Chronic diarrhea risk factors

Jump to navigation Jump to search

Chronic diarrhea Microchapters

Home

Patient Information

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

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

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

The risk factors of chronic diarrhea can be assessed based on the epidemiologic associations and the patient's characteristics. Some of these factors can be classified based on travel history, epidemics and outbreaks, diabetic patients, patients with acquired immune deficiency syndrome and whether the patients are institutionalized or hospitalized.

Risk Factors

The risk factors for chronic diarrhea include[1]

Summary of Common Causes of Chronic Diarrhea and the associated Risk Factors[3]

Condition Worldwide prevalence Risk factors
Functional diarrhea 4.7% [4] NA
Irritable bowel syndrome (IBS-D) 1.2% [5]
  • Female sex. [6]
  • Depression (incidence of IBS 2.0 per 1000 person-years )[7]
  • Acute gastroenteritis .[8]
Disaccharidase deficiency Prevalence estimate [9],[10] for loss of lactase enzyme activity is 60% globally in the adult population
  • Loss of lactase enzyme activity is associated with certain racial and ethnic populations. [9],[10]
Microscopic colitis Approximately 197.9 to 246.2 per 100,000 persons.[11],[12]
  • Female sex (incidence was 11.0 per 100,000 person-years in female individuals vs 6.1 per 100,000 person-years in male individuals).[13]
  • Increasing age (incidence was ≈3 per 100,000 person-years in ages 18-44.9 y; ≈11 per 100,000 person-years in ages 45-65 y; and ≈35 per 100,000 person-years in ages >65 y).[14]
  • Autoimmune diseases (celiac disease; incidence in individuals with vs without celiac disease was 86.1 vs 7.5 per 100,000 person-years).[15]
  • Medications (prevalence of microscopic colitis vs no microscopic colitis in individuals taking aspirin or nonsteroidal anti-inflammatory drugs was 54% vs 29%).[16]
Celiac disease 1.4%[17] based on positive celiac serologies

0.7% with biopsy-proven celiac disease (N = 138,792; meta-analysis of 57 population-based studies worldwide)

  • First-degree relative with celiac disease (pooled prevalence of 7.5% ).[18]
  • Type 1 diabetes (prevalence of 6% ).[18]
  • Autoimmune thyroid disease (prevalence of 1.6%).[19]
Exocrine Pancreatic Insufficiency (EPI) Unknown
  • Chronic pancreatitis (60%-90% have EPI) [20], cystic fibrosis (80%-90% have EPI),[21] and pancreatic carcinoma (70%-90% have EPI)[16]
Small Intestinal Bacterial Overgrowth (SIBO) Unknown
  • Abnormal small bowel contractile activity (31% of patients with IBS have evidence of SIBO).[22]
  • Other risk factors include hypochlorhydria or achlorhydria, EPI, small intestinal strictures, or resection of the ileocecal valve
Bile acid Diarrhea (BAD) Approximately 1% of the general population.
  • Terminal ileal disease (28% of patients with Crohn disease, 90% with prior ileal resection).[23]
  • Other risk factors (eg, dysregulated bile acid synthesis, impaired bile storage) have more limited data


