Chronic diarrhea screening: Difference between revisions

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==Overview==
==Overview==
There are certain features which if present in a patient complaining of diarrhea for over 4 weeks require further evaluation. Some of the screening modalities include, radiographic imaging studies<ref name="pmid2254453">{{cite journal| author=Hammer HF, Fine KD, Santa Ana CA, Porter JL, Schiller LR, Fordtran JS| title=Carbohydrate malabsorption. Its measurement and its contribution to diarrhea. | journal=J Clin Invest | year= 1990 | volume= 86 | issue= 6 | pages= 1936-44 | pmid=2254453 | doi=10.1172/JCI114927 | pmc=329829 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2254453  }} </ref>, endoscopy/enteroscopy/capsule enteroscopy<ref name="pmid26664469">{{cite journal| author=Balaban DV, Popp A, Vasilescu F, Haidautu D, Purcarea RM, Jinga M| title=Diagnostic yield of endoscopic markers for celiac disease. | journal=J Med Life | year= 2015 | volume= 8 | issue= 4 | pages= 452-7 | pmid=26664469 | doi= | pmc=4656951 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26664469  }} </ref>, histopathology of the small bowel and colon<ref name="pmid7560203">{{cite journal| author=Le Berre N, Heresbach D, Kerbaol M, Caulet S, Bretagne JF, Chaperon J et al.| title=Histological discrimination of idiopathic inflammatory bowel disease from other types of colitis. | journal=J Clin Pathol | year= 1995 | volume= 48 | issue= 8 | pages= 749-53 | pmid=7560203 | doi= | pmc=502803 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7560203  }} </ref>, bacteriology/microbiology<ref name="pmid22334221">{{cite journal| author=Khanna S, Pardi DS, Rosenblatt JE, Patel R, Kammer PP, Baddour LM| title=An evaluation of repeat stool testing for Clostridium difficile infection by polymerase chain reaction. | journal=J Clin Gastroenterol | year= 2012 | volume= 46 | issue= 10 | pages= 846-9 | pmid=22334221 | doi=10.1097/MCG.0b013e3182432273 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22334221  }} </ref>, serological testing and chemical analysis of stool<ref name="EhererFordtran1992">{{cite journal|last1=Eherer|first1=Andreas J.|last2=Fordtran|first2=John S.|title=Fecal osmotic gap and pH in experimental diarrhea of various causes|journal=Gastroenterology|volume=103|issue=2|year=1992|pages=545–551|issn=00165085|doi=10.1016/0016-5085(92)90845-P}}</ref>.
According to the USPSTF, screening for chronic diarrhea is not recommended.


==Screening==
==Screening==
There are certain features which if present in a patient complaining of diarrhea for over 4 weeks require further evaluation. these include:
According to the USPSTF, screening for chronic diarrhea is not recommended.
*Rectal bleeding<ref name="pmid16973955">{{cite journal| author=Halfdanarson TR, Litzow MR, Murray JA| title=Hematologic manifestations of celiac disease. | journal=Blood | year= 2007 | volume= 109 | issue= 2 | pages= 412-21 | pmid=16973955 | doi=10.1182/blood-2006-07-031104 | pmc=1785098 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16973955  }} </ref>
*Weight loss
*Age > 50 years<ref name="pmid14960513">{{cite journal| author=Olesen M, Eriksson S, Bohr J, Järnerot G, Tysk C| title=Microscopic colitis: a common diarrhoeal disease. An epidemiological study in Orebro, Sweden, 1993-1998. | journal=Gut | year= 2004 | volume= 53 | issue= 3 | pages= 346-50 | pmid=14960513 | doi= | pmc=1773978 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14960513  }} </ref>
*Pain<ref name="pmid15784038">{{cite journal| author=Tillisch K, Labus JS, Naliboff BD, Bolus R, Shetzline M, Mayer EA et al.| title=Characterization of the alternating bowel habit subtype in patients with irritable bowel syndrome. | journal=Am J Gastroenterol | year= 2005 | volume= 100 | issue= 4 | pages= 896-904 | pmid=15784038 | doi=10.1111/j.1572-0241.2005.41211.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15784038  }} </ref>
*Associated psychological factors
*Somatization<ref>{{cite journal|doi=10.1016/j.cgh.2006.11.024 showArticle Info}}</ref>
*Dietary causes of diarrhea<ref name="pmid2254453">{{cite journal| author=Hammer HF, Fine KD, Santa Ana CA, Porter JL, Schiller LR, Fordtran JS| title=Carbohydrate malabsorption. Its measurement and its contribution to diarrhea. | journal=J Clin Invest | year= 1990 | volume= 86 | issue= 6 | pages= 1936-44 | pmid=2254453 | doi=10.1172/JCI114927 | pmc=329829 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2254453  }} </ref>


==References==
==References==
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[[Category:Emergency medicine]]
[[Category:Disease]]
[[Category:Up-To-Date]]
[[Category:Infectious disease]]
[[Category:Gastroenterology]]
[[Category:Pediatrics]]

Latest revision as of 20:57, 29 July 2020