Chronic Diarrhea

Chronic Diarrhea:

  • 3 main categories:
    • Watery:
      • Calculate the fecal osmotic gap:
        • Distinguish:
          • Osmotic subtype: Gap > 125 mOsm/kg
          • Secretory subtype: Gap < 50 mOsm/kg
            • Differential diagnosis:
              • Diabetic autonomic neuropathy
              • Microscopic colitis
                • Need colonoscopy with random biopsies.
                • Older female
                • Younger pt with extensive NSAID use
              • Hyperthyroidism
              • Non-osmotic laxative abuse
              • Hormone-producing tumors (carcinoid)
        • Calculate gap: stool osmolarity (usually 290) – 2 X (NaStool + KStool)
    • Fatty (malabsorptive)
    • Inflammatory

stool gap

 

 

 

 

 

 

 

 

 

chronic diarrhea

 

 

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