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Diarrhea
Overview
What are the symptoms?
What are the causes?
Who is at highest risk?
Diagnosis
When to seek urgent medical care?
Treatment options
Where to find medical care for Diarrhea?
Prevention
What to expect (Outlook/Prognosis)?
Diarrhea On the Web
Ongoing Trials at Clinical Trials.gov
Images of Diarrhea
Videos on Diarrhea
FDA on Diarrhea
CDC on Diarrhea
Diarrhea in the news
Blogs on Diarrhea
Directions to Hospitals Treating Diarrhea
Risk calculators and risk factors for Diarrhea

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor-in-Chief: Meagan E. Doherty

Overview

Diarrhea is loose, watery stools. A person with diarrhea typically passes stool more than three times a day. People with diarrhea may pass more than a quart of stool a day. Acute diarrhea is a common problem that usually lasts 1 or 2 days and goes away on its own without special treatment. Prolonged diarrhea persisting for more than 2 days may be a sign of a more serious problem and poses the risk of dehydration. Chronic diarrhea may be a feature of a chronic disease. Diarrhea can cause dehydration, which means the body lacks enough fluid to function properly. Dehydration is particularly dangerous in children and older people, and it must be treated promptly to avoid serious health problems. People of all ages can get diarrhea and the average adult has a bout of acute diarrhea about four times a year. In the United States, each child will have had seven to 15 episodes of diarrhea by age 5.

What are the symptoms of Diarrhea?

Diarrhea may be accompanied by cramping, abdominal pain, bloating, nausea, or an urgent need to use the bathroom. Depending on the cause, a person may have a fever or bloody stools.

What are the causes of Diarrhea?

Acute diarrhea is usually related to a bacterial, viral, or parasitic infection. Chronic diarrhea is usually related to functional disorders such as irritable bowel syndrome or inflammatory bowel disease.

A few of the more common causes of diarrhea include the following:

• Bacterial infections. Several types of bacteria consumed through contaminated food or water can cause diarrhea. Common culprits include Campylobacter, Salmonella, Shigella, and Escherichia coli (E. coli).
• Viral infections. Many viruses cause diarrhea, including rotavirus, Norwalk virus, cytomegalovirus, herpes simplex virus, and viral hepatitis.
• Food intolerances. Some people are unable to digest food components such as artificial sweeteners and lactose—the sugar found in milk.
• Parasites. Parasites can enter the body through food or water and settle in the digestive system. Parasites that cause diarrhea include Giardia lamblia, Entamoeba histolytica, and Cryptosporidium.
• Reaction to medicines. Antibiotics, blood pressure medications, cancer drugs, and antacids containing magnesium can all cause diarrhea.
• Intestinal diseases. Inflammatory bowel disease, colitis, Crohn’s disease, and celiac disease often lead to diarrhea.
• Functional bowel disorders. Diarrhea can be a symptom of irritable bowel syndrome.

Some people develop diarrhea after stomach surgery or removal of the gallbladder. The reason may be a change in how quickly food moves through the digestive system after stomach surgery or an increase in bile in the colon after gallbladder surgery.

People who visit foreign countries are at risk for traveler’s diarrhea, which is caused by eating food or drinking water contaminated with bacteria, viruses, or parasites. Traveler’s diarrhea can be a problem for people visiting developing countries. Visitors to the United States, Canada, most European countries, Japan, Australia, and New Zealand do not face much risk for traveler’s diarrhea.

In many cases, the cause of diarrhea cannot be found. As long as diarrhea goes away on its own, an extensive search for the cause is not usually necessary.

Who is at risk for Diarrhea?

Anyone can get diarrhea. This common problem can last a day or two or for months or years, depending on the cause. Most people get better on their own, but diarrhea can be serious for babies and older people if lost fluids are not replaced. Many people throughout the world die from diarrhea because of the large volume of water lost and the accompanying loss of salts.

Diagnosis

Diagnostic tests to find the cause of diarrhea may include the following:

• Medical history and physical examination. The doctor will ask you about your eating habits and medication use and will examine you for signs of illness.
• Stool culture. A sample of stool is analyzed in a laboratory to check for bacteria, parasites, or other signs of disease and infection.
• Blood tests. Blood tests can be helpful in ruling out certain diseases.
• Fasting tests. To find out if a food intolerance or allergy is causing the diarrhea, the doctor may ask you to avoid lactose, carbohydrates, wheat, or other foods to see whether the diarrhea responds to a change in diet.
• Sigmoidoscopy. For this test, the doctor uses a special instrument to look at the inside of the rectum and lower part of the colon.
• Colonoscopy. This test is similar to a sigmoidoscopy, but it allows the doctor to view the entire colon.
• Imaging tests. These tests can rule out structural abnormalities as the cause of diarrhea.

