Assessment of chronic diarrhoea

Last reviewed: 21 Aug 2025
Last updated: 28 Apr 2023

Summary

Differentials

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
Full details

Uncommon

  • Non-steroidal anti-inflammatory drug enteropathy
  • Infiltrating malignancy
  • Protein-losing enteropathy
  • Graft-versus-host disease
  • Hodgkin's lymphoma
  • Non-Hodgkin's lymphoma
  • Tropical sprue
  • Lymphangiectasia/impaired lymphatic drainage
  • Hypoparathyroidism
  • Addison's disease
  • Gastrinoma
  • Carcinoid tumours
  • VIPomas
  • Abetalipoproteinaemia
  • Advanced liver disease
  • Common variable immune deficiency
  • Amyloidosis
Full details

Contributors

Authors

Simon Campbell, MB ChB(Hons), MRCP(UK), MD(Edin.)

Consultant Gastroenterologist

Honorary Senior Lecturer

University of Manchester

Manchester

UK

Disclosures

SC declares that he has no competing interests.

Rahul Kalla, MBChB, MRCP

Consultant Gastroenterologist

Royal Infirmary Edinburgh

Little France Crescent

Edinburgh

UK

Disclosures

RK is the author of a reference cited in this topic. RK declares that he has no competing interests.

Acknowledgements

Dr Simon Campbell and Dr Rahul Kalla would like to gratefully acknowledge Dr Abhishek Sharma, Dr Daniel Leffler, and Dr Ciaran Kelly, the previous contributors to this topic. AS has received honoraria for educational presentations, chairing educational sessions, or advisory work from Abbvie, Vifor Pharma, Almirall, Falk, and Warner Chilcott UK. DL and CK are the authors of a number of references cited in this topic.

Peer reviewers

John Kepros, MD

Director

Trauma Services

Assistant Professor

Michigan State University

Lansing

MI

Declarações

JK declares that he has no competing interests.

Julian R.F. Walters, MA, MB, FRCP

Professor of Gastroenterology

Imperial College London

Hammersmith Hospital

London

UK

Declarações

JRFW has been a member of advisory boards and has received fees for arranging an educational programme from GE Healthcare, the manufacturer of 75SeHCAT. He is a member of the Health Advisory Network for Coeliac UK.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Fernández-Bañares F, Esteve M, Salas A, et al. Systematic evaluation of the causes of chronic watery diarrhea with functional characteristics. Am J Gastroenterol. 2007;102:2520-2528. Resumo

Arasaradnam RP, Brown S, Forbes A, et al. Guidelines for the investigation of chronic diarrhoea in adults: British Society of Gastroenterology, 3rd edition. Gut. 2018 Aug;67(8):1380-99.Texto completo  Resumo

Talley NJ. Functional Gastrointestinal Disorders in 2007 and Rome III: something new, something borrowed, something objective. Rev Gastroenterol Disord. 2007;7:97-105. Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Assessment of chronic diarrhoea images
  • Diretrizes

    • AGA clinical practice guidelines on the laboratory evaluation of functional diarrhea and diarrhea-predominant irritable bowel syndrome in adults (IBS-D)
    • Diarrhoea in adult cancer patients
    Mais Diretrizes
  • Folhetos informativos para os pacientes

    Diarrhoea in adults

    Diarrhoea in children

    Mais Folhetos informativos para os pacientes
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