Chronic diarrhea natural history, complications and prognosis

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
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Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omodamola Aje B.Sc, M.D. [2]

Overview

Natural History

The natural history of chronic diarrhea is watery or bloody or fatty stools for more than 4 weeks duration associated with any of the following;

• Greasy stools that float and are malodorous may suggest fat malabsorption, while the presence of visible blood may suggest IBD).
• Travel history.
• Risk factors for HIV infection.
• Weight loss.
• Fecal incontinence (which may be confused with diarrhea).
• Occurrence of diarrhea during fasting or at night (suggesting a secretory diarrhea).
• Family history of IBD.
• Voluminous watery diarrhea due to disorders of the colon.
• Bloody diarrhea.
• Presence of systemic symptoms, which may indicate IBD (such as fevers, joint pains, mouth ulcers, eye redness).
• Use of medications (including over-the-counter drugs and supplements) (See Causes section)
• Use of sorbitol-containing products and use of alcohol.
• Association of stress and depression with onset and severity of the diarrhea.
• Association of symptoms with specific food ingestion (such as dairy products or potential food allergens).
• A sexual history (anal intercourse is a risk factor for infectious proctitis and promiscuous sexual activity is a risk factor associated with HIV infection).
• A history of recurrent bacterial infections (eg, sinusitis, pneumonia),suggesting a primary immunoglobulin deficiency.

Complications

Depending on the underlying cause, chronic or severe diarrhe can lead to potentially serious complications some of which include but are not limited to dehydration and malnutrition. It is important to keep patients hydrated by taking fluids. patients who are unable to tolerate fluids orally should be given fluids into a vein (IV) to replace the fluids and electrolytes (salts) lost in diarrhea.

Prognosis

The prognosis of chronic diarrhea is good especially when the underlying cause is identified early and treated.

References

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