PT  - JOURNAL ARTICLE
AU  - George E Hiner
AU  - Julian RF Walters
TI  - A practical approach to the patient with chronic diarrhoea
AID  - 10.7861/clinmed.2021-0028
DP  - 2021 Mar 01
TA  - Clinical Medicine
PG  - 124--126
VI  - 21
IP  - 2
4099  - http://www.rcpjournals.org/content/21/2/124.short
4100  - http://www.rcpjournals.org/content/21/2/124.full
SO  - Clin Med2021 Mar 01; 21
AB  - Chronic diarrhoea is common, occurring as the first presentation of several diagnoses, or as a prolonged disorder where stool frequency, urgency and incontinence have major impacts on quality of life. Good history taking is necessary, with different causes to be considered: onset and duration of symptoms, previous treatments, co-existing conditions, travel and drug use may all be relevant. Tests include blood and faecal screening. Exclusion of inflammatory bowel disease and colorectal neoplasia is important and may require colonoscopy. Coeliac disease, microscopic colitis and bile acid diarrhoea are all common conditions which should not be missed, as specific therapy is available for each of these. Functional bowel disorders with diarrhoea are prevalent, overlapping with other more treatable conditions. Dietetic assessment and advice are helpful. Awareness of high FODMAP foods, with identification of individual sensitivities, is often beneficial.