Chronic Diarrhea - Differential Diagnosis Algorithm
Steatorrhea
- Maldigestive
• Pancreatic Insufficiency
- Primary Malabsorption
• Celiac Disease
• Mucosal Disease
• Ileal Crohn's Disease
- Secondary Malabsorption
• Bacterial Overgrowth
• Liver Cholestasis
• Mesenteric Ischemia
• Short Bowel Resection
Large Bowel (Small Volume/ Bloody / Painful / Tenesmus / Urgency)
- Motility
• Irritable Bowel Syndrome
• Hyperthyroid
- Inflammatory
• Inflammatory Bowel Disease
• Radiation CoIits
• Ischemic Colitis
- Secretory
• Villous Adenoma
• Colon Cancer
• Microscopic Colitis
Disordered Motility
• Irritable Bowel Syndrome (diagnosis of exclusion)
• Diabetic Neuropathv
• Hyperthyroidism
Osmotic
• Magnesium, Phosphate, Sulfate
• Carbohydrate Mala bsorption
• Lactose Intolerance
Mucosal
• Crohn's Disease (Screen with CBC, albumin, ESR, endoscopy)
• Celiac Disease (screen with TTG)
• Chronic Inflammation
• Whipple's Disease
Mucosal Tumor
• Gastrinoma
• Carcinoid Syndrome
• Mastocystosis
Neoplastic Tumor
• Adenocarcinoma
• Lymphoma
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