Diarrhea
Diarrhea: Excerpt from A Pocket Manual of Differential Diagnosis
Acute Diarrhea
Infections
Viral gastroenteritis (adenovirus, Norwalk agent,
rotavirus, etc.)
Bacterial
Invasive (e.g.,
Shigella,
Salmonella,
Campylobacter,
Escherichia coli,
Yersinia)
Toxigenic (e.g.,
Staphylococcus,
E. coli,
Clostridium difficile,
Vibrio sp., toxic shock syndrome)
Food poisoning
Staphylococcus aureus
Bacillus cereus
C. perfringens
Protozoal (e.g., amebiasis, giardiasis, cryptosporidium,
Cyclospora)
Fungal
AIDS
AIDS enteropathy
Bacterial infections (see previous Bacterial listing)
Cryptosporidium
Microsporidium
Amebiasis
Giardiasis
Isospora belli
CMV
HSV
Adenovirus
Mycobacterium avium complex
Cryptococcus
Histoplasma
Candida
Stress-induced
Food allergy (rare)
Dietary indiscretion (e.g., prunes, unripe fruit, rhubarb, olestra)
Gastrointestinal disorders
Partial bowel obstruction
Fecal impaction
Diverticulitis
Appendicitis
Ischemic bowel disease
Initial attack of ulcerative colitis or Crohn's disease
Systemic/extraintestinal disorders
Uremia
Carcinoid syndrome
Endocrine disorders
Thyrotoxicosis
Addisonian crisis
Pelvic inflammation
Drugs/toxins (partial list)
Laxatives (poorly absorbable sugars, fiber)
Antibiotics
Magnesium-containing antacids/products
Colchicine
Digitalis
Iron
Antihypertensives (methyldopa, hydralazine, and
others)
Quinidine
Antidepressants (e.g., Prozac, Wellbutrin)
Cisapride
Valproic acid
Antiretrovirals
Protease inhibitors
5-Aminosalicylic acid products
Metformin
Interferon products
Immunosuppressives (cyclosporine, tacrolimus)
Potassium preparations
Nonsteroidal antiinflammatory drugs (NSAIDs)
Lipid lowering agents
Alcohol
Heavy metals (especially arsenic, cadmium, mercury)
Mushrooms
Acute exacerbation of chronic diarrhea
Chronic Diarrhea
Osmotic diarrhea
Carbohydrate malabsorption
Ingestion of poorly absorbable carbohydrates (sorbitol, mannitol fructose, lactulose, fiber)
Congenital disaccharidase deficiencies
Lactase deficiency
Isomaltase-sucrase deficiency
Trehalase deficiency
Acquired disaccharidase deficiencies
Nontropical sprue
Tropical sprue
Viral gastroenteritis
Maldigestion syndromes
Malabsorption syndromes
Osmotic solutes
Magnesium-containing laxatives
Magnesium-containing antacids
Magnesium-containing nutritional supplements
Sodium citrate
Sodium phosphate
Sodium sulfate
Polyethylene-glycol lavage solution
Enteral feedings
Reduced absorptive surface
Intestinal resection
Intestinal bypass
Other osmotic causes
Congenital chloridorrhea
Postgastrectomy “dumping” syndrome
Secretory diarrhea
Stimulant laxatives
Bisacodyl
Cascara
Senna
Ricinoleic acid
Phenopthalein
Docusate sodium
Aloe
Danthron
Infections
Enterotoxigenic bacteria (
E. coli, cholera)
Enteroviruses (Norwalk agent, rotavirus)
Chronic infections (mycobacterial, fungal, parasitic)
Bacterial overgrowth (intestinal stasis)
AIDS (see previous Acute Diarrhea section)
Inflammation
Crohn's disease
Ulcerative colitis
Lymphocytic colitis
Collagenous colitis
Celiac disease
Neoplasms
Zollinger-Ellison syndrome (gastrinoma)
Pancreatic cholera syndrome (VIPoma)
Carcinoid syndrome
Medullary carcinoma of the thyroid
Glucagonoma
Sympathetic tissue tumors (ganglioneuromas)
Villous adenoma
Carotid body tumor
Pheochromocytoma
Intestinal lymphoma [especially in human immunodeficiency virus (HIV) infection]
Other
Fatty acid malabsorption
Pancreatic insufficiency
Bile acid malabsorption
Postcholecystectomy bile acid–induced diarrhea
Postvagotomy diarrhea
Congenital absorptive defects
Hyperthyroidism
Collagen vascular disease
Intestinal resection
Hypoparathyroidism
Addison's disease
Food allergy
Exudative diarrhea
Infectious causes
Bacterial/viral infections (see previous Acute Diarrhea section)
Amebic colitis
Parasitic infestation
Pseudomembranous colitis
Diverticulitis
Idiopathic and other colitides
Ulcerative colitis
Crohn's disease
Radiation enterocolitis
Ischemic colitis
Chemotherapy-induced mucositis
Graft-versus-host disease
Abnormal motility
Idiopathic chronic diarrhea
Irritable bowel syndrome
Neoplasm (obstruction)
Postvagotomy
Postsurgical (e.g., gastrectomy, pyloroplasty)
Gastroileal or gastrocolonic fistula
Decreased rectal compliance
Scleroderma
Diabetic diarrhea
Amyloidosis
Other causes/unknown/multifactorial
Portal hypertension
Drugs (see previous Acute Diarrhea section)
Alcohol
Partial bowel obstruction
Heavy metal poisoning
Fecal incontinence (masquerading as diarrhea)
Uremia
Cirrhosis
Pernicious anemia
Pellagra
Immunoglobulin deficiencies
Chronic opiate abuse
Eosinophilic gastroenteritis
Systemic mastocytosis
Protein-losing enteropathy
Long-distance running
References
1. Fine KD: Diarrhea, pp. 128–152. See Bibliography, 1.
2. Ammon HV: Diarrhea, p. 87–101. See Bibliography, 2.
Book Source Details
- Book Title: A Pocket Manual of Differential Diagnosis
- Author(s): Stephen N. Adler, Dianne B. Gasbarra
- Year of Publication: 1999
- Copyright Details: A Pocket Manual of Differential Diagnosis, Copyright © 1999 Lippincott Williams & Wilkins.
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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
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