Chronic diarrhea differential diagnosis: Difference between revisions

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__NOTOC__
__NOTOC__
{{Chronic diarrhea}}
{{Chronic diarrhea}}
{{CMG}}; {{AE}} {{DAMI}}
{{CMG}}; {{AE}} {{SSH}}


==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 insufficienc]]<nowiki/>y. Finally, the [[inflammatory]] causes of chronic diarrhea such as [[diverticulitis]], [[ulcerative colitis]] and [[entamoeba histolytica]] must also be differentiated.
==Differential Diagnosis of Chronic Diarrhea of 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. 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>


==Differential diagnosis==
<span style="font-size:85%">'''Abbreviations:''' '''GI:''' [[Gastrointestinal tract|Gastrointestinal]], '''CBC''': [[Complete blood count]], '''WBC:''' [[White blood cells|White blood cell]], '''RBC''': [[Red blood cell]], '''Plt:''' [[Platelet]], '''Hgb:''' [[Hemoglobin]], '''ESR''': [[Erythrocyte sedimentation rate]], '''CRP''': [[C-reactive protein|C–reactive protein]], '''IgE:''' [[Immunoglobulin E]], '''IgA:''' [[Immunoglobulin A]], '''ETEC:''' [[Escherichia coli enteritis]], '''EPEC''': [[Escherichia coli|Enteropathogenic Escherichia coli]], '''EIEC''': [[Escherichia coli enteritis|Enteroinvasive Escherichia coli]], '''EHEC''': [[Escherichia coli|Enterohemorrhagic Escherichia coli]], '''EAEC''': [[Escherichia coli enteritis|Enteroaggregative Escherichia coli]], '''Nl''': Normal, '''ASCA''': [[Anti saccharomyces cerevisiae antibodies]], '''ANCA''': [[Anti-neutrophil cytoplasmic antibody|Anti–neutrophil cytoplasmic antibody]], '''DNA''': [[DNA|Deoxyribonucleic acid]], '''CFTR''': [[Cystic fibrosis transmembrane conductance regulator]], '''SLC10A2''': [[SLC10A2|Solute carrier family 10 member 2]], '''SeHCAT''': [[SeHCAT|Selenium homocholic acid taurine or tauroselcholic acid]], '''IEL''': Intraepithelial [[Lymphocyte|lymphocytes]], '''MRCP''': [[Magnetic resonance cholangiopancreatography]], '''ANA''': [[Antinuclear antibodies]], '''AMA''': [[Anti-mitochondrial antibody]], '''LDH''': [[Lactate dehydrogenase]], '''CPK''': [[Creatine phosphokinase]], '''PCR''': [[Polymerase chain reaction]], '''ELISA''': [[Enzyme linked immunosorbent assay (ELISA)|Enzyme–linked immunosorbent assay]], '''LT''': Heat–labile [[enterotoxin]], ST: Heat–stable [[enterotoxin]], '''RT-PCR''': Reverse–transcriptase [[polymerase chain reaction]], '''CD4:''' [[CD4|Cluster of differentiation 4]], '''HIV''': [[Human Immunodeficiency Virus (HIV)|Human immunodeficiency virus]], '''RUQ''': [[RUQ|Right-upper quadrant]], '''VIP''': [[Vasoactive intestinal peptide]], '''GI:''' [[Gastrointestinal tract|Gastrointestinal]], '''FAP''': [[Familial adenomatous polyposis]], '''HNPCC''': [[Hereditary nonpolyposis colorectal cancer]], '''MTP''': [[Microsomal triglyceride transfer protein]], '''Scl‑70''': Anti–[[Type I topoisomerase|topoisomerase I]], '''TSH''': [[Thyroid-stimulating hormone]], '''T4''': [[Thyroxine]], '''T3''': [[Triiodothyronine]], '''DTR''': [[Deep tendon reflex]], '''RNA''': [[RNA|Ribonucleic acid]]</span> 
'''The table below summarizes the findings that differentiate watery causes of chronic diarrhea'''<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>
 
<small>
{| class="wikitable" style="border: 0px; font-size: 100%; margin: 3px;" align="center"
{| class="wikitable"
! colspan="2" rowspan="5" style="background:#4479BA; color: #FFFFFF;" align="center" |Categories
! colspan="3" rowspan="2" |Cause
! colspan="2" rowspan="5" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause
! colspan="2" |Osmotic gap
| colspan="9" style="background:#4479BA; color: #FFFFFF;" align="center" |'''Clinical manifestation'''
! rowspan="2" |History
! colspan="9" rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |'''Lab findings'''
! rowspan="2" |Physical exam
! rowspan="5" style="background:#4479BA; color: #FFFFFF;" align="center" |Extra intestinal findings
! rowspan="2" |Gold standard
! rowspan="5" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause/Pathogenesis
! rowspan="2" |Treatment
! rowspan="5" style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard diagnosis
|-
! colspan="8" style="background:#4479BA; color: #FFFFFF;" align="center" |Symptoms
! rowspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" |GI signs
|-
! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Duration
! colspan="3" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Fever
! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal pain
! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
!
|-
! 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
|-
|-
!< 50 mOsm per kg
! style="background:#4479BA; color: #FFFFFF;" align="center" |Acute
!> 50 mOsm per kg*
! 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
|-
|-
| rowspan="5" |Watery
! colspan="2" rowspan="11" style="background:#4479BA; color: #FFFFFF;" align="center" |Gastrointestinal
| rowspan="3" |Secretory
! colspan="2" style="background:#DCDCDC;" align="center" |[[Crohns disease|Crohn's disease]]
|[[Crohns disease|Crohn's disease]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
|<nowiki>+</nowiki>
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
|<nowiki>-</nowiki>
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
|
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Abdominal pain]] followed by [[diarrhea]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
|
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
* [[Abdominal]] [[tenderness]] when palpated in severe [[disease]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* Blood seen on [[rectal exam]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
*[[Fever]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Tachycardia]]
* [[Abdominal tenderness]]
*[[Hypotension]]
* Oral [[mucosal]] lesions
|
| 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" | Nl
| 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="left" |
* [[Anti saccharomyces cerevisiae antibodies]] (ASCA)
* [[Vitamin B12]] deficiency
* Elevated [[erythrocyte sedimentation rate|ESR]]
* Elevated [[C-reactive protein|CRP]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Uveitis]]
* [[Arthritis]]
* [[Erythema nodosum]]
* [[Pyoderma gangrenosum]]
* [[Amyloidosis]]
* Venous and arterial [[thromboembolism]]
* [[Kidney stone|Renal stones]]
* [[Bronchiectasis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Abnormal immune response to self [[antigens]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Colonoscopy]] with [[biopsy]]
* [[Colonoscopy]] with [[biopsy]]
|
* Topical mucosamine and [[corticosteroids]] are preferred
* [[Mesalamine]] and [[sulfasalazine]] are used for remission
|-
|-
|[[Hyperthyroidism]]
! colspan="2" style="background:#DCDCDC;" align="center" |[[Ulcerative colitis]]
|<nowiki>+</nowiki>
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
|<nowiki>-</nowiki>
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
|
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* Excessive [[sweating]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* Heat intolerance
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Hypermotility|Increased bowel movements]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
|
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* Lump in the neck
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Proptosis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Tremors]]
* [[Abdominal tenderness]]
* Increased DTR
* [[Blood]] on [[rectal examination]]
|
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[TSH]] with [[T3]] and [[T4]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
|
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* [[Carbimazole]] and [[methimazole]]  
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
* [[Beta blockers]] like [[propylthiouracil]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* [[Iodine-131]]
| 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="left" |
* [[Anti-neutrophil cytoplasmic antibody|Anti–neutrophil cytoplasmic antibody]] ([[P-ANCA|P–ANCA]])
* [[Hypoalbuminemia]]
* [[Hypokalemia]]
* [[Hypomagnesemia]]
* Elevated [[Erythrocyte sedimentation rate|ESR]]
* Elevated [[C-reactive protein|CRP]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Skin rash]]
* [[Iritis]]
* [[Uveitis]]
* Seronegative [[arthritis]]
* [[Clubbing]]
* [[Erythema nodosum]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Abnormal immune response to self [[antigens]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Colonoscopy]] with [[biopsy]]
|-
|-
|[[VIPoma]]
! colspan="2" style="background:#DCDCDC;" align="center" |[[Celiac disease]]
|<nowiki>+</nowiki>
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| -
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
|
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
* Watery [[diarrhea]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* [[Dehydration]]  ([[thirst]], [[dry skin]], [[dry mouth]], [[tiredness]], [[headaches]], and [[dizziness]])
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ±
* [[Lethargy]], [[muscle weakness]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* [[Nausea]], [[vomiting]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* Cramping [[abdominal pain]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Weight loss]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Flushing]]
|
* [[Tachycardia]]
 
