Diarrhea - Chronic

There are A LOT of causes of chronic diarrhea. So many that I am sureI will miss a number of them in the following list, but here goes: malabsorptivediseases (anything causing an inability to absorb food, such as wheat glutensensitivity or plasmacytic-lymphocytic enteritis), maldigestion syndromessuch as pancreatic insufficiency, inflammatory bowel disease, intestinalparasites (protozoans, worms, coccidia), fungal infections (rarely), damageto vital organs such as the liver or kidney leading to secondary diarrheaproblems, diabetes mellitus, hypoadrenocorticism, small intestinal bacterial overgrowth, cancer, ulcers, bacterial enteritis or colitis, cecal inversionand irritable bowel syndromes.

Chronis Diarrhea Can Be a Small or a Large Intestinal Problem

It is important to try to decide if this is a small intestinal problem or large intestinal problem. In small intestinal disease the diarrhea tends to be pretty large volume at one time but less frequent episodes of diarrhea. In large intestinal diarrhea the volume of diarrhea tends to be smallerbut episodes are more frequent. Knowing which of these is likely to bethe problem helps in deciding which tests to run.

Diagnosing Chronic Diarrhea

In chronic diarrhea it can be very hard to find a diagnosis. The intestinal biopsies were are very good idea. It is too bad they were not more informative.It can take multiple fecal exams to find some parasites, particularly giardiaand whipworms. There are pretty good blood tests now to aid in the diagnosisof pancreatic insufficiency (blood trypsin-like immunoreactivity, folatelevels, it is always wise to do general lab panels to make sure other organsystems are functioning properly. It can be helpful to rule out food sensitivity/allergyusing special diets (elimination diets). Culture of the stool will sometimes reveal a bacteria that is very likely to be pathogenic, such as Salmonellaor Clostridium perfringens. Special cultures can be done for Campylobacter.

If sulfasalazine does help, that is a hint that the problem is likelyto be in the large intestine. If biopsies did not include the colon itmay be possible to obtain the necessary biopsy samples from the colon tomake a diagnosis using an endoscope with a biopsy forceps.

In most cases, it is possible to find a cause for the diarrheaand to successfully treat it, if you are patient enough. You can tell fromthe long list of possible causes that it can be hard, though.

please see http://www.vetinfo.com/cdiarrhea.html for more information.