 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8694025  }} </ref><ref name="pmid9414969">{{cite journal| author=Briet F, Pochart P, Marteau P, Flourie B, Arrigoni E, Rambaud JC| title=Improved clinical tolerance to chronic lactose ingestion in subjects with lactose intolerance: a placebo effect? | journal=Gut | year= 1997 | volume= 41 | issue= 5 | pages= 632-5 | pmid=9414969 | doi= | pmc=1891556 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9414969  }} </ref><ref name="pmid15391722">{{cite journal| author=BLACK-SCHAFFER B| title=The tinctoral demonstration of a glycoprotein in Whipple's disease. | journal=Proc Soc Exp Biol Med | year= 1949 | volume= 72 | issue= 1 | pages= 225-7 | pmid=15391722 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15391722  }} </ref>


Line 27: Line 29:
! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal pain
! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal pain
! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
!
|-
|-
! colspan="5" style="background:#4479BA; color: #FFFFFF;" align="center" |Stool exam
! colspan="5" style="background:#4479BA; color: #FFFFFF;" align="center" |Stool exam
Line 166: Line 167:
* Anti–tissue [[transglutaminase]] [[antibody]]
* Anti–tissue [[transglutaminase]] [[antibody]]
|-
|-
!
! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause
!
! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Duration
!
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Fever
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal pain
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |GI signs
!
! colspan="5" style="background:#4479BA; color: #FFFFFF;" align="center" |Stool exam
!
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |CBC
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Other lab findings
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Extra intestinal findings
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause/Pathogenesis
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard diagnosis
!
|-
!
! style="background:#4479BA; color: #FFFFFF;" align="center" |Acute
!
! style="background:#4479BA; color: #FFFFFF;" align="center" |Chronic
!
! style="background:#4479BA; color: #FFFFFF;" align="center" |Watery
!
! style="background:#4479BA; color: #FFFFFF;" align="center" |Bloody
!
! style="background:#4479BA; color: #FFFFFF;" align="center" |Fatty
!
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
!
! style="background:#4479BA; color: #FFFFFF;" align="center" |RBC
!
! style="background:#4479BA; color: #FFFFFF;" align="center" |Ova/Parasite
!
! style="background:#4479BA; color: #FFFFFF;" align="center" |Osmotic gap
! style="background:#4479BA; color: #FFFFFF;" align="center" |Other
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Hgb
! style="background:#4479BA; color: #FFFFFF;" align="center" |Plt
|-
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Cystic fibrosis]]
! colspan="2" style="background:#DCDCDC;" align="center" |[[Cystic fibrosis]]
Line 295: Line 300:
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[SeHCAT]] test
* [[SeHCAT]] test
|-
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Microscopic colitis]]
! colspan="2" style="background:#DCDCDC;" align="center" |[[Microscopic colitis]]
Line 363: Line 344:
** [[Lymphocytic]] [[colitis]] is characterized by ≥20 intraepithelial [[lymphocytes]] (IEL) per 100 surface epithelial cells
** [[Lymphocytic]] [[colitis]] is characterized by ≥20 intraepithelial [[lymphocytes]] (IEL) per 100 surface epithelial cells
|-
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Infective colitis]]
! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Duration
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Fever
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal pain
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |GI signs
! colspan="5" style="background:#4479BA; color: #FFFFFF;" align="center" |Stool exam
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |CBC
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Other lab findings
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Extra intestinal findings
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause/Pathogenesis
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard diagnosis
|-
! style="background:#4479BA; color: #FFFFFF;" align="center" |Acute
! style="background:#4479BA; color: #FFFFFF;" align="center" |Chronic
! style="background:#4479BA; color: #FFFFFF;" align="center" |Watery
! style="background:#4479BA; color: #FFFFFF;" align="center" |Bloody
! style="background:#4479BA; color: #FFFFFF;" align="center" |Fatty
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |RBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Ova/Parasite
! style="background:#4479BA; color: #FFFFFF;" align="center" |Osmotic gap
! style="background:#4479BA; color: #FFFFFF;" align="center" |Other
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Hgb
! style="background:#4479BA; color: #FFFFFF;" align="center" |Plt
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Infective colitis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
Line 404: Line 413:
*[[Stool culture]]
*[[Stool culture]]
*[[Blood culture]]
*[[Blood culture]]
|-
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Ischemic colitis]]
! colspan="2" style="background:#DCDCDC;" align="center" |[[Ischemic colitis]]
Line 533: Line 518:
* Diagnosis of exclusion
* Diagnosis of exclusion
|-
|-
!
! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause
!
! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Duration
!
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Fever
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal pain
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |GI signs
!
! colspan="5" style="background:#4479BA; color: #FFFFFF;" align="center" |Stool exam
!
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |CBC
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Other lab findings
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Extra intestinal findings
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause/Pathogenesis
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard diagnosis
!
!
!
!
!
!
!
!
!
!
|-
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Whipple's disease]]
! style="background:#4479BA; color: #FFFFFF;" align="center" |Acute
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
! style="background:#4479BA; color: #FFFFFF;" align="center" |Chronic
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
! style="background:#4479BA; color: #FFFFFF;" align="center" |Watery
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
! style="background:#4479BA; color: #FFFFFF;" align="center" |Bloody
! style="background:#4479BA; color: #FFFFFF;" align="center" |Fatty
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |RBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Ova/Parasite
! style="background:#4479BA; color: #FFFFFF;" align="center" |Osmotic gap
! style="background:#4479BA; color: #FFFFFF;" align="center" |Other
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Hgb
! style="background:#4479BA; color: #FFFFFF;" align="center" |Plt
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Whipple's disease]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
Line 668: Line 657:
* Diagnosis of exclusion
* Diagnosis of exclusion
|-
|-
!
! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause
!
! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Duration
!
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Fever
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal pain
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |GI signs
!
! colspan="5" style="background:#4479BA; color: #FFFFFF;" align="center" |Stool exam
!
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |CBC
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Other lab findings
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Extra intestinal findings
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause/Pathogenesis
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard diagnosis
!
!
!
!
!
!
!
!
!
!
|-
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Salmonellosis]]
! style="background:#4479BA; color: #FFFFFF;" align="center" |Acute
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
! style="background:#4479BA; color: #FFFFFF;" align="center" |Chronic
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
! style="background:#4479BA; color: #FFFFFF;" align="center" |Watery
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
! style="background:#4479BA; color: #FFFFFF;" align="center" |Bloody
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
! style="background:#4479BA; color: #FFFFFF;" align="center" |Fatty
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |RBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Ova/Parasite
! style="background:#4479BA; color: #FFFFFF;" align="center" |Osmotic gap
! style="background:#4479BA; color: #FFFFFF;" align="center" |Other
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Hgb
! style="background:#4479BA; color: #FFFFFF;" align="center" |Plt
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Salmonellosis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
Line 719: Line 712:
*[[Hypernatremia]]
*[[Hypernatremia]]
*[[Hyponatremia]]
*[[Hyponatremia]]
* [[Hypercalciuria]]
* [[Hypercalciuria]]
* [[Hypocitraturia]]
* [[Hypocitraturia]]
Line 726: Line 718:
* [[Obtundation]]
* [[Obtundation]]
* [[Bacteremia]]
* [[Bacteremia]]
* [[Pericarditis]]
* [[Pericarditis]]
* [[Pyelonephritis]]
* [[Pyelonephritis]]
Line 833: Line 824:
*Wound [[Culture collection|culture]]
*Wound [[Culture collection|culture]]
|-
|-
!
! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause
!
! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Duration
!
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Fever
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal pain
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |GI signs
!
! colspan="5" style="background:#4479BA; color: #FFFFFF;" align="center" |Stool exam
!
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |CBC
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Other lab findings
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Extra intestinal findings
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause/Pathogenesis
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard diagnosis
!
!
!
!
!
!
!
!
!
!
|-
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Mycobacterium avium complex]]
! style="background:#4479BA; color: #FFFFFF;" align="center" |Acute
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
! style="background:#4479BA; color: #FFFFFF;" align="center" |Chronic
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
! style="background:#4479BA; color: #FFFFFF;" align="center" |Watery
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
! style="background:#4479BA; color: #FFFFFF;" align="center" |Bloody
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
! style="background:#4479BA; color: #FFFFFF;" align="center" |Fatty
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |RBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Ova/Parasite
! style="background:#4479BA; color: #FFFFFF;" align="center" |Osmotic gap
! style="background:#4479BA; color: #FFFFFF;" align="center" |Other
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Hgb
! style="background:#4479BA; color: #FFFFFF;" align="center" |Plt
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Mycobacterium avium complex]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
Line 957: Line 952:
*Immunoassay 
*Immunoassay 
|-
|-
!
! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause
!
! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Duration
!
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Fever
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal pain
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |GI signs
!
! colspan="5" style="background:#4479BA; color: #FFFFFF;" align="center" |Stool exam
!
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |CBC
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Other lab findings
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Extra intestinal findings
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause/Pathogenesis
!
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard diagnosis
!
!
!
!
!
!
!
!
!
!
|-
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Entamoeba histolytica]]
! style="background:#4479BA; color: #FFFFFF;" align="center" |Acute
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
! style="background:#4479BA; color: #FFFFFF;" align="center" |Chronic
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
! style="background:#4479BA; color: #FFFFFF;" align="center" |Watery
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
! style="background:#4479BA; color: #FFFFFF;" align="center" |Bloody
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
! style="background:#4479BA; color: #FFFFFF;" align="center" |Fatty
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |RBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Ova/Parasite
! style="background:#4479BA; color: #FFFFFF;" align="center" |Osmotic gap
! style="background:#4479BA; color: #FFFFFF;" align="center" |Other
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Hgb
! style="background:#4479BA; color: #FFFFFF;" align="center" |Plt
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Entamoeba histolytica]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
Line 1,106: Line 1,105:
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Antigen detection assays
*Antigen detection assays
|-
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!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Isospora]]
! colspan="2" style="background:#DCDCDC;" align="center" |[[Isospora]]
Line 1,164: Line 1,139:
*Detecting oocysts in the feces
*Detecting oocysts in the feces
|-
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Carcinoid syndrome|Carcinoid tumor]]
! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Duration
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Fever
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal pain
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |GI signs
! colspan="5" style="background:#4479BA; color: #FFFFFF;" align="center" |Stool exam
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |CBC
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Other lab findings
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Extra intestinal findings
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause/Pathogenesis
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard diagnosis
|-
! style="background:#4479BA; color: #FFFFFF;" align="center" |Acute
! style="background:#4479BA; color: #FFFFFF;" align="center" |Chronic
! style="background:#4479BA; color: #FFFFFF;" align="center" |Watery
! style="background:#4479BA; color: #FFFFFF;" align="center" |Bloody
! style="background:#4479BA; color: #FFFFFF;" align="center" |Fatty
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |RBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Ova/Parasite
! style="background:#4479BA; color: #FFFFFF;" align="center" |Osmotic gap
! style="background:#4479BA; color: #FFFFFF;" align="center" |Other
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Hgb
! style="background:#4479BA; color: #FFFFFF;" align="center" |Plt
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Carcinoid syndrome|Carcinoid tumor]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
Line 1,264: Line 1,267:
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Secretin]] stimulation test
* [[Secretin]] stimulation test
|-
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Neuroendocrine tumors|Somatostatinoma]]
! colspan="2" style="background:#DCDCDC;" align="center" |[[Neuroendocrine tumors|Somatostatinoma]]
Line 1,320: Line 1,299:
*Followed by imaging
*Followed by imaging
|-
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Lymphoma]]
! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Duration
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Fever
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal pain
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |GI signs
! colspan="5" style="background:#4479BA; color: #FFFFFF;" align="center" |Stool exam
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |CBC
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Other lab findings
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Extra intestinal findings
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause/Pathogenesis
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard diagnosis
|-
! style="background:#4479BA; color: #FFFFFF;" align="center" |Acute
! style="background:#4479BA; color: #FFFFFF;" align="center" |Chronic
! style="background:#4479BA; color: #FFFFFF;" align="center" |Watery
! style="background:#4479BA; color: #FFFFFF;" align="center" |Bloody
! style="background:#4479BA; color: #FFFFFF;" align="center" |Fatty
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |RBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Ova/Parasite
! style="background:#4479BA; color: #FFFFFF;" align="center" |Osmotic gap
! style="background:#4479BA; color: #FFFFFF;" align="center" |Other
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Hgb
! style="background:#4479BA; color: #FFFFFF;" align="center" |Plt
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Lymphoma]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
Line 1,379: Line 1,386:
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
** [[Colonoscopy]] and [[biopsy]]
** [[Colonoscopy]] and [[biopsy]]
|-
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
|-
! colspan="2" style="background:#DCDCDC;" align="center" |Medications
! colspan="2" style="background:#DCDCDC;" align="center" |Medications
Line 1,477: Line 1,460:
*Clinical evaluation after discontinuation of the drugs
*Clinical evaluation after discontinuation of the drugs
|-
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Heavy metal ingestion]]
! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Duration
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Fever
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal pain
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |GI signs
! colspan="5" style="background:#4479BA; color: #FFFFFF;" align="center" |Stool exam
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |CBC