When to seek urgent medical care

Diarrhea is not usually harmful, but it can become dangerous or signal a more serious problem. You should see the doctor if you experience any of the following:

• Diarrhea for more than 3 days
• Severe pain in the abdomen or rectum
• A fever of 102 degrees or higher
• Blood in your stool or black, tarry stools
• Signs of dehydration

Treatment options

In most cases of diarrhea, replacing lost fluid to prevent dehydration is the only treatment necessary. Medicines that stop diarrhea may be helpful, but they are not recommended for people whose diarrhea is caused by a bacterial infection or parasite. If you stop the diarrhea before having purged the bacteria or parasite, you will trap the organism in the intestines and prolong the problem. Rather, doctors usually prescribe antibiotics as a first-line treatment. Viral infections are either treated with medication or left to run their course, depending on the severity and type of virus.

Tips About Food

Until diarrhea subsides, try to avoid caffeine, milk products, and foods that are greasy, high in fiber, or very sweet. These foods tend to aggravate diarrhea.

As you improve, you can add soft, bland foods to your diet, including bananas, plain rice, boiled potatoes, toast, crackers, cooked carrots, and baked chicken without the skin or fat. For children, the pediatrician may also recommend a bland diet. Once the diarrhea has stopped, the pediatrician will likely encourage children to return to a normal and healthy diet if it can be tolerated.

Contraindicated medications

Patients diagnosed with Diarrhea should avoid using the following medications:

• Ethacrynic acid
  If you have been diagnosed with Diarrhea, consult your physician before starting or stopping any of these medications.

Where to find medical care for Diarrhea

Directions to Hospitals Treating Diarrhea

Prevention of Diarrhea

• Wash your hands often, especially after going to the bathroom and before eating.
• Teach children to not put objects in their mouth.
• When taking antibiotics, try eating food with Lactobacillus acidophilus, a healthy bacteria. This helps replenish the good bacteria that antibiotics can kill. Yogurt with active or live cultures is a good source of this healthy bacteria.
• Use alcohol-based hand gel frequently.

Traveler’s diarrhea happens when you consume food or water contaminated with bacteria, viruses, or parasites. You can take the following precautions to prevent traveler’s diarrhea when you travel outside of the United States:

• Do not drink tap water or use it to brush your teeth.
• Do not drink unpasteurized milk or dairy products.
• Do not use ice made from tap water.
• Avoid all raw fruits and vegetables, including lettuce and fruit salads, unless they can be peeled and you peel them yourself.
• Do not eat raw or rare meat and fish.
• Do not eat meat or shellfish that is not hot when served.
• Do not eat food from street vendors.

You can safely drink bottled water—if you are the one to break the seal—along with carbonated soft drinks, and hot drinks such as coffee or tea.

Depending on where you are going and how long you will stay, your doctor may recommend that you take antibiotics before leaving to protect you from possible infection.

What to expect (Outlook/Prognosis)

The Prognosis for diarrhea is usually good. Diarrhea is common and usually goes away on its own unless it is an underlying symptom of a chronic disease. It is important to replace lost fluid due to diarrhea because if you become severely dehydrated it can be fatal.

Sources

http://digestive.niddk.nih.gov/ddiseases/pubs/diarrhea/

Classification

There are at least four types of diarrhea: secretory diarrhea, osmotic diarrhea, motility-related diarrhea, and inflammatory diarrhea.

Secretory Diarrhea

Secretory diarrhea means that there is an increase in the active secretion, or there is an inhibition of absorption. There is little to no structural damage. The most common cause of this type of diarrhea is a cholera toxin that stimulates the secretion of anions, especially chloride ions. Therefore, to maintain a charge balance in the lumen, sodium is carried with it, along with water.

Osmotic Diarrhea

Osmotic diarrhea occurs when there is a loss of water due to a heavy osmotic load. This can occur when there is maldigestion (e.g., pancreatic disease or Coeliac disease), where the nutrients are left in the lumen, which pulls water into the lumen.

Motility-Related Diarrhea

Motility-related diarrhea occurs when the motility of the gastrointestinal tract is abnormally high. If the food moves too quickly, there is not enough time for sufficient nutrients and water to be absorbed. This can be due to a vagotomy or diabetic neuropathy, or a complication of menstruation.

Inflammatory Diarrhea

Inflammatory diarrhea occurs when there is damage to the mucosal lining or brush border, which leads to a passive loss of protein-rich fluids, and a decreased ability to absorb these lost fluids. Features of all three of the other types of diarrhea can be found in this type of diarrhea. It can be caused by bacterial infections, viral infections, parasitic infections, or autoimmune problems such as inflammatory bowel disease.