* [[Rash]]
* [[Facial flushing]]
* [[Abdominal distention]]
* [[Abdominal distention]]
* [[Abdominal tenderness]] in the right upper abdominal quadrant
* Increased [[bowel]] sounds
|
* Oral [[Mucous membrane|mucosal]] lesions
* Elevated [[VIP]] levels
* [[Hepatosplenomegaly]]
* Followed by imaging
* [[Ascites]]
|
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* [[Sandostatin]] or [[chemotherapy]] for [[malignant tumors]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* Surgical removal of the [[tumor]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Fat droplets on [[sudan stain]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ↓
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[IgA]] endomysial [[antibody]]
* Anti–tissue [[transglutaminase]] [[antibody]]
* [[Anti-gliadin antibodies|Anti–gliadin antibody]]
* [[Fat soluble vitamins]] deficiency
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Malabsorption]]
* [[Dementia]]
* [[Dermatitis herpetiformis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[HLA-DQ2|HLA–DQ2]]
* [[HLA-DQ8|HLA–DQ8]]
* Innate responses to wheat [[Protein|proteins]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[IgA]] endomysial [[antibody]]
* Anti–tissue [[transglutaminase]] [[antibody]]
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Cystic fibrosis]]
| 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="left" |
*[[Abdominal distension|Abdominal distention]]
*[[Hepatosplenomegaly]]
*[[Rectal prolapse]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Fat droplets on [[sudan stain]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Positive [[DNA]] analysis for [[CFTR|cystic fibrosis transmembrane conductance regulator]] [[CFTR|(CFTR)]]
* Nasal transepithelial potential difference
* [[Fat soluble vitamins]] deficiency
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Malabsorption]]
* Recurrent [[respiratory tract infection]]
* [[Bronchiectasis]]
* [[Diabetes mellitus]]
* [[Scoliosis]]
* [[Infertility]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Mutations in the [[cystic fibrosis transmembrane conductance regulator]] ([[CFTR]]) protein
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Positive [[genetic testing]]
* Elevated [[Sweat chloride test|sweat chloride]] ≥60 mmol/L
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Chronic pancreatitis]]
| 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="left" |
* [[Tenderness (medicine)|Abdominal tenderness]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Fat droplets on [[sudan stain]]
* Positive [[fecal elastase]] measurement
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Slightly elevated [[amylase]] and [[lipase]]
* Abnormal pancreatic function test
* [[Secretin]] stimulation test
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Malabsorption]]
* [[Diabetes mellitus]]
* [[Pancreatic pseudocyst]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Toxin|Toxins]]
* Recurrent [[acute pancreatitis]]
* [[Genetics|Genetic]] predesposition
* [[Autoimmunity|Autoimmune]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Magnetic resonance cholangiopancreatography]] ([[Magnetic resonance cholangiopancreatography|MRCP]])
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Bile acid malabsorption]]
| 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="Left" |
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Fat droplets on [[sudan stain]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Reduced [[cholesterol]] level
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Malabsorption]]
*[[Hypotension]]
*[[Tachycardia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Genetic defects in ''[[SLC10A2]]''
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[SeHCAT]] test
|-
|-
| rowspan="2" |[[Osmotic]]
! colspan="2" style="background:#DCDCDC;" align="center" |[[Microscopic colitis]]
|[[Lactose intolerance]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| -
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
|<nowiki>+</nowiki>
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
|
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* [[Abdominal pain]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* [[Bloating]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* [[Diarrhea]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Flatulence]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
|
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Abdominal tenderness]]
* [[Abdominal tenderness]]
|
* Fecal [[incontinence]]
* Intestinal [[biopsy]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
|
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
* Avoidance of dietary [[lactose]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* Substitution to maintain nutrient intake
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
* Regulation of [[calcium]] intake
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
* Use of [[enzyme]] [[lactase]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Hypokalemia]]
* Elevated [[C-reactive protein|CRP]]
* Positive [[autoantibodies]] include:
**RF
**[[ANA]]
**[[Anti-mitochondrial antibody|AMA]]
**[[ANCA]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Arthritis]]
* [[Uveitis]]
* [[Idiopathic thrombocytopenic purpura]]
* Pleuro [[pericarditis]]
* [[Hypothyroidism]]
* [[Psoriasis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Mucosal]] [[immune responses]] to luminal factors in a genetically predisposed individual
* Drug–induced
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Colonoscopy]] with [[mucosal]] [[biopsy]] with [[mononuclear]] infiltrates:
** [[Collagenous colitis]] is characterized by a colonic subepithelial [[collagen]] band >10 micrometers in diameter
** [[Lymphocytic]] [[colitis]] is characterized by ≥20 intraepithelial [[lymphocytes]] (IEL) per 100 surface epithelial cells
|-
! 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" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="Left" |
*Rebound [[Tenderness (medicine)|abdominal tenderness]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive [[stool culture]]
*Positive fecal calprotectin
*Positive fecal [[lactoferrin]]
| 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="left" |
*Elevated [[C-reactive protein|CRP]]
*Elevated [[Erythrocyte sedimentation rate|ESR]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Arthritis]]
* [[Uveitis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Salmonella|''Salmonella'']]
*[[Shigella|''Shigella'']]
*[[Campylobacter|''Campylobacter'']]
*''[[Escherichia coli|E. coli 0157:H7]]''
*[[Clostridium difficile|''Clostridium difficile'']]
*[[Entamoeba histolytica|''Entamoeba histolytica'']]
*[[Adenoviridae|''Adenovirus'']]
*[[Cytomegalovirus|''Cytomegalovirus'']]
*[[Herpes simplex virus|''Herpes simplex virus'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Stool culture]]
*[[Blood culture]]
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Ischemic 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" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="Left" |
*Hyperactive then absent [[Stomach rumble|bowel sounds]]
*[[Tenderness (medicine)|Abdominal tenderness]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| 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="left" |
*Elevated [[C-reactive protein|CRP]]
*Elevated [[Erythrocyte sedimentation rate|ESR]]
*Elevated serum [[Lactic acid|lactate]]
*Elevated [[lactate dehydrogenase]] ([[Lactate dehydrogenase|LDH]]) 
*Elevated [[Creatine kinase|creatine phosphokinase]] ([[Creatine kinase|CPK]])
*Elevated [[amylase]]
*[[Hypoalbuminemia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Henoch-Schönlein purpura|IgA vasculitis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Thrombophilia|Hypercoagulability]] 
*Nonocclusive [[Ischemic colitis|colonic ischemia]]
*[[Embolism|Embolic]] and [[Thrombosis|thrombotic]] arterial occlusion
*[[Mesenteric vein thrombosis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Abdominal [[Computed tomography|CT scan]]
|-
|-
|[[Celiac disease (patient information)|Celiac disease]]
! colspan="2" style="background:#DCDCDC;" align="center" |[[Lactose intolerance]]
| -
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
|
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* May be [[asymptomatic]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* Vague [[abdominal pain]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* [[Diarrhea]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* [[Weight loss]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Malabsorption]]/[[steatorrhea]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* Bloatedness
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |  
|
* [[Abdominal tenderness ]]
* [[Abdominal pain]] and [[cramping]]
* [[Abdominal distention]]
* [[Abdominal distention]]
* [[Tetany]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
* [[Mouth ulcers]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
* [[Dermatitis herpetiformis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* Signs of the fat-soluble [[Vitamin A|vitamins A]], D, E, and K deficiency
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
|
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
* [[IgA]] tissue [[transglutaminase]] Ab
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
|
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
* [[Gluten-free diet]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Lactose tolerance test
* Genetic testing
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Headache]]
* [[Vertigo]]
* [[Memory impairment]]
* [[Lethargy]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |  
* Reduction of lactase enzyme activity or inability to produce persistent [[lactase]]  
* Congenital [[lactase deficiency]]
* Secondary lactose malabsorption
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |  
* [[Small bowel]] [[biopsy]] 
* Lactose breath hydrogen test
|-
|-
|
! colspan="2" style="background:#DCDCDC;" align="center" |[[Irritable bowel syndrome]]
|Functional
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
|[[Irritable bowel syndrome]]
| 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" |±
[[Abdominal pain]] or discomfort recurring at least 3 days per month in the past 3 months and associated with 2 or more of the following:
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* Improves with [[defecation]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
 
