RT Journal Article
SR Electronic
T1 A practical approach to the patient with chronic diarrhoea
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 124
OP 126
DO 10.7861/clinmed.2021-0028
VO 21
IS 2
A1 George E Hiner
A1 Julian RF Walters
YR 2021
UL http://www.rcpjournals.org/content/21/2/124.abstract
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.