Chronic diarrhea classification: Difference between revisions
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==Overview== | ==Overview== | ||
[[Chronic diarrhea causes|Chronic diarrhea]] may be classified into 3 basic categories: [[Watery diarrhea|watery]], [[Steatorrhea|fatty]]([[malabsorption]]) and [[inflammatory]] (with [[blood]] and [[pus]]). It is important to note that not all chronic diarrhea falls into one category alone. Classifying the patient with [[chronic diarrhea]] into a subcategory helps to direct the diagnostic work-up. | [[Chronic diarrhea causes|Chronic diarrhea]] may be classified into 3 basic categories: [[Watery diarrhea|watery]], [[Steatorrhea|fatty]]([[malabsorption]]) and [[inflammatory]] (with [[blood]] and [[pus]]). It is important to note that not all chronic [[diarrhea]] falls into one category alone. Classifying the patient with [[chronic diarrhea]] into a subcategory helps to direct the [[diagnostic]] work-up. | ||
==Classification== | ==Classification== | ||
Chronic diarrhea may be classified into:<ref name="FineSchiller1999">{{cite journal|last1=Fine|first1=K|last2=Schiller|first2=L|title=AGA Technical Review on the Evaluation and Management of Chronic Diarrhea☆|journal=Gastroenterology|volume=116|issue=6|year=1999|pages=1464–1486|issn=00165085|doi=10.1016/S0016-5085(99)70513-5}}</ref><ref>{{cite journal|title=American Gastroenterological Association medical position statement: Guidelines for the evaluation and management of chronic diarrhea☆, ☆☆|journal=Gastroenterology|volume=116|issue=6|year=1999|pages=1461–1463|issn=00165085|doi=10.1016/S0016-5085(99)70512-3}}</ref><ref name="pmid15017602">{{cite journal| author=Camilleri M| title=Chronic diarrhea: a review on pathophysiology and management for the clinical gastroenterologist. | journal=Clin Gastroenterol Hepatol | year= 2004 | volume= 2 | issue= 3 | pages= 198-206 | pmid=15017602 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15017602 }} </ref><ref name="pmid10699778">{{cite journal| author=Fine KD, Seidel RH, Do K| title=The prevalence, anatomic distribution, and diagnosis of colonic causes of chronic diarrhea. | journal=Gastrointest Endosc | year= 2000 | volume= 51 | issue= 3 | pages= 318-26 | pmid=10699778 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10699778 }} </ref> | Chronic [[diarrhea]] may be classified into:<ref name="FineSchiller1999">{{cite journal|last1=Fine|first1=K|last2=Schiller|first2=L|title=AGA Technical Review on the Evaluation and Management of Chronic Diarrhea☆|journal=Gastroenterology|volume=116|issue=6|year=1999|pages=1464–1486|issn=00165085|doi=10.1016/S0016-5085(99)70513-5}}</ref><ref>{{cite journal|title=American Gastroenterological Association medical position statement: Guidelines for the evaluation and management of chronic diarrhea☆, ☆☆|journal=Gastroenterology|volume=116|issue=6|year=1999|pages=1461–1463|issn=00165085|doi=10.1016/S0016-5085(99)70512-3}}</ref><ref name="pmid15017602">{{cite journal| author=Camilleri M| title=Chronic diarrhea: a review on pathophysiology and management for the clinical gastroenterologist. | journal=Clin Gastroenterol Hepatol | year= 2004 | volume= 2 | issue= 3 | pages= 198-206 | pmid=15017602 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15017602 }} </ref><ref name="pmid10699778">{{cite journal| author=Fine KD, Seidel RH, Do K| title=The prevalence, anatomic distribution, and diagnosis of colonic causes of chronic diarrhea. | journal=Gastrointest Endosc | year= 2000 | volume= 51 | issue= 3 | pages= 318-26 | pmid=10699778 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10699778 }} </ref> | ||
*[[Inflammatory|Inflammatory diarrhea]] | *[[Inflammatory|Inflammatory diarrhea]] | ||
*[[Watery diarrhea]] | *[[Watery diarrhea]] | ||
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[[Diarrhea (patient information)|Diarrhea]] is said to be due to an [[inflammatory]] cause when [[Stool examination|stool analysis]] such as [[Stool culture|stool cultures]], [[flexible sigmoidoscopy]] or [[colonoscopy]] with [[biopsies]] show evidence of the presence of [[Fecal occult blood|fecal leukocytes]]. Causes of [[Inflammatory|inflammatory diarrhea]] include: | [[Diarrhea (patient information)|Diarrhea]] is said to be due to an [[inflammatory]] cause when [[Stool examination|stool analysis]] such as [[Stool culture|stool cultures]], [[flexible sigmoidoscopy]] or [[colonoscopy]] with [[biopsies]] show evidence of the presence of [[Fecal occult blood|fecal leukocytes]]. Causes of [[Inflammatory|inflammatory diarrhea]] include: | ||