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* Onset associated with change in frequency of [[stool]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |  
 
* Onset associated with change in appearance of [[stool]]
 
* 25% of [[Bowel movement|bowel movements]] are loose [[stools]]
History of straining is also common.
|
* [[Abdominal tenderness]]
* [[Abdominal tenderness]]
* Hard [[stool]] in the rectal vault
* [[Abdominal distention]]
|
* Normal [[Stomach rumble|bowel sounds]]
* [[Diagnosis|Clinical diagnosis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
** ROME III criteria
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
** [[Pharmacological|Pharmacologic]] studies based criteria
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
|
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
* High [[dietary fiber]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
* [[Osmotic]] [[laxatives]] such as [[polyethylene glycol]], [[sorbitol]], and [[lactulose]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
* [[Antispasmodic]] drugs (e.g. [[Anticholinergic|anticholinergics]] such as [[hyoscyamine]] or [[dicyclomine]])
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
|}{{WikiDoc Help Menu}} {{WikiDoc Sources}}
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Anxiety]]
*[[Palpitation]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Unknown
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Diagnosis of exclusion
|-
! rowspan="29" style="background:#4479BA; color: #FFFFFF;" align="center" |Infection
! rowspan="18" style="background:#4479BA; color: #FFFFFF;" align="center" |Bacterial
! 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" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Hepatosplenomegaly]]
* [[Ascites]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Positive [[fecal fat]]
| 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="left" |
*[[Hypoalbuminemia]]
*[[Fat soluble vitamins]] deficiency
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Malabsorption]]
* [[Ocular motility disorders|Abnormal extraocular movement]]
* [[Lymphadenopathy]]
* [[Hyperpigmentation]]
* [[Uveitis]]
* [[Endocarditis]]
* [[Encephalitis]]
* [[Dementia]]
* [[Pleural effusion]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Tropheryma whipplei|''Tropheryma whipplei'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Small intestine]] [[biopsy]] for [[Tropheryma whipplei]] testing
* [[PCR]] testing
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Tropical sprue]]
| 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="left" |
* Angular [[stomatitis]]
* Oral mucosal lesion
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive [[stool culture]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ↓
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Fat soluble vitamins]] deficiency
* [[Vitamin B12 deficiency]]
* [[Folate deficiency]]
* [[Hypokalemia]] 
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Myalgia]]
*[[Neuropathy]]
*[[Edema]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |  
* ''[[Escherichia coli]]''
* ''[[Klebsiella pneumoniae]]''
* ''[[Enterobacter cloacae]]''
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Diagnosis of exclusion
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Small bowel bacterial overgrowth syndrome|Small bowel bacterial overgrowth]]
| 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="left" |
* [[Abdominal distension|Abdominal distention]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive [[stool culture]]
*Positive [[fecal fat]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Hypoalbuminemia]]
* Abnormal [[Hydrogen Breath Test|hydrogen breath test]]
* [[Lactic acidosis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Malabsorption]]
* [[Rosacea]] 
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Excess bacteria in the [[small intestine]]
* Alterations in [[Intestine|intestinal]] [[anatomy]] or GI motility
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Diagnosis of exclusion
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Pseudomembranous enterocolitis]]
| 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="left" |
* Generalized [[Tenderness (medicine)|abdominal tenderness]]
* [[Abdominal distention]]
* [[Rebound tenderness|Rebound abdominal tenderness]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Enzyme linked immunosorbent assay (ELISA)|Enzyme–linked immunosorbent assay]] ([[Enzyme linked immunosorbent assay (ELISA)|ELISA]])
* [[Polymerase chain reaction]] ([[Polymerase chain reaction|PCR]]) assay or ''[[Clostridium difficile infection|C. difficile]]'' antigen
| 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="left" |
* Elevated [[Creatinine|serum creatinine]]
* [[Hypoalbuminemia]]
* Elevated [[lactic acid]]  
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Dehydration]]
* [[Acute kidney injury]]


