Chronic Inflammatory Diarrhea

Aka: Chronic Inflammatory Diarrhea, Inflammatory Diarrhea

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II. Definitions

  1. Chronic Inflammatory Diarrhea
    1. Bloody or purulent stool seen in Inflammatory Bowel Disease and infectious enteritis

III. Causes

  1. See Acute Inflammatory Diarrhea
  2. Inflammatory Bowel Disease
    1. Ulcerative Colitis
    2. Crohn's Disease
    3. Diverticulitis
  3. Invasive Infections
    1. Bacterial Infections
      1. Clostridium difficile
      2. Mycobacterium tuberculosis
      3. Yersinia enterocolitica
    2. Viral Infection (ulcerative)
      1. Cytomegalovirus (CMV)
      2. Herpes Simplex Virus (HSV)
    3. Parasitic Infection
      1. Giardiasis causes Chronic Fatty Diarrhea (Diarrhea due to Malabsorption)
      2. Amebiasis
      3. Strongyloides
      4. Ascaris Lumbricoides (Roundworm infection)
  4. Ischemic Colitis (typically acute)
  5. Radiation Colitis
  6. Malignancy
    1. Colon Cancer
    2. Lymphoma
    3. Villous adenocarcinoma

IV. Labs

  1. Stool Leukocytes with gross blood and pus present
  2. Fecal Calprotectin level
    1. Highly sensitive and specific for Inflammatory Bowel Disease

V. Diagnostics

  1. Colonoscopy with biopsy

VI. References

  1. Schiller in Feldman (2002) Sleisenger GI, p. 136
  2. Burgers (2020) Am Fam Physician 101(8): 472-80 [PubMed]

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