Physiologic |
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Infection-related |
Postinfectious malabsorptive diarrhea*
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Persistent or recurrent infection
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Drug-induced |
Antibiotic-associated diarrhea* |
Non-antibiotic-associated
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Functional diarrhea |
Functional diarrhea in young children*Δ
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Irritable bowel syndrome (diarrhea-predominant) |
Immune-mediated |
Common causes
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Uncommon causes
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Fat malabsorption |
Pancreatic exocrine insufficiency
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Bile acid insufficiency
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Mucosal malabsorption
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Neuroendocrine tumors and related disorders |
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Congenital anomalies associated with bowel obstruction |
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Other mechanisms |
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5-FU: 5-fluorouracil; C. difficile: Clostridioides difficile; CVID: common variable immunodeficiency; E. coli: Escherichia coli; G. lamblia: Giardia lamblia; HIV: human immunodeficiency virus; IgE: immunoglobulin E; IPEX: immune dysregulation, polyendocrinopathy, enteropathy, X-linked; NSAIDs: nonsteroidal antiinflammatory drugs; S. typhi: Salmonella typhi; SCID: severe combined immunodeficiency; SSRIs: selective serotonin reuptake inhibitors; VIPoma: vasoactive intestinal polypeptide-secreting tumor.
* Relatively common causes (although prevalence varies with age group).
¶ Pathogens that tend to be involved in persistent or recurrent enteric infections in immunocompromised patients include parasites (C. difficile, Cryptosporidium, Isospora, Cyclospora, G. lamblia), viruses (rotavirus, norovirus, astrovirus, adenovirus, and cytomegalovirus), and bacteria (Salmonella spp, Campylobacter, E. coli).
Δ In some toddlers, low-volume loose stools may also be physiologic; these are not related to excessive carbohydrate intake and often do not meet criteria for diarrhea.
◊ The term "food protein-induced proctocolitis/enteritis" is now preferred. Previously used terms (eg, milk protein intolerance, cow's milk sensitivity, and soy intolerance) are no longer recommended. The new terminology helps to distinguish these non-IgE-mediated disorders from classical food allergies/hypersensitivities that are mediated by IgE. It also distinguishes them from food intolerances that do not involve immunologic mechanisms (eg, lactose intolerance).Do you want to add Medilib to your home screen?