21. Differential diagnosis of chronic diarrhea.

Page created on February 14, 2022. Not updated since.

Etiology Typical features
Lactose intolerance Gas, abdominal pain, vomiting, onset in school age, non-Caucasian race
Coeliac disease Abdominal pain, abdominal distension, fatigue, failure to thrive
Cow’s milk/soy protein intolerance/allergy <1 year, vomiting, failure to thrive, abdominal pain
Cystic fibrosis Delayed meconium passage, fatty stools, failure to thrive, protein-calorie malnutrition, respiratory infections
Irritable bowel syndrome Altered bowel habits, vague pain, poorly localised, resolves spontaneously, family history, triggered or exacerbated by stress
Inflammatory bowel disease Dull, crampy pain, fever, weight loss, haematochezia. Lower right quadrant
Functional diarrhoea (toddler’s diarrhoea) <5 years, undigested foods in the stool, normal child growth

Functional diarrhoea is due to excessive intake of foods with osmotically active carbohydrates, like juice, which overwhelm the intestine’s capacity to absorb the carbs, causing osmotic diarrhoea. Reducing this intake treats it.

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