Chronic Diarrhea

HomeDigestive system diseasesChronic Diarrhea

Chronic diarrhea is defined as the passage of loose or watery stools that persist for more than four weeks. It can significantly affect a person's quality of life, leading to dehydration, malnutrition, an d weight loss if not properly managed.

Symptoms

Symptoms of chronic diarrhea can include:

Frequent loose or watery stools
Abdominal cramping or pain
Urgency to have a bowel movement
Bloating and gas
Fatigue and weakness
Unintended weight loss

Causes

Chronic diarrhea is a multifactorial condition that can be caused by the following:

Infections

Persistent infections by bacteria, viruses, or parasites.

Inflammatory conditions

Diseases like Crohn's disease and ulcerative colitis and microscopic colitis.

Malabsorption

Conditions such as celiac disease or chronic pancreatitis.

Functional disorders

Irritable bowel syndrome (IBS).

Medications

Long-term use of antibiotics, laxatives, or other drugs.

Endocrine disorders

Thyroid disease, diabete

Food intolerances

Lactose intolerance, fructose malabsorption.

Malignancy (colon cancer, neuroendocrine maligancies)
Small intestinal bacterial overgrowth (SIBO)

Risk Factors

Risk factors for chronic diarrhea include:

Chronic infections
Inflammatory bowel diseases
Long-term medication use
Endocrine disorders
Age-related changes in bowel function

Investigations

Diagnosing chronic diarrhea and finding its cause can involve:

Medical history and physical examination
Stool tests

To identify infections, blood, or malabsorption markers.

Blood tests

To check for anemia, inflammation, or metabolic disorders.

Colonoscopy or sigmoidoscopy

Colonoscopy or sigmoidoscopy

Imaging studies

CT scan or MRI to assess structural abnormalities.

Breath testing
Hydrogen breath test

To detect lactose or fructose intolerance.

Lactulose + glucose breath testing (work up SIBO)

Management

Treating chronic diarrhea typically entails:

Dietary modifications

Avoiding trigger foods, following a low-FODMAP diet.

Medications

Antibiotics for infections, anti-inflammatory drugs for IBD, antidiarrheal agents.

Probiotics

To restore healthy gut flora.

Hydration

Ensuring adequate fluid and electrolyte intake.

Treatment of underlying conditions

Managing chronic diseases or infections.