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Other lab findings
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Extra intestinal findings
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause/Pathogenesis
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard diagnosis
|-
! style="background:#4479BA; color: #FFFFFF;" align="center" |Acute
! style="background:#4479BA; color: #FFFFFF;" align="center" |Chronic
! style="background:#4479BA; color: #FFFFFF;" align="center" |Watery
! style="background:#4479BA; color: #FFFFFF;" align="center" |Bloody
! style="background:#4479BA; color: #FFFFFF;" align="center" |Fatty
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |RBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Ova/Parasite
! style="background:#4479BA; color: #FFFFFF;" align="center" |Osmotic gap
! style="background:#4479BA; color: #FFFFFF;" align="center" |Other
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Hgb
! style="background:#4479BA; color: #FFFFFF;" align="center" |Plt
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Heavy metal ingestion]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
Line 1,507: Line 1,518:
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Plasma level of heavy metal
*Plasma level of heavy metal
|-
!
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!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Organophosphate poisoning]]
! colspan="2" style="background:#DCDCDC;" align="center" |[[Organophosphate poisoning]]
Line 1,607: Line 1,594:
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Clinical diagnosis following [[opium withdrawal]]
*Clinical diagnosis following [[opium withdrawal]]
|-
! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause
! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Duration
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Fever
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal pain
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |GI signs
! colspan="5" style="background:#4479BA; color: #FFFFFF;" align="center" |Stool exam
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |CBC
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Other lab findings
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Extra intestinal findings
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause/Pathogenesis
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard diagnosis
|-
! style="background:#4479BA; color: #FFFFFF;" align="center" |Acute
! style="background:#4479BA; color: #FFFFFF;" align="center" |Chronic
! style="background:#4479BA; color: #FFFFFF;" align="center" |Watery
! style="background:#4479BA; color: #FFFFFF;" align="center" |Bloody
! style="background:#4479BA; color: #FFFFFF;" align="center" |Fatty
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |RBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Ova/Parasite
! style="background:#4479BA; color: #FFFFFF;" align="center" |Osmotic gap
! style="background:#4479BA; color: #FFFFFF;" align="center" |Other
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Hgb
! style="background:#4479BA; color: #FFFFFF;" align="center" |Plt
|-
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Short bowel syndrome]]
! colspan="2" style="background:#DCDCDC;" align="center" |[[Short bowel syndrome]]
Line 1,644: Line 1,659:
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Clinical diagnosis following [[bowel resection]]
*Clinical diagnosis following [[bowel resection]]
|-
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Radiation enteropathy|Radiation enteritis]]
! colspan="2" style="background:#DCDCDC;" align="center" |[[Radiation enteropathy|Radiation enteritis]]
Line 1,730: Line 1,721:
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Clinical diagnosis following [[gastrectomy]]
*Clinical diagnosis following [[gastrectomy]]
|-
! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause
! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Duration
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Fever
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal pain
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |GI signs
! colspan="5" style="background:#4479BA; color: #FFFFFF;" align="center" |Stool exam
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |CBC
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Other lab findings
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Extra intestinal findings
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause/Pathogenesis
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard diagnosis
|-
! style="background:#4479BA; color: #FFFFFF;" align="center" |Acute
! style="background:#4479BA; color: #FFFFFF;" align="center" |Chronic
! style="background:#4479BA; color: #FFFFFF;" align="center" |Watery
! style="background:#4479BA; color: #FFFFFF;" align="center" |Bloody
! style="background:#4479BA; color: #FFFFFF;" align="center" |Fatty
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |RBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Ova/Parasite
! style="background:#4479BA; color: #FFFFFF;" align="center" |Osmotic gap
! style="background:#4479BA; color: #FFFFFF;" align="center" |Other
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Hgb
! style="background:#4479BA; color: #FFFFFF;" align="center" |Plt
|-
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Abetalipoproteinemia]]
! colspan="2" style="background:#DCDCDC;" align="center" |[[Abetalipoproteinemia]]
Line 1,763: Line 1,782:
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Clinical findings and low [[triglyceride]] and [[cholesterol]] level
* Clinical findings and low [[triglyceride]] and [[cholesterol]] level
|-
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
|-
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Hyperthyroidism]]
! colspan="2" style="background:#DCDCDC;" align="center" |[[Hyperthyroidism]]

Latest revision as of 23:00, 8 February 2019

To review the differential diagnosis of diarrhea, click here.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2], Seyedmahdi Pahlavani, M.D. [3]

Overview

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 a patient's chronic diarrhea into a subcategory such as watery, fatty and inflammatory helps to direct the diagnostic work-up. Some watery causes of chronic diarrhea which should be differentiated from one another include crohn's disease, hyperthyroidism, VIPoma, lactose intolerance, celiac disease and irritable bowel syndrome (IBS). The causes of fatty diarrhea that should be differentiated from one another include celiac sprue, pancreatic insufficiency, bacterial overgrowth and maldigestion problems which results from pancreatic exocrine insufficiency. Finally, the inflammatory causes of chronic diarrhea such as ulcerative colitis and entamoeba histolytica must also be differentiated.