'''The table below summarizes the findings that differentiate fatty causes of chronic diarrhea'''<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>
* [[Bacteremia]]
{| class="wikitable"
* [[Reactive arthritis]]
! rowspan="2" |Cause
* [[Necrotizing fasciitis]]
! colspan="2" |Osmotic gap
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
! rowspan="2" |History
* [[Clostridium difficile|''Clostridium difficile'']]
! rowspan="2" |Physical exam
* Recent [[antibiotics]] use
! rowspan="2" |Gold standard
* Recent [[surgery]]
! rowspan="2" |Treatment
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Stool examination|Stool exam]]
* Pseudomembranes on [[colonoscopy]]
|-
! colspan="2" style="background:#DCDCDC;" align="center" | [[Campylobacteriosis]]
| 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="Left" |
*Diffuse [[abdominal tenderness]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive [[stool culture]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Toxic megacolon]]
*[[Sepsis]]
*[[Arthritis]]
*[[Endocarditis]] 
*[[Guillain-Barré syndrome|Guillain–Barré syndrome]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Campylobacter jejuni|''Campylobacter jejuni'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Stool culture]]
|-
|-
!< 50
! colspan="2" style="background:#DCDCDC;" align="center" |[[Salmonellosis]]
mOsm
| 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="Left" |
*[[Abdominal distention]]
*Diffuse [[abdominal tenderness]]
*[[Hepatosplenomegaly]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive [[stool culture]]
*Positive serologic testing
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Hypokalemia]]
*[[Hypernatremia]]
*[[Hyponatremia]]


per kg
* [[Hypercalciuria]]
!> 50
* [[Hypocitraturia]]
mOsm
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Post-infectious arthritis|Post–infectious arthritis]]
* [[Obtundation]]
* [[Bacteremia]]