References

  1. ↑ Schiller LR, Pardi DS, Spiller R, Semrad CE, Surawicz CM, Giannella RA; et al. (2014). "Gastro 2013 APDW/WCOG Shanghai working party report: chronic diarrhea: definition, classification, diagnosis". J Gastroenterol Hepatol. 29 (1): 6–25. doi:10.1111/jgh.12392. PMID 24117999.
  2. ↑ Duplessis, Christopher A.; Gutierrez, Ramiro L.; Porter, Chad K. (2017). "Review: chronic and persistent diarrhea with a focus in the returning traveler". Tropical Diseases, Travel Medicine and Vaccines. 3 (1). doi:10.1186/s40794-017-0052-2. ISSN 2055-0936.
  3. ↑ Singh P, Lee A, Sheth NM, Chey WD (March 2026). "Chronic, Noninfectious Diarrhea: A Review". JAMA. doi:10.1001/jama.2026.0872. PMID 41770539 Check |pmid= value (help).
  4. ↑ Palsson OS, Whitehead W, Törnblom H, Sperber AD, Simren M (April 2020). "Prevalence of Rome IV Functional Bowel Disorders Among Adults in the United States, Canada, and the United Kingdom". Gastroenterology. 158 (5): 1262–1273.e3. doi:10.1053/j.gastro.2019.12.021. PMID 31917991.
  5. ↑ Sperber AD, Bangdiwala SI, Drossman DA, Ghoshal UC, Simren M, Tack J, Whitehead WE, Dumitrascu DL, Fang X, Fukudo S, Kellow J, Okeke E, Quigley EM, Schmulson M, Whorwell P, Archampong T, Adibi P, Andresen V, Benninga MA, Bonaz B, Bor S, Fernandez LB, Choi SC, Corazziari ES, Francisconi C, Hani A, Lazebnik L, Lee YY, Mulak A, Rahman MM, Santos J, Setshedi M, Syam AF, Vanner S, Wong RK, Lopez-Colombo A, Costa V, Dickman R, Kanazawa M, Keshteli AH, Khatun R, Maleki I, Poitras P, Pratap N, Stefanyuk O, Thomson S, Zeevenhooven J, Palsson OS (January 2021). "Worldwide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global Study". Gastroenterology. 160 (1): 99–114.e3. doi:10.1053/j.gastro.2020.04.014. PMID 32294476 Check |pmid= value (help).
  6. ↑ Sperber AD, Dumitrascu D, Fukudo S, Gerson C, Ghoshal UC, Gwee KA, Hungin AP, Kang JY, Minhu C, Schmulson M, Bolotin A, Friger M, Freud T, Whitehead W (June 2017). "The global prevalence of IBS in adults remains elusive due to the heterogeneity of studies: a Rome Foundation working team literature review". Gut. 66 (6): 1075–1082. doi:10.1136/gutjnl-2015-311240. PMID 26818616.
  7. ↑ Wang W, Wang M, Peng H, Huang J, Wu T (January 2024). "Association of major depressive disorder and increased risk of irritable bowel syndrome: A population-based cohort study and a two-sample Mendelian randomization study in the UK biobank". J Affect Disord. 345: 419–426. doi:10.1016/j.jad.2023.10.111.
  8. ↑ Rahman MM, Ghoshal UC, Sultana S, Kibria MG, Sultana N, Khan ZA, Ahmed F, Hasan M, Ahmed T, Sarker SA (September 2018). "Long-Term Gastrointestinal Consequences are Frequent Following Sporadic Acute Infectious Diarrhea in a Tropical Country: A Prospective Cohort Study". Am J Gastroenterol. 113 (9): 1363–1375. doi:10.1038/s41395-018-0208-3. PMID 30171215.
  9. ↑ 9.0 9.1 Swallow DM (2003). "Genetics of lactase persistence and lactose intolerance". Annu Rev Genet. 37: 197–219. doi:10.1146/annurev.genet.37.110801.143820. PMID 14616060.
  10. ↑ 10.0 10.1 Scrimshaw NS, Murray EB (October 1988). "The acceptability of milk and milk products in populations with a high prevalence of lactose intolerance". Am J Clin Nutr. 48 (4 Suppl): 1079–159. doi:10.1093/ajcn/48.4.1142. PMID 3140651.
  11. ↑ Tome J, Sehgal K, Kamboj AK, Harmsen WS, Kammer PP, Loftus EV, Tremaine WJ, Khanna S, Pardi DS (May 2022). "The Epidemiology of Microscopic Colitis in Olmsted County, Minnesota: Population-Based Study From 2011 to 2019". Clin Gastroenterol Hepatol. 20 (5): 1085–1094. doi:10.1016/j.cgh.2021.06.027. PMC 8716639 Check |pmc= value (help). PMID 34216819 Check |pmid= value (help).
