Chronic diarrhea history and symptoms
Chronic diarrhea Microchapters
The hallmark of chronic diarrhea is loose stools lasting for 4 weeks or more. A positive history of foul smelling stools that are difficult to flush, bloody loose bowel movements, and cramping abdominal pain are suggestive of chronic diarrhea. The most common symptoms of chronic diarrhea include cramping abdominal pain, elevation in body temperature, and increased frequency of bowel movements.
Obtaining the history is the most important aspect of making a diagnosis of chronic diarrhea. It provides insight into the cause, precipitating factors, and associated comorbid conditions. A complete history will help determine the correct therapy and the prognosis. Specific histories about symptoms (duration, onset, progression), associated symptoms, and drug usage have to be obtained. Specific areas of focus when obtaining the history are outlined below:
- Age and gender
- Onset, duration, progression, pattern, and timing of symptoms
- Associated symptoms (lethargy, fever, confusion)
- Current medications
- Association with food and fasting states
- Symptoms of other organ failure (renal failure, liver failure, adrenal failure)
- Ingestion of poisons or chemicals
- Co-morbid conditions like diabetes, immunodeficiency
- Severe infections
- Any alterations in sensorium as a result of dehydration
- Family history
Less common symptoms
- Confusion or agitation
- Altered mental status
- Abdominal guarding
- Difficulty speaking
- Stupor or coma
- Kleinman RE (2005). "Chronic nonspecific diarrhea of childhood". Nestle Nutr Workshop Ser Pediatr Program. 56: 73–9, discussion 79-84. doi:10.1159/000086276. PMID 16632945.
- Eherer AJ, Fordtran JS (1992). "Fecal osmotic gap and pH in experimental diarrhea of various causes". Gastroenterology. 103 (2): 545–51. PMID 1634072.