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Saturday, October 1, 2011

Chronic Diarrhea - Symptoms, Types, Causes, Investigations

Chronic Diarrhea:
 
Most common cause is irritable bowel syndrome.

The usual symptoms of chronic diarrhea are:

1. Increased frequency of defecation
2. Loose, watery or pellet stools
3. Diarrhoea occurs rarely at night and is most sever before and after breakfast.

3. The 24 hour stool volume is less than 200g.

Categories of chronic diarrhea:

Types:
Colonic
Malabsorption
Small bowel
Clinical features:
Blood and mucus in stool,
Cramping lower abdominal pain
Steatorrhoea,
Undigested food in the stool,
Weight loss and nutritional disturbances
Large volume and water stool,
Abdominal bloating,
Cramping mid abdominal pain
Some causes:
Inflammatory bowel disease,
Neoplasia,
Ischeamia,
Irritable bowel syndrome
Pancreatic-
    Chronic pancreatitis
    Pancreatic cancer
    Cystic fibrosis
Enteropathy-
    Coeliac disease
    Tropical sprue
    Lymphoma
    Lymphangiectasia
VIPoma
Drug-induced-
    NSAIDs
    Aminosalicylates
    Selective serotonin re-uptake inhibitors(SSRIs)
Investigations:
Colonoscopy with biopsies
Ultrasound, CT and MRCP,
Small bowel biopsy,
Barium follow-through
Stool volume,
Gut hormone profile,
Barium follow-through


 

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Note: In the making of the above article, following books were used:





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