per kg*
* [[Pericarditis]]
* [[Pyelonephritis]]
*[[Brain abscess]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Salmonella|''Salmonella'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Stool culture]]
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Shigellosis]]
| 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="Left" |
* [[Abdominal distention]]
* Hyperactive [[Stomach rumble|bowel sounds]]
* Diffuse [[abdominal tenderness]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive [[stool culture]]
| 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="left" |
*Elevated [[C-reactive protein|CRP]]
*Elevated [[Erythrocyte sedimentation rate|ESR]]
*[[Hyponatremia]]
* [[Hypoglycemia]]
* [[Azotemia]] 
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Headache]]
* [[Lethargy]]
* [[Seizures]]
* [[Delirium]]
* [[Post-infectious arthritis|Post–infectious arthritis]]
* [[Myocarditis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Shigella|''Shigella'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Stool culture]]
|-
|-
|[[Lactose intolerance]]
! rowspan="5" style="background:#DCDCDC;" align="center" |[[Escherichia coli enteritis]]
| -
| style="background:#DCDCDC;" align="center" |[[ETEC|'''ETEC''']]
| +
([[Traveler's diarrhea]])
|
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Bloating]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* [[Flatulence]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Abdominal pain]] and/or [[chronic diarrhea]]  
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* After ingestion of [[lactose]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
|
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Abdominal]] [[tenderness]] when palpated in severe [[disease]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* [[Fever]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* [[Hypotension]]
| style="padding: 5px 5px; background: #F5F5F5;" align="Left" |
* [[Tachycardia]]
*Diffuse [[abdominal tenderness]]
* [[Nausea and vomiting]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
|[[Hydrogen Breath Test|Lactose breath hydrogen test]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
|Restriction of  [[lactose]] and  maintaining [[calcium]] and [[vitamin D]] intake.
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive [[stool culture]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Escherichia coli|''Enterotoxigenic escherichia coli'']]
*[[Enterotoxin|Enterotoxins]]:
**Heat–labile [[enterotoxin]] (LT)
**Heat–stable [[enterotoxin]] (ST)
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Stool culture]]
|-
|-
|[[Celiac sprue]]
| style="background:#DCDCDC;" align="center" |[[EPEC|'''EPEC''']]
| -
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
|
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Diarrhea]] with bulky, [[Steatorrhea|foul-smelling stools]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Growth failure]] in children
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
* [[Weight loss]]  
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Anemia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Neurologic diseases|Neurologic disorders]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Osteopenia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="Left" |
|
*Diffuse [[abdominal tenderness]]
* [[Neuropsychiatric|Neuropsychiatric disease]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Dermatitis herpetiformis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Arthritis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* [[Iron deficiency]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
* [[Metabolic]] bone disease
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Hyposplenism]]  
*Positive [[stool culture]]
* [[Kidney disease]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
* [[Idiopathic pulmonary hemosiderosis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
|[[Immunoglobulin A]] ([[IgA]]) [[Tissue transglutaminase|anti-tissue transglutaminase]] (TTG) antibody followed by upper [[endoscopy]] with [[biopsy]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
|Dietary counseling, elimination of [[gluten]] in the diet.
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*''[[Enteropathogenic E. coli]]''
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Hybridization probe|DNA probe]] or [[polymerase chain reaction]] ([[Polymerase chain reaction|PCR]]) of the ''EPEC'' adherence factor
*[[Stool culture]]
|-
| style="background:#DCDCDC;" align="center" |[[EIEC|'''EIEC''']]
| 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="Left" |
*Diffuse [[abdominal tenderness]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive [[stool culture]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Escherichia coli enteritis|''Enteroinvasive E. coli'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Hybridization probe|DNA probe]]
*[[Stool culture]]
|-
| style="background:#DCDCDC;" align="center" |[[EHEC|'''EHEC''']]
| 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="Left" |
*Diffuse [[abdominal tenderness]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive [[stool culture]]
| 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="left" |
* [[Azotemia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Hemolytic-uremic syndrome|Hemolytic uremic syndrome]] ([[Hemolytic-uremic syndrome|HUS]])
*[[Renal insufficiency|Renal failure]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Enterohemorrhagic escherichica coli|''Enterohemorrhagic E. coli'']] 
*[[Shiga toxin|Shiga toxins]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Stool culture]]
|-
| style="background:#DCDCDC;" align="center" |[[EAEC|'''EAEC''']]
| 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="Left" |
*Diffuse [[abdominal tenderness]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive [[stool culture]]
| 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="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Chronic infection in [[Immunodeficiency|immunocompromised]] patients
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Escherichia coli enteritis|''Enteroaggregative E. coli'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Stool culture]]
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Yersinia enterocolitica]]
| 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="Left" |
* [[Abdominal distention]]
* Hyperactive [[Stomach rumble|bowel sounds]]
* Diffuse [[abdominal tenderness]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive [[stool culture]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Bacteremia]]
*[[Reactive arthritis]]
*[[Glomerulonephritis]]
*[[Endocarditis]]
*[[Erythema nodosum]]
*[[Abscess]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Yersinia enterocolitica|''Yersinia enterocolitica'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Stool culture]]
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Vibrio cholerae|Vibrio cholera]]
| 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="Left" |
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive [[stool culture]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Azotemia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Severe [[dehydration]]
*Decreased [[Turgor|skin turgor]]
*[[Oliguria]]
*[[Renal insufficiency|Renal failure]]
*[[Cramp|Muscle cramps]]
*[[Seizure]]
*[[Somnolence]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Cholera toxin]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Stool culture]]
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Aeromonas]]
| 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="Left" |
* [[Abdominal distention]]
* Hyperactive [[Stomach rumble|bowel sounds]]
* Diffuse [[abdominal tenderness]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive [[stool culture]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Wound [[infection]]
*[[Bacteremia]]
*[[Hemolytic-uremic syndrome|Hemolytic uremic syndrome]] 
*[[Meningitis]]
*[[Ocular]] infection
*[[Pneumonia]] 
*[[Urinary tract infection]]
*[[Osteomyelitis]]
*[[Peritonitis]]
*[[Acute cholecystitis]]
*[[Opportunistic infection|Opportunistic infections]] in [[Immunodeficiency|immunocompromised]] patients
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*''[[Aeromonas]]'' virulence factors including [[Endotoxin|endotoxins]], [[Hemolysin|hemolysins]], [[Enterotoxin|enterotoxins]], and adherence factors
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Blood culture]]
*Wound [[Culture collection|culture]]
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Plesiomonas shigelloides|Plesiomonas]]
| 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="Left" |
* Hyperactive [[Stomach rumble|bowel sounds]]
* Diffuse [[abdominal tenderness]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive [[stool culture]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Opportunistic infection|Opportunistic infections]] in [[Immunodeficiency|immunocompromised]] patients or [[Hepato-biliary diseases|hepatobiliary disease]]
*[[Bacteremia]]
*[[Cellulitis]] and [[Skin and soft-tissue infections|skin abscesses]]
*[[Peritonitis]]
*[[Meningoencephalitis]]
*[[Ocular]] [[infection]]
*[[Pneumonia]]
*[[Prosthetic devices|Prosthetic]] joint [[infection]] 
*Septic [[Pregnancy termination complications|abortion]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Plesiomonas shigelloides|''Plesiomonas shigelloides'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Blood culture]]
|-
! 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" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Abdominal distension|Abdominal distention]]
*[[Hepatosplenomegaly]] 
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Elevated [[Liver function tests|liver enzymes]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Opportunistic infection]] in [[Immunodeficiency|immunocompromised]] patients
*[[Pulmonary]] [[infection]]
*[[Lymphadenopathy|Adenopathy]] 
*[[Sleep hyperhidrosis|Night sweats]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Mycobacterium avium complex|''Mycobacterium avium complex'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Blood culture]]
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Foodborne illness|Food poisoning]]
* [[Staphylococcus aureus]]
* [[Bacillus cereus]]
* [[Clostridium perfringens]]
| 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="left" |
*[[Abdominal distension|Abdominal distention]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive [[stool culture]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*History of travel or ingestion of infected food
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Enterotoxin|Enterotoxins]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Stool culture]]
|-
| rowspan="6" style="background:#4479BA; color: #FFFFFF;" align="center" |Virus
! colspan="2" style="background:#DCDCDC;" align="center" |[[Norovirus]]
| 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="Left" |
*[[Abdominal distension|Abdominal distention]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive stool reverse–transcriptase [[polymerase chain reaction]] (RT–PCR)
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Myalgia]]
*[[Headache]] 
*[[Seizure]] 
*[[Encephalopathy]] 
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Norovirus|''Norovirus'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Clinical diagnosis
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Rotavirus]]
| 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="Left" |
* Hyperactive [[Stomach rumble|bowel sounds]]
* Diffuse [[abdominal tenderness]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Elevated [[blood urea nitrogen]]
*[[Hyperchloremic acidosis]]
*[[Hypocalcemia]] 
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Necrotizing enterocolitis]]
*[[Intussusception]] 
*[[Biliary atresia]]
*[[Central nervous system]] involvement
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Rotavirus|''Rotavirus'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Stool immune–based assays
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Echovirus]]
| 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="Left" |
*[[Abdominal distension|Abdominal distention]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Hepatic failure|Liver failure]]
*[[Myocarditis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Echovirus|''Echovirus'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Clinical diagnosis
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Adenoviridae|Adenovirus]]
| 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="Left" |
*[[Abdominal distension|Abdominal distention]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Viral antigen assay
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Respiratory disease]]
*[[Hyperkeratosis|Follicular]] [[conjunctivitis]]
*Epidemic [[keratoconjunctivitis]]
*[[Hepatitis]] 
*[[Urethritis]] 
*[[Myocarditis]] 
*[[Meningitis]] 
*[[Bacteremia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Adenoviridae|''Adenovirus'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Clinical diagnosis
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[CMV 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" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Diffuse [[Tenderness (medicine)|abdominal tenderness]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Viral antigen assay
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Decreased [[CD4]] level
*Abnormal [[Liver function tests|liver function test]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Encephalitis]] 
*[[Guillain-Barré syndrome|Guillain–Barré syndrome]]
*[[Pneumonia]] 
*[[Retinitis]]
*[[Pericarditis]] and [[myocarditis]]
*[[Atherosclerosis]] 
*[[Venous thromboembolism|Venous thrombosis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Cytomegalovirus|''Cytomegalovirus'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Quantitative polymerase chain reaction|Quantitative PCR]] tests 
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Human Immunodeficiency Virus (HIV)|HIV]]
| 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="Left" |
*[[Abdominal distension|Abdominal distention]]
*Diffuse [[Tenderness (medicine)|abdominal tenderness]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Decreased [[CD4]] level
*[[Electrolyte disturbance|Electrolyte imbalance]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Lymphadenopathy]]
*Disseminated [[infection]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Human Immunodeficiency Virus (HIV)|''HIV'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*HIV virologic (viral load) test
*Immunoassay 
|-
! rowspan="5" style="background:#4479BA; color: #FFFFFF;" align="center" |Parasite
! 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" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="Left" |
*[[Abdominal distension|Abdominal distention]]
*Diffuse [[Tenderness (medicine)|abdominal tenderness]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Liver abscess]]
*Pleuropulmonary infection
*[[Cardiac]] [[infection]]
*[[Brain abscess]]
*[[Skin and soft-tissue infections|Cutaneous infection]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Entamoeba histolytica|''Entamoeba histolytica'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Antigen testing
*Serology 
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Giardia lamblia|Giardia]]
| 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="Left" |
*[[Abdominal distension|Abdominal distention]]
*Diffuse [[Tenderness (medicine)|abdominal tenderness]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Malabsorption]]
*[[Urticaria]]
*[[Depression]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*''[[Giardia lamblia]]''
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Antigen detection assays
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Cryptosporidium]]
| 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="Left" |
*[[Abdominal distension|Abdominal distention]]
*Diffuse [[Tenderness (medicine)|abdominal tenderness]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive stool microscopy
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Elevated [[alkaline phosphatase]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Chronic, life–threatening illness in [[Immunodeficiency|immunocompromised]] patients
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Cryptosporidium|''Cryptosporidium'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Polymerase chain reaction
