What are the acute and chronic causes of diarrhoea, and what are the investigations required?
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Hello, What are the acute and chronic causes of diarrhoea, and what are the investigations required? For last 7 days I am suffering from diarrhoea. Is it normal? Please help me.
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@kamal Acute diarrhea is defined as the abrupt onset of 3 or more loose stools per day and lasts no longer than 14 days; chronic or persistent diarrhea is defined as an episode that lasts longer than 14 days. Causes
Infectious - Gastroenteritis, Antibiotic associated colitis, Giardia, amoebiasis (bloody stools)
Inflammatory - Ulcerative colitis (bloody), Crohn's disease
Functional - Irritable bowel syndrome, Laxative abuse
Osmotic - related to oral intake of unabsorbed sugars
Drug induced - laxatives, colchicine, PPIs
Malabsorption - Coeliac disease, Crohn's disease
Neoplastic - colorectal (bloody), rectal villous adenoma (mucus)
Investigations required
Assess stool with Bristol stool scale
Stool microscopy and culture
Clostridium difficile toxin
Check U&E for dehydration. In children consider Haemolytic uraemic syndrome with certain E coli
FBC - elevated WCC, Anaemia - Microcytic suggests possibly a colonic malignancy or inflammatory
bowel disease. Macrocytosis may suggest malabsorption. Dimorphic may suggest both. LFTS - elevated ALP and Bilirubin with obstruction may cause steatorhoea