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Diarrhea, Chronic

Marie L Borum, MD, EdD, MPH and Jacob Thomas Newman, D.O. Reviewed 06/2022
 


BASICS

DESCRIPTION

  • An increase in frequency of defecation, urgency, or decrease in stool consistency (typically >3 loose stools per day) for >4 weeks  (1,2)

    • Abnormal stool form is the most importa...

DIAGNOSIS

HISTORY

  • Detailed history of symptoms  (1,2,3):

    • Onset, pattern, and frequency of stooling, aggravating or alleviating factors

    • Stool volume and quality (including presence of blood or mucus)

    • Trave...

TREATMENT

GENERAL MEASURES

  • Volume resuscitation, electrolyte repletion

  • If stable, generally outpatient treatment (1)[C]

MEDICATION

First Line

  • Based on underlying cause:

    • Lactose intolerance: lactose-free di...

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 patien...

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...

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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