Others

• Infectious diarrhea
• Inflammatory bowel disease
• Irritable bowel syndrome
• Malabsorption

Pathophysiology Diarrhea

Normal fluid intake for an adult is about 2 L/d. The average amount of gastrointestinal secretions (composed of salivary glands, gastric, biliary, and pancreatic secretions) is 7-8 L/d, depending on the weight and age. The absorptive surface of the small intestine is formed by villis that reabsorb the majority of secreted water and electrolytes. The small intestine absorbs 75% of upper GI tract secretions. The rest of the secretions absorb in the large intestine. Colon absorbs 90% of its exposed volume, means that colon is the most effective absorbing organ in the GI system.
Decrease in the small intestine absorption, regardless of causes, may not cause diarrhea unless, there is a dysfunction in colon or the volume of the secretions exceeds the absorptive ability of the colon.

Overview

The principal cause of diarrhea stems from ingestion of unsafe drinking water (typically from admixture of raw sewage to water supplies); the occurrence is predominantly in lesser developed countries. The common causes of acute diarrhea are infection, allergy, food intolerance, foodborne illness and/or extreme excesses of vitamin C and/or magnesium and may be accompanied by abdominal pain, nausea and vomiting. Infectious diarrhea is most commonly caused by viral infections or bacterial toxins. Diarrhea can also be a principal symptom of more serious diseases, such as dysentery, Montezuma's Revenge, cholera, or botulism, and can also be indicative of a chronic syndrome such as Crohn's disease. Temporary diarrhea can also result from the ingestion of laxative medications or large quantities of certain foods like prunes with laxative properties. Though appendicitis patients do not generally have diarrhea, it is a common symptom of a ruptured appendix. It is also an effect of severe radiation sickness.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Acute appendicitis Acute kidney failure Acute pancreatitis Anaphylaxis Angioedema Carbon monoxide poisoning Digoxin toxicity Ergotism

Food poisoning Heavy metal poisoning Herbal extract overdose Infectious diarrhea Inflammatory bowel disease Insect bite allergy Intususception

Ischemic colitis Organophosphate poisoning Pesticide poisoning Pseudomembranous colitis Severe combined immunodeficiency Staphylococcal toxic shock syndrome Waterhouse-Friederichsen syndrome

Common Causes

ACE inhibitors Alcohol intoxication Alcohol withdrawal Amebiasis Anti retroviral agents Antifungals Bacillary dysentery Bacterial toxin Bile acid sequestrant Campylobacter jejuni Cephalosporins Chemotherapeutic agents

Cholestatic jaundice Citalopram Colitis Colorectal polyps Diabetic neuropathy Diverticulitis Doxycycline Entamoeba histolytica Escherichia coli Food poisoning Fosfomycin Helminthiasis Hepatitis A Hepatitis E

Inflammatory bowel disease Lactose intolerance Macrolides Malabsorption syndrome Opioid withdrawal Proton pump inhibitors Pseudomembranous colitis Radiation sickness Salmonellosis Statins Thiazide diuretics Triptans

Causes According to Pathophysiology

Osmotic Diarrhea

Abetalipoproteinaemia Alagille syndrome Alpha-glucosidase inhibitor Aminoglycosides Ampicillin Antacids Apolipoprotein B deficiency Ascariasis Auranofin Autoimmune polyendocrine syndrome Bacitracin Biguanides Billroth II procedure Blind loop syndrome Carcinoid syndrome Celiac disease Cholesteryl ester storage disease Cholestyramine Chronic granulomatous disease Chylomicron retention disease Colchicine Colestyramine

Common variable immunodeficiency Cronkhite-Canada disease Diabetic neuropathy Diffuse systemic sclerosis Dumping syndrome Eflornithine Fasciolopsiasis Fructose malabsorption Gastrointestinal amyloidosis Gastrointestinal lymphomas Giardiasis Glucose-galactose malabsorption HIV Kanamycin Kwashiorkor Lactose intolerance Magnesium salts Malabsorption syndrome Malassimilation Mannitol Mastocytosis Ménétrier's disease

Methyldopa Microsporidiosis Milk allergy Mixed connective tissue disease Neomycin Octreotide Orlistat Osmotic laxative Pearson syndrome Protein losing enteropathy Short bowel syndrome Shwachman-Diamond syndrome Small bowel bacterial overgrowth syndrome Somatostatinoma Sorbitol Strongyloidiasis Sucrase-isomaltase deficiency Sucrose intolerance Tetracyclines Tropical sprue Whipple disease

Secretory Diarrhea

Addison's disease Anaphylaxis Angioedema Anthraquinone Antidepressants Antineoplastic agents Auranofin Bacterial toxin Biguanides Bisacodyl Brainerd diarrhea Calcitonin Carcinoid syndrome Cardiac glycosides Cephalosporins Chenodeoxycholic acid Cholera Cholestatic jaundice Colchicine

