Summary
Chronic diarrhoea is defined as the presence of ≥3 loose stools per day for more than 4 weeks. [1] Although stool weight has been used in scientific studies, it is not useful in clinical practice, as some patients may have increased stool weight (higher than normal faecal weight of 200 g/day) but normal stool consistency, therefore do not complain of diarrhoea. [2] Diagnosis can be challenging as a large number of aetiologies present in a similar way and range from benign to life threatening. A systematic method of evaluation, knowledge of the common causes, and an understanding of the local epidemiology are crucial for efficient and effective diagnosis and management of chronic diarrhoea. [3]
Differential diagnosis
Sort by: common/uncommon or category
- Common
-
- Ulcerative colitis
- Microscopic colitis (lymphocytic colitis and collagenous colitis)
- Viral, bacterial, parasitic, HIV enteropathy
- Irritable bowel syndrome
- Drug effects
- Faecal impaction
- Coeliac disease
- Crohn's disease
- Bile salt malabsorption
- Brush border enzyme deficiency (lactose, fructose, sucrose, isomaltase)
- Small intestinal bacterial overgrowth
- Pancreatic insufficiency
- Alcohol
- Hyperthyroidism
- Diabetes mellitus
- Radiation enteritis/colitis
- Eosinophilic enteritis
- Chronic ischaemic colitis
- Surgical bypass or resection
- Uncommon
-
- NSAID enteropathy
- Infiltrating malignancy
- Protein-losing enteropathy
- Graft-versus-host disease
- Lymphoma
- Tropical sprue
- Lymphangiectasia/impaired lymphatic drainage
- Hypoparathyroidism
- Addison's disease
- Functional endocrine tumours: gastrinoma, carcinoid tumours, VIPomas
- Abetalipoproteinaemia
- Advanced liver disease
- Common variable immune deficiency
- Amyloidosis
Last updated: Apr 10, 2013
