Classification of chronic diarrhoea
Classification of chronic diarrhoea (1, 2)
Chronic diarrhoea can be divided into six broad categories.
- osmotic
- medications e.g. - laxatives
- undigested sugars e.g. diet foods/drinks/gum
- secretory
- medications e.g. - non-osmotic laxatives, antibiotics etc
- small intestinal bacterial overgrowth
- endocrine e.g. - carcinoid, gastrinoma, adrenal insufficiency, hyperthyroidism
- bile salt malabsorption e.g. - ileal resection, idiopathic, post cholecystectomy
- non-invasive infections e.g. - giardiasis, cryptosporidiosis
- steatorrhoea
- maldigestion
- decreased bile salts - cirrhosis, bile duct obstruction, ileal resection
- pancreatic dysfunction - chronic pancreatitis, cystic fibrosis
- malabsorption e.g. - Coeliac sprue, tropical sprue, Chronic mesenteric ischaemia, short bowel syndrome
- maldigestion
- inflammatory
- inflammatory bowel disease e.g. - ulcerative colitis, Crohn's disease,
- malignancy e.g. - colon cancer, lymphoma
- radiation colitis
- motility
- post-surgical (vagotomy, dumping)
- scleroderma
- diabetes
- hyperthyroidism
- miscellaneous
- irritable bowel syndrome
- fictitious
References:
- Schiller LR et al. Gastro 2013 APDW/WCOG Shanghai working party report: chronic diarrhea: definition, classification, diagnosis. J Gastroenterol Hepatol. 2014;29(1):6-25.
- Sweetser S. Evaluating the patient with diarrhoea: a case-based approach. Mayo Clin Proc. 2012 Jun;87(6):596-602
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