Collagenous colitis Colorectal cancer Congenital chloride diarrhea Diabetic neuropathy Diacerein Diverticulitis Gastrinoma Graves disease Heavy metal poisoning Herbal extract poisoning Hyperthyroidism Hypoaldosteronism Inflammatory bowel disease Intestinal lymphoma IPEX (syndrome) Irritable bowel syndrome Lymphocytic colitis Macrolides Mastocytosis

Medullary carcinoma of thyroid Microvillous inclusion disease Mushroom poisoning NSAIDS Olsalazine Oxyphenisatin Penicillins Pesticide poisoning Phenolphthalein Postsympathectomy Postvagotomy Prostaglandins Ricinoleic acid Somatostatinoma Ticlopidine Vasculitis Villous adenoma VIPoma Zollinger-Ellison syndrome

Motility Related Diarrhea

Cephalosporins Cisapride Colchicine Diabetic neuropathy Erythromycin Hyperthyroidism

Levothyroxine Macrolides Penicillins Postileal resection Postvagotomy

Quinolones Short bowel syndrome Sulphonamides Tetracyclines Ticlopidine

Causes According to Duration

Acute Diarrhea

Addison's disease Appendicitis Bacterial: Aeromonas Campylobacter jejuni Chlamydia Clostridium difficile E.coli Enterobacter Klebsiella Neisseria gonorrhea Plesiomonas Salmonella Shigella Staphylococcus aureus Vibrio cholerae Yersinia enterocolitica Carcinoid syndrome C-cell carcinoma Chronic inflammatory bowel disease Colitis

Drugs: Abuse of laxatives Alcohol Antibiotics Biguanides Cefpodoxime Chemotherapeutics Chemotherapy Cholestyramin Digitalis Diuretics Ergotamine Hydralazine Hydrochlorothiazide Mercaptopurine Opiate withdrawal Parasympathomimetics Physostigmine Quinidine Rabeprazole Reserpine Warfarin Food: Bacillus cereus Clostridium perfringens Staphylococcus aureus

Food allergy Graft versus host reaction Heavy metal intoxication HIV Hyperthyroidism Irritable bowel syndrome (IBS) Lactose intolerance Neuroendocrine tumors Parasites: Cryptosporidium Entamoeba histolytica Giardia intestinalis Viral: Adenovirus Coxsackie virus Cytomegalovirus (CMV) Echovirus Influenza virus Norwalk virus Poliovirus Rotavirus

Chronic Diarrhea

Achylia Addison's Disease Amebiasis Amyloidosis Anxiety Autonomous neuropathy Bacterial gastroenteritis Bacterial toxin Behcet syndrome Bile acid malabsorption Biliary fistula Carcinoid syndrome Carcinoma of the pancreas Celiac Sprue Chronic inflammatory bowel disease Collagenous colitis Colon cancer Colorectal polyps Cryptosporidiosis Diabetic enteropathy Diverticular disease

Drugs: Antacids Anthraquinone Castor oil Elvitegravir Lactulose Levofloxacin Mannitol Sorbitol Dumping syndrome Excess coffee, tea Fecal impaction Gastrocolic fistula Giardia Hyperthyroidism HIV Idiopathic lymphangiectasis Irritable bowel syndrome Lymphocytic colitis Lymphomas Malabsorption Maldigestion Medullary thyroid carcinoma

Neuroendocrine tumors Nontropical sprue Obstructive jaundice Parasites: Ascariasis Hookworm Whipworm Pellagra Polyarteritis Postileal resection Postvagotomy Prostaglandins Radiation proctitis Rectal surgery Scleroderma Short bowel syndrome Tuberculosis Verner-Morrison syndrome Villous adenoma Villous carcinoma Whipple's disease