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Microsporidia]]
| 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="Left" |
*[[Abdominal distension|Abdominal distention]]
*Diffuse [[Tenderness (medicine)|abdominal tenderness]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive stool microscopy
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Decreased [[CD4]] count
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Malabsorption]]
*[[Keratitis]] 
*[[Seizure]]
*[[Myositis]] 
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Microsporidia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Antigen detection assays
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Isospora]]
| 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="left" |
*[[Abdominal distension|Abdominal distention]]
*Diffuse [[Tenderness (medicine)|abdominal tenderness]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive stool microscopy
*Positive [[fecal fat]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Elevated [[Eosinophil granulocyte|eosinophils]] 
*[[Hypokalemia]]
*Increased [[creatinine]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Chronic illness in [[Immunodeficiency|immunocompromised]] patients
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Isospora|''Isospora'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Detecting oocysts in the feces
|-
! colspan="2" rowspan="6" style="background:#4479BA; color: #FFFFFF;" align="center" |Tumors
! 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="Left" |
* [[Abdominal distention]]
| 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="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Elevated urinary [[5-Hydroxyindoleacetic acid|5–hydroxyindoleacetic acid]] ([[5-Hydroxyindoleacetic acid|5–HIAA]]) level
*High [[chromogranin A]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Flushing|Facial flushing]]
*[[Jaundice]]
*[[Edema]]
*[[Valvular heart disease]]
*[[Congestive heart failure|Right–sided heart failure]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Well–differentiated [[Neuroendocrine tumors|neuroendocrine tumor]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Blood [[chromogranin A]]  level
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[VIPoma]]
| 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="Left" |
* [[Abdominal distention]]
* Abdominal [[RUQ]] [[tenderness]]
* [[Nausea]]
* [[Vomiting]]
| 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="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Elevated [[VIP]] level
*[[Hypokalemia]]
*[[Hypochlorhydria]] or [[achlorhydria]]
*Low osmotic gap (<50 mOsm/kg)
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Rash]]
* [[Facial flushing]]
* [[Dehydration]]
* [[Lethargy]]
* [[Muscle weakness]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Primary secretory tumor
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Blood [[VIP]] levels
* Followed by imaging
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Zollinger-Ellison syndrome|Zollinger–Ellison syndrome]]
| 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="Left" |
** [[Tenderness|Epigastric tenderness]]
| 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="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Positive [[secretin]] stimulation test
* Elevated serum [[chromogranin A]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
** [[Jaundice]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Gastrin]] producing [[tumor]] mainly in [[duodenum]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Secretin]] stimulation test
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Neuroendocrine tumors|Somatostatinoma]]
| 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="Left" |
** [[Tenderness|Epigastric tenderness]]
| 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="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Elevated fasting plasma [[somatostatin]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
** [[Diabetes mellitus]]
** [[Gallstone disease|Cholelithiasis]]
** [[Jaundice]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Neuroendocrine tumors]] of D–cell origin
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Plasma [[somatostatin]] level
*Followed by imaging
|-
! 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" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="Left" |
*Diffuse [[Tenderness (medicine)|abdominal tenderness]]
*[[Hepatosplenomegaly]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Paraproteinemia]] 
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Malabsorption]]
* [[Lactose intolerance]]
* [[Ascites]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Primary [[tumor]] of GI tract
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Colonoscopy]] with [[biopsy]]
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Colorectal cancer]]
| 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="left" |
*Diffuse [[Tenderness (medicine)|abdominal tenderness]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Positive [[carcinoembryonic antigen]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Metastasis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[FAP|FAP gene]]
*[[Hereditary nonpolyposis colorectal cancer|HNPCC gene]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
** [[Colonoscopy]] and [[biopsy]]
|-
! colspan="2" rowspan="5" style="background:#4479BA; color: #FFFFFF;" align="center" |Medication/Toxicity
! colspan="2" style="background:#DCDCDC;" align="center" |Medications
* [[ACE inhibitor|ACE inhibitors]]
* [[Digoxin]]
* [[Cephalosporin|Cephalosporins]]
* [[Statins]]
* [[Thiazide|Thiazide diuretics]]
* [[Triptans]]
* [[Lactulose]]
* [[HIV AIDS medical therapy|Anti retroviral agents]]
* [[Chemotherapy|Chemotherapeutic agents]]
* [[Antifungal drug|Antifungals]]
* [[Magnesium]]
| 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="Left" |
*[[Abdominal distention]]
*[[Dehydration]]
| 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="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Elevated plasma level of drug
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Inflammation]]
*[[Pseudomembranous enterocolitis|Pseudomembranous colitis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Clinical evaluation after discontinuation of the drugs
|-
! colspan="2" style="background:#DCDCDC;" align="center" |Factitious diarrhea
| 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="Left" |
*[[Abdominal distention]]
| 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="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Hypokalemia]] 
*[[Metabolic alkalosis]]
*[[Hypermagnesemia]] 
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Malabsorption]]
*[[Lethargy]]
*[[Generalized weakness]]
*[[Acute kidney injury|Acute renal failure]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Medication|Medications]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Clinical evaluation after discontinuation of the drugs
|-
! 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" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="Left" |
*[[Abdominal distention]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Elevated plasma heavy metal level
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Headache]]
*[[Paresthesia|Numbness]]
*[[Alopecia]]
*[[Vertigo]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Heavy metal ingestion]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Plasma level of heavy metal
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Organophosphate poisoning]]
| 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="Left" |
*[[Saliva|Salivation]]
*[[Nausea and vomiting|Vomiting]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Reduced RBC acetylcholinesterase
*Plasma [[cholinesterase]] activity
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Dysautonomia|Autonomic dysfunction]]
*Motor deficit
*Sensory deficit
*[[Bronchospasm]]
*[[Urination]]
*[[Miosis]]
*[[Bradycardia]]
*[[Lacrimation]]
*[[Sweating]]
*[[Cardiac arrhythmia|Cardiac arrhythmias]]
*[[Acute kidney injury|Acute renal injury]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Neurotoxin|Neurotoxins]] bind to [[ACHE|acetylcholinesterase]] (AChE)
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Clinical diagnosis
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Opium withdrawal]]
| 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="Left" |
*Hyperactive [[Stomach rumble|bowel sounds]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Azotemia]]
*[[Hypokalemia]]
*[[Metabolic alkalosis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Dysphoria]] 
*[[Agitation (emotion)|Restlessness]]
*[[Perspiration|Sweating]]
*[[Rhinorrhea]]
*[[Tears|Lacrimation]]
*[[Myalgia]]
*[[Arthralgia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Opium|Opium withdrawal]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Clinical diagnosis following [[opium withdrawal]]
|-
! colspan="2" rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Iatrogenic
! colspan="2" style="background:#DCDCDC;" align="center" |[[Short bowel syndrome]]
| 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="left" |
* [[Abdominal distension|Abdominal distention]]
* [[Tenderness (medicine)|Abdominal tenderness]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive [[fecal fat]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ↑
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Hypoalbuminemia]]
* High level of [[Acute phase protein|acute phase reactant]]
* Abnormal [[liver function tests]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Prior [[Intestine|intestinal]] surgery
* [[Malabsorption]]
* [[Crohn's disease]]
* [[Cancer|Malignancy]]
* Peripheral [[edema]]
* [[Muscle atrophy]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Surgical [[bowel resection]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Clinical diagnosis following [[bowel resection]]
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Radiation enteropathy|Radiation enteritis]]
| 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="Left" |
* [[Tenderness (medicine)|Abdominal tenderness]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive [[fecal fat]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Vitamin B12 deficiency
*[[Hypoalbuminemia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Prior history of [[Cancer|malignancy]] and [[radiation therapy]]
*[[Malabsorption]]
*[[Telangiectasia|Telangiectasias]] 
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Radiation therapy|Radiation]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Segmental bowel [[inflammation]] on [[endoscopy]] or [[colonoscopy]]
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Gastric dumping syndrome|Dumping syndrome]]
| 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="Left" |
*Hyperactive [[bowel sound]]
| 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" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Hypoglycemia]]
* [[Hydrogen Breath Test|Hydrogen breath test]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Malnutrition]]
*[[Fat soluble vitamins|Fat soluble vitamin]] deficiency
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Post operative complications|Postgastrectomy]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Clinical diagnosis following [[gastrectomy]]
|-
|-
|[[Whipple's disease|Whipple disease]]
! colspan="2" rowspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" |Others
| -
! colspan="2" style="background:#DCDCDC;" align="center" |[[Abetalipoproteinemia]]
| +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
|
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Arthralgias]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Weight loss]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
* [[Diarrhea]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Abdominal pain]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
|
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Leukocytopenia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Thrombocytopenia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Skin hyperpigmentation]]
* [[Abdominal distension]]
|Upper [[endoscopy]] with [[biopsies]] of the [[small intestine]] for ''[[Tropheryma whipplei|T. whipplei]]'' testing ([[histology]] with [[Periodic acid-Schiff stain|PAS staining]], [[polymerase chain reaction]] [[PCR]] testing, and [[immunohistochemistry]])
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
|[[Doxycycline]] and [[hydroxychloroquine]] are [[bactericidal]].
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
|}
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
'''The table below summarizes the findings that differentiate inflammatory causes of chronic diarrhea'''<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="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="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="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>
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
{| class="wikitable"
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
!Cause
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
!History
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
!Laboratory findings
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
!Diagnosis
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
!Treatment
* Low [[triglyceride]]
* Low total [[cholesterol]] levels 
* [[Acanthocytes]]
* Low [[vitamin E]] levels
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Ataxia]]
* [[Visual field defect]]
* [[Dysarthria]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Autosomal recessive]] disorder caused by mutations encoding the [[microsomal triglyceride transfer protein]] (MTP)
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Clinical findings and low [[triglyceride]] and [[cholesterol]] level
|-
|-
|[[Diverticulitis]]
! colspan="2" style="background:#DCDCDC;" align="center" |[[Hyperthyroidism]]
|
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* [[Bloody diarrhea]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* Left lower quadrant [[abdominal pain]]  
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Abdominal tenderness]] on [[physical examination]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* Low grade [[fever]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
|
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
* [[Leukocytosis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* Elevated serum [[amylase]] and [[lipase]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Sterile]] [[pyuria]] on [[urinalysis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
|Abdominal [[CT scan]] with oral and intravenous [[Contrast medium|(IV) contrast]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
|Bowel rest, [[Intravenous fluids|IV fluid]] resuscitation, and [[Broad-spectrum antibiotic|broad-spectrum antimicrobial therapy]] that covers [[Anaerobic organism|anaerobic]] [[bacteria]] and [[gram-negative]] [[Bacteria|rods]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive [[fecal fat]]  
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Elevated [[T4]]
* Elevated [[T3]]
* Decreased [[TSH]]
* High serum [[alkaline phosphatase]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Lump in the neck
* Lid lag
* [[Malabsorption]]
* [[Sweating]]
* [[Hyperpigmentation]]
* [[Proptosis]]
* [[Tremor]]
* Increased [[Deep tendon reflex|DTR]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Graves' disease]]
* [[Hashimoto's thyroiditis]]
* [[Toxic adenoma]]  
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[TSH]]
|-
|-
|[[Ulcerative colitis]]
! colspan="2" style="background:#DCDCDC;" align="center" |[[Diabetic neuropathy]]
|
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* [[Diarrhea]] mixed with blood and [[mucus]], of gradual onset
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* Signs of [[weight loss]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Rectal pain|Rectal urgency]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* [[Tenesmus]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Blood]] is often noticed on underwear
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* Different degrees of [[abdominal pain]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
|
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Anemia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="Left" |
* [[Thrombocytosis]]
*[[Fecal incontinence]]
* A high [[platelet]] count
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
 