Differential Diagnosis of Chronic Diarrhea from other diseases

The following table outlines the major differential diagnoses of chronic diarrhea.[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]

Abbreviations: GI: Gastrointestinal, CBC: Complete blood count, WBC: White blood cell, RBC: Red blood cell, Plt: Platelet, Hgb: Hemoglobin, ESR: Erythrocyte sedimentation rate, CRP: C–reactive protein, IgE: Immunoglobulin E, IgA: Immunoglobulin A, ETEC: Escherichia coli enteritis, EPEC: Enteropathogenic Escherichia coli, EIEC: Enteroinvasive Escherichia coli, EHEC: Enterohemorrhagic Escherichia coli, EAEC: Enteroaggregative Escherichia coli, Nl: Normal, ASCA: Anti saccharomyces cerevisiae antibodies, ANCA: Anti–neutrophil cytoplasmic antibody, DNA: Deoxyribonucleic acid, CFTR: Cystic fibrosis transmembrane conductance regulator, SLC10A2: Solute carrier family 10 member 2, SeHCAT: Selenium homocholic acid taurine or tauroselcholic acid, IEL: Intraepithelial lymphocytes, MRCP: Magnetic resonance cholangiopancreatography, ANA: Antinuclear antibodies, AMA: Anti-mitochondrial antibody, LDH: Lactate dehydrogenase, CPK: Creatine phosphokinasePCR: Polymerase chain reaction, ELISA: Enzyme–linked immunosorbent assay, LT: Heat–labile enterotoxin, ST: Heat–stable enterotoxin, RT-PCR: Reverse–transcriptase polymerase chain reaction, CD4: Cluster of differentiation 4, HIV: Human immunodeficiency virus, RUQ: Right-upper quadrant, VIP: Vasoactive intestinal peptide, GI: Gastrointestinal, FAP: Familial adenomatous polyposis, HNPCC: Hereditary nonpolyposis colorectal cancer, MTP: Microsomal triglyceride transfer protein, Scl‑70: Anti–topoisomerase I, TSH: Thyroid-stimulating hormone, T4: Thyroxine, T3: Triiodothyronine, DTR: Deep tendon reflex, RNA: Ribonucleic acid

Cause Clinical manifestation Lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis
Symptoms GI signs
Duration Diarrhea Fever Abdominal pain Weight loss
Stool exam CBC Other lab findings
Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt
Crohn's disease + + + + ± + + + + Nl
  • Abnormal immune response to self antigens
Ulcerative colitis + + + + ± + + + + Nl
  • Abnormal immune response to self antigens
Celiac disease + ± ± + + Nl Nl Nl
Cause Duration Diarrhea Fever Abdominal pain Weight loss GI signs Stool exam CBC Other lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis
Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt
Cystic fibrosis + + ± + + Nl Nl Nl
Chronic pancreatitis + + + + + Nl Nl Nl Nl
Bile acid malabsorption + + + + Nl Nl Nl Nl
Microscopic colitis + + + + Nl Nl Nl
Cause Duration Diarrhea Fever Abdominal pain Weight loss GI signs Stool exam CBC Other lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis
Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt
Infective colitis + + + + + + + + + Nl
Ischemic colitis + + + + + + + + + Nl
Lactose intolerance + + + + Nl Nl Nl
  • Lactose tolerance test
  • Genetic testing
  • Reduction of lactase enzyme activity or inability to produce persistent lactase
  • Congenital lactase deficiency
  • Secondary lactose malabsorption
Irritable bowel syndrome + ± ± ± Nl Nl Nl Nl Nl
  • Unknown
  • Diagnosis of exclusion
Cause Duration Diarrhea Fever Abdominal pain Weight loss GI signs Stool exam CBC Other lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis
Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt
Whipple's disease + + + ± + + Nl ↓/↑
Tropical sprue + + + + + + + + Nl Nl Nl
  • Diagnosis of exclusion
Small bowel bacterial overgrowth + + + + + + Nl Nl Nl
