Algorithm for the Evaluation of Chronic Diarrhea (< 7 days) Exclude: 1. Causes of acute diarrhea 2. Lactose intolerance 3. Irritable bowel syndrome 4. Previous gastric surgery or ileal resection 5. Parasitic infections 6. Medications 7. Systemic disease - Fecal leukocytes and occult blood - Colonoscopy with biopsy - Small bowel imaging with barium, CT, or MR enterography - Stool electrolytes, osmolality, weight/24 h, quantitative fat Increased fecal fat: Malabsorption syndromes, Pancreatic insufficiency, Bacterial overgrowth Normal fecal fat: Lactose intolerance, Sorbitol, lactulose, Laxative abuse Normal stool weight: Irritable bowel syndrome, Factitious diarrhea Increased stool weight: Secretory laxative abuse (1000 g/24 h) #Chronic #Diarrhea #management #algorithm #workup #diagnosis #differential
