Chronic diarrhea is defined as the frequent passage of loose stools greater than 200 grams per day for more than 3 weeks.
Inflammatory diarrhea can be caused by: inflammatory bowel disease (ulcerative colitis and CrohnÕs disease); radiation enterocolitis; eosinophilic gastroenteritis; and AIDS. Risk factors include: infections, and radiation.
Osmotic diarrhea can be caused by: pancreatic insufficiency; bacterial overgrowth; Celiac disease; Lactase deficiency; WhippleÕs disease; abetalipoproteinemia; short bowel syndrome; drugs (colchicine, neomycin, and para-aminosalicylic acid - nondigestible intraluminal solute that exerts an osmotic force increasing the intraluminal fluid overwhelming the colonic mucosal absorptive capacities). Risk factors include: bacterial infections, abdominal surgery (cholecystectomy, gastric and small bowel resection), vagotomy, chronic alcohol abuse, Sorbitol, fructose, and gluten.
Secretory diarrhea can be caused by: carcinoid syndrome; Zollinger-Ellison syndrome; vasoactive intestinal peptide-secreting pancreatic adenomas; medullary carcinoma of thyroid; villous adenoma of rectum; microscopic colitis; choleraic diarrhea (excessive secretion of electrolytes). Risk factors include distal ileal surgery. Altered intestinal motility can be caused by: irritable bowel syndrome; fecal impaction; neurologic diseases; diabetes (increased transit and possible bacterial overgrowth) Factitious diarrhea can be caused by: laxative abuse; or self induced (patient may add water or urine to stool).
Standard lab tests include: Stool ova and parasites; Stool leukocytes; Stool fat and osmolality, and occult blood; Serum electrolytes and blood count; serum Iron studies, vitamin B12, folate, vitamin D, PT, blood chemistry for albumin and cholesterol, serum carotene; D-xylose absorption test A barium enema and KUB are usually ordered. A colonoscopy and esophagogastroduodenoscopy (EGD) may be ordered, usually with biopsy.
Fantastic new books!
CAM Therapies has studies on natural therapies for over 100 diseases.
CAM Labs lists lab tests for 100 diseases.
Nutritional Genetics is a fantastic resource.