chronic diarrhea
Testing
- CBC, iron studies, TSH, fecal calprotectin
- celiac disease, C.diff
- small intestine evaluation: small bowel xray, CT enterography, MR enterography for diverticular disease, inflammation, strictures
- upper endoscopy: when small bowel mucosal disease suspected
- capsule endoscopy: visualize small bowel but no sampling
- colonoscopy: evaluate malignancy, IBD, microscopic colitis
- stool studies:
- fecal weight, fecal electrolytes, pH, calprotectin,
- blood/leukocytes: inflammatory cause
- fecal fat: 72 hour collection confirms steatorrhea
- reduced fecal elastase: exocrine pancreatic function
- laxative screen: laxative abuse
- osmotic gap: 290 – (2 × [stool sodium + stool potassium])
-
50: osmotic diarrhea
- < 50: secretory diarrhea
Backlinks
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Microscopic Colitis
microscopic colitis
- patient: older
- pathophysiology:
- sometimes medications such as PPI or NSAIDS
- associated with immune conditions, DM, psoriasis, celiac disease
- sx:
- dx:
- random colonic mucosal biopsies
- no endoscopically visible inflammation
- subtypes: lymphocytic and collagenous colitis
This patient has **mic