  • Diagnosis of exclusion
Cause Duration Diarrhea Fever Abdominal pain Weight loss GI signs Stool exam CBC Other lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis
Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt
Salmonellosis + + + + + + + + Nl Nl
Escherichia coli enteritis EPEC + + + + + + + + + Nl Nl Nl
EAEC + + + + + + + Nl
Aeromonas + + + + + + + + Nl Nl Nl
Cause Duration Diarrhea Fever Abdominal pain Weight loss GI signs Stool exam CBC Other lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis
Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt
Mycobacterium avium complex + + + + + + + + Nl Nl
CMV colitis + + + ± + + + Nl
  • Viral antigen assay
Nl Nl
HIV + + + + + + Nl Nl
  • HIV virologic (viral load) test
  • Immunoassay 
Cause Duration Diarrhea Fever Abdominal pain Weight loss GI signs Stool exam CBC Other lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis
Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt
Entamoeba histolytica + + + + + + + + + Nl Nl Nl
  • Antigen testing
  • Serology 
Giardia + + + + + + Nl Nl Nl Nl
  • Antigen detection assays
Cryptosporidium + + + + + Nl
  • Positive stool microscopy
Nl Nl Nl
  • Polymerase chain reaction
Microsporidia + + + + + + Nl
  • Positive stool microscopy
Nl Nl Nl
  • Decreased CD4 count
  • Antigen detection assays
Isospora + + + + + + + + + + Nl Nl Nl
  • Detecting oocysts in the feces
Cause Duration Diarrhea Fever Abdominal pain Weight loss GI signs Stool exam CBC Other lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis
Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt
Carcinoid tumor + + + + + + Nl Nl Nl
VIPoma + + + + + + Nl Nl Nl
  • Primary secretory tumor
  • Blood VIP levels
  • Followed by imaging
Zollinger–Ellison syndrome + + + + + + Nl Nl
Somatostatinoma + + + + Nl Nl Nl
Cause Duration Diarrhea Fever Abdominal pain Weight loss GI signs Stool exam CBC Other lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis
Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt
Lymphoma + + + + + + + Nl Nl Nl
  • Primary tumor of GI tract
Colorectal cancer + + + + + + + Nl Nl Nl
Medications + + + ± ± + + ↑/↓ Nl Nl
  • Elevated plasma level of drug
  • Clinical evaluation after discontinuation of the drugs
Factitious diarrhea + + + + + ↑/↓ Nl Nl Nl
  • Clinical evaluation after discontinuation of the drugs
Cause Duration Diarrhea Fever Abdominal pain Weight loss GI signs Stool exam CBC Other lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis
Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt
Heavy metal ingestion + + + + Nl Nl Nl Nl
  • Elevated plasma heavy metal level
  • Plasma level of heavy metal
Organophosphate poisoning + + + + Nl Nl Nl Nl
  • Clinical diagnosis
Opium withdrawal + + + + Nl Nl Nl Nl
Cause Duration Diarrhea Fever Abdominal pain Weight loss GI signs Stool exam CBC Other lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis
Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt
Short bowel syndrome + + + + + Nl Nl
Radiation enteritis + + + + + + + + + Nl Nl Nl
Dumping syndrome + + + + Nl Nl Nl Nl
Cause Duration Diarrhea Fever Abdominal pain Weight loss GI signs Stool exam CBC Other lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis
Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt
Abetalipoproteinemia + + + + + Nl Nl Nl Nl
Hyperthyroidism + + ± + + Nl Nl Nl Nl
Diabetic neuropathy + + + + + Nl Nl Nl
Systemic sclerosis + + ± + + + + Nl Nl Nl
  • Clinical diagnosis
  • Followed by serologic tests

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