Higuera-de la Tijera MF, Alexanderson-Rosas EG, Servín-Caamaño AI

Language: Spanish
References: 19
Page: 583-589
PDF size: 403.11 Kb.

ABSTRACT

Chronic diarrhoea is defined as the abnormal deposition of three or more liquid or diminished in consistency evacuations per day, and/ or evacuations with a weight›200g/day, for more than four weeks. In developed countries the most frequent causes are irritable bowel syndrome, intestinal inflammatory disease, syndrome of malabsorption, chronic infections, and idiopathic secretory diarrhoea. In underdeveloped countries are more frequent bacterial chronic infections, by mycobacterium or parasites. In the evaluation of this entity we must try to establish if the origin is organic or functional. It must be investigated if the diarrhoea is secretory, osmotic or inflammatory, this orients to us towards the possible etiology, for it is useful to determine the fecal osmolarity and to calculate the fecal osmotic gap. The presence of blood in feces and the determination of fecal leukocytes can orient towards an inflammatory origin.

REFERENCES

1. Thomas P, Forbes A, Green J, et al. Guidelines for the investigation of chronic diarrhoea. 2nd edition. Gut 2003;52: v1-v15.

2. Carmona-Sánchez R. Diarrea crónica. Rev Gastroenterol Mex 004; 69 (Supl 3): 95-97.

3. American Gastroenterological Association Clinical Practice and Practice Economics Committee. AGA Technical review on the evaluation and management of chronic Diarrhea. Gastroenterology 1999;116:1464–1486.

4. Farrell R, Kelly C. Celiac sprue. N Engl J Med 2002; 346 (3): 180-188.

5. Lomer M, Parkes G, Sanderson J. Review article: Lactose intolerance in clinical practice – myths and realities. Alimentary Pharmacol Ther 2008;27(2):93-103.

6. Haque R, Huston C, Hughes M, Houpt E, Petri W. Amibiasis. N Engl J Med 2003;348:1565-73.

7. Santoyo R. Diarrea crónica. Rev Gastroenterol Mex 2006; 71 (Supl 1): 83-85.

8. Nightingale J, Woodward J, and on behalf of the Small Bowel and Nutrition Committee of the British Society of Gastroenterology. Guidelines for management of patients with a short bowel. Gut 2006; 55: iv1-iv12.

9. Tangri V, Chande N. Microscopic colitis, an update. J Clin Gastroenterol 2009;43:293–296.

10. Kornbluth A, Sachar D. Ulcerative colitis practice guidelines in adults: American College of Gastroenterology, Practice Parameters Committee. Am J Gastroenterol 2010; 105: 501-523.

11. Lichtenstein G, Hanauer S, Sandborn W, and the Practice Parameters Committee of the American College of Gastroenterology. Management of Crohn’ s disease in adults. Am J Gastroenterol 2009; 104: 465-483.

12. Green P, Cellier C. Celiac disease. N Engl J Med 2007;357:1731-43.

13. American Gastroenterological Association (AGA) Institute Technical Review on the Diagnosis and Management of Celiac Disease. Gastroenterology 2006;131:1981–2002.

14. Marmo R, Rotondano G, Piscopo R, Blanco M, Cipolletta L. Meta-analysis: capsule enteroscopy vs. conventional modalities in diagnosis of small bowel diseases. Alimentary Pharmacol Ther 2005;22(7):595-604.

15. Conwell D, Banks P. Chronic pancreatitis. Curr Opin Gastroenterol. 2008;24(5):586-590.

16. Forsmark C. Chronic pancreatitis. En: Feldman M, Friedman L, Brandt L, editores. Sleisenger and Fordtran´s Gastrointestinal and Liver Disease; pathophysyology, diagnosis, management. 8th Edition. Philadelphia: Saunders Elsevier 2006: 1271-1300.

17. Lauritano E, Gabrielli M, Scarpellini E, et al. Small intestinal bacterial overgrowth recurrence after antibiotic therapy. Am J Gastroenterol 2008;103(8):2031-2035.

18. Teo M, Chung S, Chitti L, et al. Small Bowel Bacterial Overgrowth is a common cause of chronic diarrhea. J Gastroenterol Hepatol. 2004;19(8): 904-909.

19. Ramage J, Davies A, Ardill J, et al. Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours. Gut 2005;54;iv1-iv16.