Chronic diarrhea
Chronic diarrhea is a topic covered in the Diagnosaurus.
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DDx
Common
- Irritable bowel syndrome, lactase deficiency, parasites, caffeine, alcohol, laxative abuse
- Lactase deficiency
- Medications: antacids, lactulose, sorbitol, Olestra
- Factitious: magnesium-containing antacids or laxatives
- Hormonal: Zollinger-Ellison syndrome (gastrinoma), carcinoid, VIPoma, medullary thyroid carcinoma
- Laxative abuse: phenolphthalein, cascara, senna
- Villous adenoma
- Medications
- Inflammatory bowel disease
- Microscopic colitis (lymphocytic or collagenous)
- Cancer with obstruction and pseudodiarrhea
- Radiation colitis
- Small bowel: celiac sprue, Whipple's disease, tropical sprue, eosinophilic gastroenteritis, small bowel resection, Crohn's disease
- Lymphatic obstruction: lymphoma, carcinoid, tuberculosis, Mycobacterium avium complex (MAC), Kaposi's sarcoma, sarcoidosis, retroperitoneal fibrosis
- Pancreatic insufficiency: chronic pancreatitis, cystic fibrosis, pancreatic cancer
- Bacterial overgrowth, eg, diabetes
- Reduced bile salts: ileal resection, Crohn's disease, postcholecystectomy
- Irritable bowel syndrome
- Postsurgical: vagotomy, partial gastrectomy, blind loop with bacterial overgrowth
- Systemic disease: diabetes mellitus, hyperthyroidism, scleroderma
- Caffeine or alcohol use
- Parasites: giardiasis, amebiasis, strongyloidiasis
- Ischemic colitis
- Adrenal insufficiency
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DDx
Common
- Irritable bowel syndrome, lactase deficiency, parasites, caffeine, alcohol, laxative abuse
- Lactase deficiency
- Medications: antacids, lactulose, sorbitol, Olestra
- Factitious: magnesium-containing antacids or laxatives
- Hormonal: Zollinger-Ellison syndrome (gastrinoma), carcinoid, VIPoma, medullary thyroid carcinoma
- Laxative abuse: phenolphthalein, cascara, senna
- Villous adenoma
- Medications
- Inflammatory bowel disease
- Microscopic colitis (lymphocytic or collagenous)
- Cancer with obstruction and pseudodiarrhea
- Radiation colitis
- Small bowel: celiac sprue, Whipple's disease, tropical sprue, eosinophilic gastroenteritis, small bowel resection, Crohn's disease
- Lymphatic obstruction: lymphoma, carcinoid, tuberculosis, Mycobacterium avium complex (MAC), Kaposi's sarcoma, sarcoidosis, retroperitoneal fibrosis
- Pancreatic insufficiency: chronic pancreatitis, cystic fibrosis, pancreatic cancer
- Bacterial overgrowth, eg, diabetes
- Reduced bile salts: ileal resection, Crohn's disease, postcholecystectomy
- Irritable bowel syndrome
- Postsurgical: vagotomy, partial gastrectomy, blind loop with bacterial overgrowth
- Systemic disease: diabetes mellitus, hyperthyroidism, scleroderma
- Caffeine or alcohol use
- Parasites: giardiasis, amebiasis, strongyloidiasis
- Ischemic colitis
- Adrenal insufficiency
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