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* Elevated [[ESR]] (>30mm/hr)
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* Low [[albumin]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
|[[Endoscopy]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
|Induction of  [[Remission (medicine)|remission]] with [[mesalamine]] and [[corticosteroids]] followed by the administration of [[sulfasalazine]] and [[Mercaptopurine|6-Mercaptopurine]] depending on the severity of the [[disease]].
*Positive [[fecal fat]]  
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Hyperglycemia]]
*[[Azotemia]]
*[[Hypokalemia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Malabsorption]] 
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Unclear
*Disordered [[motility]]
*Increased [[Intestine|intestinal]] secretion
*[[Small intestinal bacterial overgrowth]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Clinical diagnosis in a patient with long lasting [[diabetes mellitus]]
|-
|-
|''[[Entamoeba histolytica]]''
! colspan="2" style="background:#DCDCDC;" align="center" |[[Scleroderma|Systemic sclerosis]]
|
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* [[Abdominal cramps]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Diarrhea]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
** Passage of 3 - 8 semiformed [[stools]] per day
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
** Passage of soft [[stools]] with [[mucus]] and occasional [[blood]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Fatigue]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* [[Intestinal]] gas (excessive [[flatus]])
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Rectal pain]] while having a [[bowel movement]] ([[tenesmus]])
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* Unintentional [[weight loss]]
| style="padding: 5px 5px; background: #F5F5F5;" align="Left" |
|Cysts shed with the stool
*[[Abdominal pain|Epigastric tenderness]]
|Detects amoeba [[DNA]] in feces
*[[Fecal incontinence]]
|[[Amebic dysentery]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
* [[Metronidazole]] 500-750mg three times a day for 5-10 days
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
* [[Tinidazole]] 2g once a day for 3 days is an alternative to [[metronidazole]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
Luminal amebicides for ''[[E. histolytica]]'' in the [[colon]]:
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
* [[Paromomycin]] 500mg three times a day for 10 days
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Diloxanide furoate]] 500mg three times a day for 10 days
*Positive [[fecal fat]]
* [[Iodoquinol]] 650mg three times a day for 20 days
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
For [[Amoebiasis|amebic liver abscess]]:
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
* [[Metronidazole]] 400mg three times a day for 10 days
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
* [[Tinidazole]] 2g once a day for 6 days is an alternative to [[metronidazole]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Diloxanide furoate]] 500mg three times a day for 10 days must always be given afterwards
* Anti–[[Type I topoisomerase|topoisomerase I]] (Scl‑70) antibodies
* [[Antinuclear antibodies]] ([[Antinuclear antibodies|ANA]])
* [[Anti-centromere antibodies|Anti–centromere antibodies]]
* Anti–[[RNA polymerase III]] antibody
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Malabsorption]]
*[[Skin changes]]
*[[Raynaud's phenomenon|Raynaud phenomenon]]
*[[Pulmonary hypertension]]
*[[Arthritis]]
*[[Telangiectasia]]
*[[Chronic renal failure]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Autoimmunity|Autoimmune reaction]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Clinical diagnosis
*Followed by serologic tests
|- }
|}
|}
<small>
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
{{WS}}[[Category:Emergency medicine]]
[[Category:Disease]]
[[Category:Primary care]]
[[Category:Up-To-Date]]
[[Category:Infectious disease]]
[[Category:Gastroenterology]]
[[Category:Pediatrics]]

