Summary
Differentials
Common
- Ulcerative colitis
- Microscopic colitis (lymphocytic colitis and collagenous colitis)
- Viral, bacterial, parasitic, HIV enteropathy
- Irritable bowel syndrome
- Drug effects
- Fecal impaction
- Celiac disease
- Crohn 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 ischemic colitis
- Surgical bypass or resection
Uncommon
- Nonsteroidal anti-inflammatory drug enteropathy
- Infiltrating malignancy
- Protein-losing enteropathy
- Graft versus host disease
- Hodgkin lymphoma
- Non-Hodgkin lymphoma
- Tropical sprue
- Lymphangiectasia/impaired lymphatic drainage
- Hypoparathyroidism
- Addison disease
- Gastrinoma
- Carcinoid tumors
- VIPomas
- Abetalipoproteinemia
- Advanced liver disease
- Common variable immune deficiency
- Amyloidosis
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
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.
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.
References
Key articles
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. Abstract
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.Full text Abstract
Talley NJ. Functional Gastrointestinal Disorders in 2007 and Rome III: something new, something borrowed, something objective. Rev Gastroenterol Disord. 2007;7:97-105. Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Patient information
Diarrhea in adults
Diarrhea in children
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