Chronic Diarrhea

This chapter presents a case of 78-year-old woman who presented with a 3-year history of diarrhea. Chronic diarrhea is a common clinical problem, most inclusively defined as frequent passage of fluid stools lasting more than 1 month. Probably the most important features to define are the onset i.e. acute or gradual, pattern, severity causing dehydration or not, and type of stool produced. Coexisting symptoms, such as weight loss or abdominal pain, may be important clues to etiology. Patients with irritable bowel syndrome (IBS) should be identified by the presence of characteristic abdominal pain associated with variable stool form or frequency, and should be distinguished from others with chronic diarrhea. The differential diagnosis of continuing chronic diarrhea is broad, but targeted evaluation is often rewarded with a diagnosis that can be treated. The most effective and most widely applicable symptomatic therapy is antidiarrheal opiates. Non-specific therapy with antidiarrheal drugs can provide symptomatic relief.