Revision as of 17:00, 21 December 2017

Chronic diarrhea Microchapters

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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: Sadaf Sharfaei M.D.[2]

Overview

Differential Diagnosis of Chronic Diarrhea of 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

Categories 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
Gastrointestinal Crohn's disease + + + + ± + + + + Nl
  • Abnormal immune response to self antigens
Ulcerative colitis + + + + ± + + + + Nl
  • Abnormal immune response to self antigens
Celiac disease + ± ± + + Nl Nl Nl
Cystic fibrosis + + ± + + Nl Nl Nl
Chronic pancreatitis + + + + + Nl Nl Nl Nl
Bile acid malabsorption + + + + Nl Nl Nl Nl
Microscopic colitis + + + + Nl Nl Nl
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
Infection Bacterial Whipple's disease + + + ± + + Nl ↓/↑
Tropical sprue + + + + + + + + Nl Nl Nl
  • Diagnosis of exclusion
Small bowel bacterial overgrowth + + + + + + Nl Nl Nl
  • Diagnosis of exclusion
Pseudomembranous enterocolitis + + ± + + ± + + Nl
 Campylobacteriosis + + + + + + + Nl Nl Nl Nl
Salmonellosis + + + + + + + + Nl Nl
Shigellosis + + + + + + + Nl ↑/↓
Escherichia coli enteritis ETEC

(Traveler's diarrhea)

+ + + + Nl Nl Nl
EPEC + + + + + + + + + Nl Nl Nl
EIEC + + + + + + + Nl Nl Nl
EHEC + + + + + + Nl
EAEC + + + + + + + Nl
Yersinia enterocolitica + + + + + + + Nl Nl Nl
Vibrio cholera + + + + Nl Nl Nl
Aeromonas + + + + + + + + Nl Nl Nl
Plesiomonas + + + + + + + Nl Nl Nl
Mycobacterium avium complex + + + + + + + + Nl Nl
Food poisoning + + ± + + ± + ± Nl Nl Nl
  • History of travel or ingestion of infected food
Virus Norovirus + + + + Nl Nl Nl
  • Clinical diagnosis
Rotavirus + + + + Nl Nl Nl Nl
  • Stool immune–based assays
Echovirus + + + + Nl Nl Nl Nl
  • Clinical diagnosis
Adenovirus + + + + Nl
  • Viral antigen assay
Nl Nl Nl
  • Clinical diagnosis
CMV colitis + + + ± + + + Nl
  • Viral antigen assay
Nl Nl
HIV + + + + + + Nl Nl
  • HIV virologic (viral load) test
  • Immunoassay 
Parasite 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
Tumors 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
Lymphoma + + + + + + + Nl Nl Nl
  • Primary tumor of GI tract
Colorectal cancer + + + + + + + Nl Nl Nl
Medication/Toxicity 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
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
Iatrogenic Short bowel syndrome + + + + + Nl Nl
Radiation enteritis + + + + + + + + + Nl Nl Nl
Dumping syndrome + + + + Nl Nl Nl Nl
Others 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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