Causes by Organ System

Cardiovascular	Portal vein thrombosis, superior mesenteric artery syndrome
Chemical / poisoning	Acrodynia, Amlodipine besylate and Atorvastatin calcium trihydrate, acute zinc toxicity, arsenic poisoning, Azacitidine , Cabozantinib carbamate insecticide poisoning, carbon monoxide poisoning, chlordane toxicity, chloroform toxicity, copper toxicity, diazinon poisoning, glutaraldehyde toxicity, heavy metal poisoning, lead poisoning, mercury poisoning, metal fume fever, naphthalene poisoning, organophosphate poisoning, paraquat toxicity, selenium toxicity, thallium toxicity
Dermatologic	Acrodermatitis enteropathica, necrotizing fasciitis
Drug Side Effect	Ambenonium, 2C-B, 5-HT3 antagonist, 5-methoxy-diisopropyl tryptamine, abacavir, Acamprosate calcium, acarbose, acebutolol, Acetylcysteine, acyclovir, acitretin, aconitine, adefovir, afatinib, alatrofloxacin, albendazole, aldesleukin, Alemtuzumab, alendronate, aliskiren, allopurinol, alosetron, alpha-amanitin, alpha-glucosidase inhibitor, alprazolam, altretamine, ambenonium chloride, amifostine, amiloride, aminocaproic acid, aminophylline, amlexanox, amlodipine, Amlodipine besylate and Atorvastatin calcium trihydrate, ammonium lauryl sulfate, amoxicillin, amphetamine, amphotericin B, amprenavir, amitriptyline, anadenanthera peregrina, anagrelide, anakinra, anastrozole, Anidulafungin, anisindione, Apremilast, aprepitant, atazanavir, atenolol, atorvastatin, atovaquone, Atropine, auranofin, azithromycin, aztreonam, bacitracin, baclofen, barium nitrate, barium sulfate, Basiliximab, Benzphetamine, benazepril, bentiromide, bepridil, betaxolol, Bethanechol chloride, bevacizumab, bezafibrate, bicalutamide, biguanide, bisacodyl, bisoprolol, bortezomib, Bosutinib, bromocriptine, brompheniramine, bumetanide, buspirone, busulfan, candesartan, capecitabine, carbamazepine, carbidopa, carboplatin, carvedilol, cefaclor, cefadroxil, cefamandole nafate, cefazolin, cefazolin, cefdinir, Cefditoren, cefepime, Cefixime, cefoperazone, cefotaxime, cefotetan disodium, cefoxitin, cefpodoxime, Cefprozil, Ceftaroline fosamil, ceftazidime, Ceftibuten, ceftizoxime, ceftriaxone, cefuroxime, cephalexin, cephradine, Ceritinib, cerivastatin, cetuximab, cevimeline, Chenodiol, chloral hydrate, chlorambucil, chlordiazepoxide, chlorodyne, chlorothiazide, chlorpheniramine, Chlorpropamide, chlorthalidone, cholestyramine, ciclosporin, cidofovir, cilostazol,, cinacalcet, cisapride, citalopram, cladribine, clamoxyquine, clarithromycin, clavulanic acid, clindamycin, clofarabine, clofibrate, clomipramine, clonazepam, clopidogrel, clorazepate, Conjugated estrogens/bazedoxifene, colchicine, colistimethate, conjugated estrogens, Crizotinib, cyclophosphamide, cyproheptadine, cytarabine, dactinomycin, dalfopristin, dantrolene, daptomycin, darbepoetin alfa, darifenacin, darunavir, dasatinib, daunorubicin, deferasirox, delavirdine, demeclocycline, Denileukin diftitox deracoxib, desoxyn, Dexchlorpheniramine, dextroamphetamine, dextromethorphan, diacerein, diazepam, diclofenac, dicloxacillin, didanosine, diflunisal, digitoxin, digoxin, diltiazem, dipyridamole, dirithromycin, disopyramide, docetaxel, dofetilide, dolasetron, donepezil, doripenem, doxorubicin, doxycycline, DTPA, duloxetine, Ecallantide, eculizumab, efavirenz, Elvitegravir, emtricitabine, Emtricitabine, Rilpivirine Hydrochloride, And Tenofovir Disoproxil Fumarate enalapril, endosulfan, enoxacin, entacapone, Epirubicin hydrochloride, eplerenone, epoetin alfa, ergotamine, erlotinib, Eliglustat, erythromycin, esomeprazole, estazolam, estradiol, ethacrynic acid, ethosuximide, etidronate, etodolac, etoposide, exemestane, exenatide, ezetimibe, famciclovir, famotidine, felbamate, Ferric oxyhydroxide, fexofenadine, floxuridine, foscarnet sodium, fluconazole, flucytosine, fludarabine, fluoride, fluorouracil, fluoxetine, flurazepam, Flurbiprofen, flutamide, fluticasone, fluvastatin, fluvoxamine, fosamprenavir, foscarnet, fosinopril, frovatriptan, fulvestrant, gabapentin, galantamine, ganciclovir, gatifloxacin, gefitinib, gemcitabine, gemeprost, gemfibrozil, glatiramer, Glipizide, Glyburide and Metformin, glycopyrrolate, granisetron, griseofulvin, guanethidine, guanfacine, hydralazine, hydrochlorothiazide, hydroxychloroquine, Hydroxyprogesterone