*[[Idiopathic]] [[inflammatory bowel disease]] such as [[Crohn’s disease]] or [[ulcerative colitis]] | *[[Idiopathic]] [[inflammatory bowel disease]] such as [[Crohn’s disease]] or [[ulcerative colitis]] | ||
*[[Infectious disease|Infectious diseases]] such as [[cytomegalovirus]], [[herpes simplex]] | *[[Infectious disease|Infectious diseases]] such as: | ||
**[[cytomegalovirus]], | |||
**[[herpes simplex]] | |||
**[[tuberculosis]] | |||
**[[strongyloidiasis]] | |||
**[[Aeromonas]] | |||
**[[Plesiomonas shigelloides|Plesiomonas]] | |||
*[[Ischemic colitis]] | *[[Ischemic colitis]] | ||
*[[Radiation colitis]] | *[[Radiation colitis]] | ||
*[[Neoplasia]] | *[[Neoplasia]] | ||
===Watery diarhea=== | ===Watery diarhea=== | ||
Watery diarrhea can be classified as: | Watery [[diarrhea]] can be classified as: | ||
*Osmotic diarrhea ([[Stools]] with high osmotic gap >100 mosm/kg). Causes of osmotic diarrhea include: | *Osmotic [[diarrhea]] ([[Stools]] with high osmotic gap >100 mosm/kg). Causes of osmotic [[diarrhea]] include: | ||
**[[Celiac sprue]] | **[[Celiac sprue]] | ||
**[[Chronic pancreatitis]] | **[[Chronic pancreatitis]] | ||
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**[[Whipple's disease]] | **[[Whipple's disease]] | ||
*Secretory diarrhea (Stools with low osmotic gap <50 mosm/kg) causes of secretory diarrhea include: | *Secretory [[diarrhea]] (Stools with low osmotic gap <50 mosm/kg) causes of secretory [[diarrhea]] include: | ||
**[[Cholera]] | **[[Cholera]] | ||
**[[ETEC|Enterotoxigenic strains of E. coli]] | **[[ETEC|Enterotoxigenic strains of E. coli]] |
Revision as of 16:18, 28 July 2017
Chronic diarrhea Microchapters |
Diagnosis |
---|
Treatment |
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
Chronic diarrhea may be classified into 3 basic categories: watery, fatty(malabsorption) and inflammatory (with blood and pus). It is important to note that not all chronic diarrhea falls into one category alone. Classifying the patient with chronic diarrhea into a subcategory helps to direct the diagnostic work-up.
Classification
Chronic diarrhea may be classified into:[1][2][3][4]
Inflammatory diarrhea
Diarrhea is said to be due to an inflammatory cause when stool analysis such as stool cultures, flexible sigmoidoscopy or colonoscopy with biopsies show evidence of the presence of fecal leukocytes. Causes of inflammatory diarrhea include:
- Idiopathic inflammatory bowel disease such as Crohn’s disease or ulcerative colitis
- Infectious diseases such as:
- Ischemic colitis
- Radiation colitis
- Neoplasia
Watery diarhea
Watery diarrhea can be classified as:
A normal gap is between 50 and 100 mosm/kg.[6]
Fatty diarrhea
Fatty diarrhea can be described either due to malabsorption or maldigestion problems:
- The most common causes of malabsorption are:
- Maldigestion results from pancreatic exocrine insufficiency.
References
- ↑ Fine, K; Schiller, L (1999). "AGA Technical Review on the Evaluation and Management of Chronic Diarrhea☆". Gastroenterology. 116 (6): 1464–1486. doi:10.1016/S0016-5085(99)70513-5. ISSN 0016-5085.
- ↑ "American Gastroenterological Association medical position statement: Guidelines for the evaluation and management of chronic diarrhea☆, ☆☆". Gastroenterology. 116 (6): 1461–1463. 1999. doi:10.1016/S0016-5085(99)70512-3. ISSN 0016-5085.
- ↑ Camilleri M (2004). "Chronic diarrhea: a review on pathophysiology and management for the clinical gastroenterologist". Clin Gastroenterol Hepatol. 2 (3): 198–206. PMID 15017602.
- ↑ Fine KD, Seidel RH, Do K (2000). "The prevalence, anatomic distribution, and diagnosis of colonic causes of chronic diarrhea". Gastrointest Endosc. 51 (3): 318–26. PMID 10699778.
- ↑ Oster JR, Materson BJ, Rogers AI (1980). "Laxative abuse syndrome". Am J Gastroenterol. 74 (5): 451–8. PMID 7234824.
- ↑ Shiau, Yih-Fu (1985). "Stool Electrolyte and Osmolality Measurements in the Evaluation of Diarrheal Disorders". Annals of Internal Medicine. 102 (6): 773. doi:10.7326/0003-4819-102-6-773. ISSN 0003-4819.