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Showing posts from July, 2020

Differential Diagnosis of Chronic Watery Diarrhea

Chronic Watery Diarrhea can be subdivided in: osmotic, secretory and functional. Secretory Diarrhea:: bowel secretes too much fluid  VERY HIGH volume stools (>1L) Stool Osmolar Gap less than 50. No changes on Fasting. Caused by enterotoxins, bile acids(when ileal resection), carcinoid sx, VIPoma. Osmotic Diarrhea::   Non absorbable solutes that stay in bowel and drag water in its SMALLER volume stools. (<1L) Stool Osmolar Gap more than 50. Stops on fasting. ex. lactose intolerance and celiac disease Functional Diarrhea::   IBS, where hallmark is hypermotility,  has smaller volume and symptoms disappear at night.