caproate hydroxyurea, hyoscyamine, ibandronate, Ibritumomab Tiuxetan ibuprofen, idarubicin, Idelalisib, Idursulfase, imatinib, Imiglucerase infliximab, interferon alfacon-1 , Interferon alfa-2b , interferon beta-1b, irinotecan hydrochloride, iron supplements, isocarboxazid, isradipine, itraconazole, Ivacaftor, Ivermectin, Ixabepilone, ketoconazole, Ketorolac tromethamine, Lactulose, lamivudine, lamotrigine, lanreotide, lansoprazole, lanthanum,Lapatinib, leflunomide, lenalidomide, letrozole, leuprolide, levalbuterol, levetiracetam, Lenvatinib, levocarnitine, levodopa, levofloxacin, Linaclotide, Lincomycin Hydrochloride, linezolid, liothyronine sodium, lisinopril, lithium, lomefloxacin, lopinavir, loracarbef, loratadine, lorazepam, loxapine, magnesium hydroxide, mebendazole, mechlorethamine, meclofenamate, Mercaptopurine, mefenamic acid, mefloquine, megestrol, Meloxicam, meprobamate, mercaptopurine, meropenem, mesalazine, mesna, mesoridazine, Metirosine, metformin, methamphetamine, methenamine, methotrexate, methoxychlor, methsuximide, methyclothiazide, methylergonovine, methyprylon, metoclopramide, metolachlor, metolazone, metoprolol, metronidazole, Micafungin sodium, miconazole, mifepristone, miglitol, Miglustat, miltefosine minocycline, misoprostol, mitotane, mitoxantrone, moclobemide, modafinil, moexipril, moricizine, moxifloxacin, mycophenolate, nabumetone, nafcillin, naltrexone, naphthalene, naproxen and esomeprazole magnesium, natalizumab, natamycin, nateglinide, nelfinavir, nevirapine, Niacin/simvastatin, niclosamide, Nilotinib, Nintedanib, nizatidine, norfloxacin, nystatin, ofloxacin, Olsalazine, omalizumab, omeprazole, ondansetron, oseltamivir, oxaliplatin, oxazepam, oxcarbazepine, oxtriphylline, oxybutynin, Palbociclib, palivizumab, pancrelipase, Panitumumab, pantoprazole, Paromomycin sulfate, Paroxetine, Pasireotide, pegaspargase, peginterferon alfa-2a, peginterferon alfa-2b, pemetrexed, pemoline, penbutolol, penicillin, pentamidine, pentostatin, pergolide, perindopril, perphenazine, Pertuzumab, phenazopyridine, Phenoxymethylpenicillin, phentermine, pilocarpine, pimecrolimus, pimozide, Pirfenidone, piroxicam, Plerixafor, Potassium iodide, plicamycin, polythiazide, posaconazole, Potassium chloride, Potassium citrate, pramipexole, pramlintide, prazepam, praziquantel, prazosin, procainamide, procarbazine, promethazine, propafenone, propranolol, permethrin, protriptyline, pseudoephedrine, Pyrantel pamoate, pyridostigmine, quinapril, quinidine, quinupristin, rabeprazole, Radium chloride, ramipril, Ramucirumab, ranitidine, rasagiline, Rasburicase, repaglinide, reserpine, retapamulin, ribavirin, rifabutin, rifampin, rilmenidine, riluzole, risedronate, risperidone, ritonavir, rituximab, rivastigmine, rizatriptan, Riluzole, roflumilast, Sacrosidase, salsalate, saquinavir mesylate, Saxagliptin hydrochloride and Metformin hydrochloride sargramostim, Secukinumab, selegiline, sevelamer, sildenafil, Siltuximab, simethicone, simvastatin, sirolimus, sitagliptin, sodium oxybate, sodium picosulfate, sodium polystyrene sulfonate, solanine, solifenacin, sorafenib, sotalol, sparfloxacin, spironolactone, stavudine, streptozocin, sulfadiazine, sulfasalazine, sulfisoxazole, sulfisoxazole, sulindac, sumatriptan, sunitinib, tacrine, Tacrolimus, tamsulosin, tedizolid, tegaserod, telbivudine, telithromycin, telmisartan, temozolomide, teniposide, tenofovir, terbinafine, teriparatide, tetraferric tricitrate decahydrate, Thallous Chloride Tl 201, theophylline, thiabendazole, thioguanine, thioridazine, thiothixene, thyroxine, ticlopidine, Tigecycline, tiludronate, tipranavir, tocopherol, tolcapone, Tolmetin, topiramate, topotecan, Trametinib dimethyl sulfoxide, trandolapril, tranylcypromine, trastuzumab, trazodone, treprostinil, Tretinoin, triamterene, triazolam, trifluoperazine, trihexyphenidyl, trimeprazine, trimethadione, trimethobenzamide, trimetrexate glucuronate, trimipramine, triprolidine, trovafloxacin, valacyclovir, valganciclovir, valproic acid, valsartan, verapamil, Vandetanib, Vilazodone, vinblastine, voriconazole, vorinostat, zanamivir, Zafirlukast, zidovudine, ziprasidone, zoledronic acid, zolmitriptan, Zoledronate
Ear Nose Throat	Otitis media in children