  12. ↑ Weimers P, Ankersen DV, Lophaven S, Bonderup OK, Münch A, Løkkegaard EC, Burisch J, Munkholm P (December 2020). "Incidence and Prevalence of Microscopic Colitis Between 2001 and 2016: A Danish Nationwide Cohort Study". J Crohns Colitis. 14 (12): 1717–1723. doi:10.1093/ecco-jcc/jjaa108. PMID 32502240 Check |pmid= value (help).
  13. ↑ Pardi DS, Loftus EV, Smyrk TC, Kammer PP, Tremaine WJ, Schleck CD, Harmsen WS, Zinsmeister AR, Melton LJ, Sandborn WJ (April 2007). "The epidemiology of microscopic colitis: a population based study in Olmsted County, Minnesota". Gut. 56 (4): 504–8. doi:10.1136/gut.2006.105890. PMC 1856874. PMID 17135309.
  14. ↑ Williams JJ, Kaplan GG, Makhija S, Urbanski SJ, Dupre M, Panaccione R, Beck PL (January 2008). "Microscopic colitis-defining incidence rates and risk factors: a population-based study". Clin Gastroenterol Hepatol. 6 (1): 35–40. doi:10.1016/j.cgh.2007.10.031. PMID 18166476.
  15. ↑ Bergman D, Khalili H, Lebwohl B, Roelstraete B, Green PH, Ludvigsson JF (March 2023). "Celiac disease and risk of microscopic colitis: A nationwide population-based matched cohort study". United European Gastroenterol J. 11 (2): 189–201. doi:10.1002/ueg2.12374. PMC 10039793 Check |pmc= value (help). PMID 36939488 Check |pmid= value (help).
  16. ↑ 16.0 16.1 Sikkens EC, Cahen DL, de Wit J, Looman CW, van Eijck C, Bruno MJ (2014). "A prospective assessment of the natural course of the exocrine pancreatic function in patients with a pancreatic head tumor". J Clin Gastroenterol. 48 (5): e43–6. doi:10.1097/MCG.0b013e31829f56e7. PMID 24717227.
  17. ↑ Singh P, Arora A, Strand TA, Leffler DA, Catassi C, Green PH, Kelly CP, Ahuja V, Makharia GK (June 2018). "Global Prevalence of Celiac Disease: Systematic Review and Meta-analysis". Clin Gastroenterol Hepatol. 16 (6): 823–836.e2. doi:10.1016/j.cgh.2017.06.037. PMID 29551598.
  18. ↑ 18.0 18.1 Singh P, Arora S, Lal S, Strand TA, Makharia GK (November 2015). "Risk of Celiac Disease in the First- and Second-Degree Relatives of Patients With Celiac Disease: A Systematic Review and Meta-Analysis". Am J Gastroenterol. 110 (11): 1539–48. doi:10.1038/ajg.2015.296. PMID 26416192.
  19. ↑ Roy A, Laszkowska M, Sundström J, Lebwohl B, Green PH, Kämpe O, Ludvigsson JF (July 2016). "Prevalence of Celiac Disease in Patients with Autoimmune Thyroid Disease: A Meta-Analysis". Thyroid. 26 (7): 880–90. doi:10.1089/thy.2016.0108. PMID 27256300.
  20. ↑ Machicado JD, Chari ST, Timmons L, Tang G, Yadav D (January 2018). "A population-based evaluation of the natural history of chronic pancreatitis". Pancreatology. 18 (1): 39–45. doi:10.1016/j.pan.2017.11.012. PMC 5794616. PMID 29221631.
  21. ↑ Haupt ME, Kwasny MJ, Schechter MS, McColley SA (May 2014). "Pancreatic enzyme replacement therapy dosing and nutritional outcomes in children with cystic fibrosis". J Pediatr. 164 (5): 1110–1115.e1. doi:10.1016/j.jpeds.2014.01.022. PMID 24560182.
  22. ↑ Ford AC, Spiegel BM, Talley NJ, Moayyedi P (December 2009). "Small intestinal bacterial overgrowth in irritable bowel syndrome: systematic review and meta-analysis". Clin Gastroenterol Hepatol. 7 (12): 1279–86. doi:10.1016/j.cgh.2009.06.031. PMID 19602448.
  23. ↑ Nyhlin H, Merrick MV, Eastwood MA (January 1994). "Bile acid malabsorption in Crohn's disease and indications for its assessment using SeHCAT". Gut. 35 (1): 90–3. doi:10.1136/gut.35.1.90. PMC 1374639. PMID 8307458.


Template:WH Template:WS


Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Chronic_diarrhea_risk_factors&oldid=1743780"