Assessment of chronic diarrhoea

Last reviewed: 28 Aug 2022
Last updated: 13 Jan 2021

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

Clinical Research Fellow

Gastrointestinal Unit

University of Edinburgh

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

Disclosures

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

Disclosures

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.

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