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Diarrhea, Chronic

Marie L Borum, MD, EdD, MPH and Reid Evan Schalet, BA, DO Reviewed 04/2024
 


BASICS

DESCRIPTION

  • Chronic diarrhea refers to a sustained change in stool consistency, characterized by loose stools (consistency between types 5-7 on the Bristol stool chart) and an increase in freque...

DIAGNOSIS

HISTORY

  • Detailed history: Stooling onset, pattern, frequency, characteristics (greasy, floating, watery), volume, travel, diet, medications, family history, urgency, fecal incontinence.

  • Alarm ...

TREATMENT

GENERAL MEASURES

Volume resuscitation, electrolyte repletion; if stable, outpatient treatment (1)[C

MEDICATION

First Line

  • Lactose intolerance: lactose-free diet; postcholecystectomy, abdomina...

ONGOING CARE

DIET

Elimination diet: Avoid gluten-containing foods, nonabsorbable carbohydrates, lactose-containing products, and food allergens. Low FODMAP diet helps symptoms in up to 75% of IBS patie...

REFERENCES

1
Schiller  LR, Pardi  DS, Sellin  JH. Chronic diarrhea: diagnosis and management. Clin Gastroenterol Hepatol.  2017;15(2):182—193.e3. [View Abstract on OvidMedl...

ADDITIONAL READING

SEE ALSO

Tripathi PR, Srivastava A. Approach to a Child with Chronic Diarrhea. Indian J Pediatr. 2023. doi: 10.1007/s12098-023-04587-9. PMID: 37368219. ...

SEE ALSO

Algorithm: Diarrhea, Chronic 

CODES

ICD10

K52.9 Noninfective gastroenteritis and colitis, unspecified 

SNOMED

236071009 Chronic diarrhea (disorder) 

CLINICAL PEARLS

  • A comprehensive medical history guides the appropriate workup and avoids unnecessary testing.

  • Consider IBS, IBD, malabsorption syndromes, celiac disease, prescribed or OTC medication us...

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