Endocrine	Addison's disease, carcinoid syndrome, diabetes insipidus, diabetic neuropathy, glucagonoma, Graves disease, hyperthyroidism, hypoaldosteronism, multiple endocrine neoplasia type 1 neuroendocrine tumors, somatostatinoma, subacute thyroiditis
Environmental	Abrus precatorious, agastache rugosa, alchornea castaneifolia, amanita phalloides poisoning, amnesic shellfish poisoning, azalea poisoning, bee stings, datura stramonium poisoning, endosulfan toxication, food poisoning, herbal extract overdose, honey intoxication, insect bite allergy, isomalt toxicity, lycorine, marine toxins, mushroom poisoning, narcissus pseudonarcissus, oleander poisoning, pesticide poisoning, phytohaemagglutinin poisoning, phytolacca americana toxicity, ricinus communis poisoning, snakebites, solanine poisoning
Gastroenterologic	Abdominal abscess, abdominal cancer, achlorhydria, acute appendicitis, acute gastritis, bile acid sequestrant, biliary atresia, biliary tract cancer, blind loop syndrome, caecitis, carcinoid syndrome, celiac disease, cholestatic jaundice, colitis, colonic inertia, colonic malakoplakia, colonic villous adenomata, colorectal cancer, colorectal polyps, Crohn's disease, diverticulitis, enteritis, enterocele, enterocolitis, food poisoning, fructose malabsorption, gastric dumping syndrome, gastrinoma, gastritis, gastro-enteropancreatic neuroendocrine tumor, gastroenteritis, gastrointestinal amyloidosis, glucose-galactose malabsorption, gluten sensitivity, Habba syndrome ileitis, inflammatory bowel disease, intestinal lymphangiectasis, intestinal pseudoobstruction, intususception, irritable bowel syndrome, ischemic colitis, lactose intolerance, listeriosis, malabsorption syndrome, malassimilation, Meckel diverticulitis, polyposis, proctitis, protein losing enteropathy, tropical sprue, ulcerative colitis, Whipple's disease, Zollinger-Ellison syndrome
Genetic	3-hydroxyacyl-coenzyme A dehydrogenase deficiency, 3-methylcrotonyl-CoA carboxylase deficiency, abetalipoproteinaemia, Arakawa's syndrome II, aromatic amino acid decarboxylase deficiency, aspartylglycosaminuria, Baber's syndrome, Brown-symmers disease, congenital adrenal hyperplasia, congenital disorder of glycosylation type 1B, congenital intrinsic factor deficiency, congenital short bowel syndrome, congenital toxoplasmosis, Cornelia de Lange syndrome 2, Cronkhite-Canada disease, dibasic aminoaciduria 2, Fabry's disease, familial amyloid polyneuropathy, galactosemia, Gardner's syndrome, Gilbert's syndrome, glutathione synthetase deficiency, Hartnup disease, hereditary angioedema, HNPCC, hyper IgM syndrome, hyperlipoproteinemia type I, inborn amino acid metabolism disorder, juvenile polyposis syndrome, lipoid congenital adrenal hyperplasia, malonic aciduria, malonyl-CoA decarboxylase deficiency, mucopolysaccharidosis, neuroblastoma, neurofibromatosis, Sanfilippo syndrome, Slone's disease, sphingolipidosis, sucrase-isomaltase deficiency, Turcot syndrome, very long-chain acyl-coenzyme A dehydrogenase deficiency, Von Gierke disease, Wiskott-Aldrich syndrome, X-linked agammaglobulinaemia
Hematologic	Amyloidosis, C1 esterase inhibitor, chronic myeloproliferative disorders, hyper IgM syndrome, idiopathic hypereosinophilic syndrome, megaloblastic anemia, myleofibrosis, neutropenia, porphyria Wiskott-Aldrich syndrome, X-linked agammaglobulinaemia
Iatrogenic	Adjustable gastric band, colonoscopy, dumping syndrome, graft versus host disease, percutaneous endoscopic gastrostomy, postileal resection, postvagotomy, radiation proctitis, rectal surgery, radiation sickness, short bowel syndrome, vaccination
Infectious Disease	Adenophorea, adenoviridae, aeromonas hydrophila, AIDS, amebiasis, ancylostoma duodenale, anguillulosis, anthrax, ascariasis, astrovirus, bacillary dysentery, bacillus cereus, bacterial toxin, balantidiasis, beef tapeworm, blastocystis hominis, borrelia anserina, botulism, campylobacter jejuni, candida, capillaria, cestoda, ciguatera poisoning, clostridium difficile, clostridium perfringens, clostridium sordellii, clostridium welchii, coccidia, cryptosporidiosis, cyclosporiasis, cysticercosis, cytomegalovirus, dientamoeba fragilis, diphyllobothrium infection, dipylidium caninum infection, Ebola, echinococcosis, ehrlichiosis, entamoeba histolytica, escherichia coli, fasciolopsiasis, filariasis, flavivirus, fusarium