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>.
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>.


==Screening==
==Screening==
There are certain features which if present in a patient complaining of diarrhea for over 4 weeks require further evaluation. these include:
There are certain features which if present in a patient complaining of diarrhea for over 4 weeks require further evaluation. these include:
*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>
*[[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
*[[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>
*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>
*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
*Associated psychological factors
*Somatization<ref>{{cite journal|doi=10.1016/j.cgh.2006.11.024 showArticle Info}}</ref>
*[[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>
*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>


Revision as of 19:25, 21 June 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

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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

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[1], endoscopy/enteroscopy/capsule enteroscopy[2], histopathology of the small bowel and colon[3], bacteriology/microbiology[4], serological testing and chemical analysis of stool[5].

Screening

There are certain features which if present in a patient complaining of diarrhea for over 4 weeks require further evaluation. these include:

References

  1. ↑ 1.0 1.1 Hammer HF, Fine KD, Santa Ana CA, Porter JL, Schiller LR, Fordtran JS (1990). "Carbohydrate malabsorption. Its measurement and its contribution to diarrhea". J Clin Invest. 86 (6): 1936–44. doi:10.1172/JCI114927. PMC 329829. PMID 2254453.
  2. ↑ Balaban DV, Popp A, Vasilescu F, Haidautu D, Purcarea RM, Jinga M (2015). "Diagnostic yield of endoscopic markers for celiac disease". J Med Life. 8 (4): 452–7. PMC 4656951. PMID 26664469.
  3. ↑ Le Berre N, Heresbach D, Kerbaol M, Caulet S, Bretagne JF, Chaperon J; et al. (1995). "Histological discrimination of idiopathic inflammatory bowel disease from other types of colitis". J Clin Pathol. 48 (8): 749–53. PMC 502803. PMID 7560203.
  4. ↑ Khanna S, Pardi DS, Rosenblatt JE, Patel R, Kammer PP, Baddour LM (2012). "An evaluation of repeat stool testing for Clostridium difficile infection by polymerase chain reaction". J Clin Gastroenterol. 46 (10): 846–9. doi:10.1097/MCG.0b013e3182432273. PMID 22334221.
  5. ↑ Eherer, Andreas J.; Fordtran, John S. (1992). "Fecal osmotic gap and pH in experimental diarrhea of various causes". Gastroenterology. 103 (2): 545–551. doi:10.1016/0016-5085(92)90845-P. ISSN 0016-5085.
  6. ↑ Halfdanarson TR, Litzow MR, Murray JA (2007). "Hematologic manifestations of celiac disease". Blood. 109 (2): 412–21. doi:10.1182/blood-2006-07-031104. PMC 1785098. PMID 16973955.
  7. ↑ Olesen M, Eriksson S, Bohr J, Järnerot G, Tysk C (2004). "Microscopic colitis: a common diarrhoeal disease. An epidemiological study in Orebro, Sweden, 1993-1998". Gut. 53 (3): 346–50. PMC 1773978. PMID 14960513.
  8. ↑ Tillisch K, Labus JS, Naliboff BD, Bolus R, Shetzline M, Mayer EA; et al. (2005). "Characterization of the alternating bowel habit subtype in patients with irritable bowel syndrome". Am J Gastroenterol. 100 (4): 896–904. doi:10.1111/j.1572-0241.2005.41211.x. PMID 15784038.
  9. ↑ . doi:10.1016/j.cgh.2006.11.024 showArticle Info Check |doi= value (help). Missing or empty |title= (help)


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