venenatum, giardia lamblia, hantavirus pulmonary syndrome, helminthiasis, hepatitis A, hepatitis B, hepatitis C, hepatitis D, hepatitis E, hepatitis X, hookworm infection, isosporiasis, katayama fever, lassa fever, legionella pneumophila, legionnaires' disease, leptospirosis, lymphogranuloma venereum, malaria, marburg virus, measles, metagonimiasis, mycobacterium avium complex, norwalk gastroenteritis, opisthorchis infection, paragonimus infection, pelvic abscess, pseudomembranous colitis, psittacosis, Q fever, rhabditida, rotavirus, roundworm, salmonellosis, sarcocystis, schistosomiasis, secernentea, shigellosis, small bowel bacterial overgrowth syndrome, staphylococcal food poisoning, staphylococcal toxic shock syndrome, streptobacillus, streptococcal infections, strongyloides, tapeworms, trematoda, trichinella spiralis, trichinosis, trichuriasis, tularemia, typhoid fever, vancomycin, vibrio cholerae, vibrio mimicus, vibrio parahemolyticus, vibrio vulnificus, visceral leishmaniasis, Whipple disease, whipworm infection, yersinia enterocolitica
Musculoskeletal / Ortho	No underlying causes
Neurologic	Common migraine, neuroblastoma, Waterhouse-Friederichsen syndrome
Nutritional / Metabolic	Folate deficiency, food allergies, food intolerances, iron supplements, kwashiorkor, lactose intolerance, milk allergy, pellagra, pernicious anemia, protein losing enteropathy, sucrose intolerance, vitamin C toxicity, zinc deficiency
Obstetric/Gynecologic	Childbirth, endometriosis, neonatal sepsis, ovarian cancer, ovarian hyperstimulation syndrome
Oncologic	Adrenal tumor, carcinoid syndrome, colorectal cancer, Ewing's sarcoma, Gardner's syndrome, gastric cancer, HNPCC, juvenile polyposis syndrome, Kaposi's sarcoma, multiple endocrine neoplasia type 1, neuroendocrine tumors, pancreatic adenoma, peritoneal mesothelioma, neuroendocrine tumors, ovarian cancer, small bowel lymphoma, somatostatinoma, thymus cancer, Vipoma,
Opthalmologic	No underlying causes
Overdose / Toxicity	Carbon monoxide toxicity, carnitine overuse, colchicine toxicity, digoxin toxicity, ergotism, heavy metal ingestion, mazindol
Psychiatric	Anxiety-tension syndrome, chronic fatigue syndrome, dissociative disorder, panic attack
Pulmonary	Anthrax, cystic fibrosis, diffuse systemic sclerosis, legionellosis
Renal / Electrolyte	Acute kidney failure, chronic renal failure, hyperchloremia
Rheum / Immune / Allergy	Acquired angioedema, Amyloidosis, anaphylaxis, autoimmune adrenalitis, autoimmune enteropathy, autoimmune polyendocrine syndrome, autonomic neuropathy, C1 esterase inhibitor, chronic granulomatous disease, complement 5 deficiency, hereditary angioedema, hyper IgM syndrome, Kawasaki disease, Omenn syndrome, Reiter’s syndrome, Satoyoshi syndrome, severe combined immunodeficiency, Wiskott-Aldrich syndrome, X-linked agammaglobulinaemia
Trauma	No underlying causes
Urologic	Proctitis, Reiter’s syndrome
Miscellaneous	Alcohol intoxication, alcohol withdrawal, anopsology

Causes in Alphabetical Order

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5

References

Pathophysiology prev

https://https://www.youtube.com/watch?v=5szNmKtyBW4%7C350}}

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Video codes

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Video in table

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Floating video

Title

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Redirect

1. REDIRECTEsophageal web

synonym website

https://mq.b2i.sg/snow-owl/#!terminology/snomed/10743008

Image

Normal versus Abnormal Barium study of esophagus with varices

Image to the right

C. burnetii, the Q fever causing agent

Image and text to the right

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Gallery

• 

  Histopathology of a pancreatic endocrine tumor (insulinoma). Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas

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  Histopathology of a pancreatic endocrine tumor (insulinoma). Chromogranin A immunostain. Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas

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  Histopathology of a pancreatic endocrine tumor (insulinoma). Insulin immunostain. Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas

References

REFERENCES