Gastroenterology Book

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Chronic Fatty Diarrhea

Aka: Chronic Fatty Diarrhea, Diarrhea due to Malabsorption
  1. See Also
    1. Diarrhea
    2. Chronic Inflammatory Diarrhea
    3. Chronic Watery Diarrhea (Secretory or Osmotic Diarrhea)
    4. Infectious Diarrhea
    5. Drug-Induced Diarrhea
    6. Diarrhea in Cancer
    7. Diarrhea in Children
    8. Diarrhea in Pregnancy
    9. Diarrhea in HIV
  2. Causes: Malabsorption or altered digestion
    1. Drug-Induced Diarrhea
    2. Amyloidosis
    3. Carbohydrate malabsorption (e.g. lactose intollerance)
    4. Gluten Sensitive Enteropathy (Celiac Sprue)
    5. Gastric Bypass
    6. Whipple's Disease (Tropheryma whipplei infection)
    7. Short bowel syndrome
    8. Superior Mesenteric Artery insufficiency
    9. Pancreatic insufficiency
    10. Bile acid inadequate in bowel
    11. Mesenteric Ischemia
    12. Non-invasive Small Bowel infection
      1. Giardia
      2. Small BowelBacterial overgrowth (>100,000 Bacteria/ml)
      3. Tropical sprue
  3. Symptoms
    1. Pale, bulky stools
      1. Frothy or greasy stools
      2. Foul odor to stool
    2. Weight loss with nutritional deficiency
    3. Resolves within 1-2 days of not eating
    4. Excessive flatus
  4. Evaluation
    1. Evaluate for anatomic abnormality
      1. Consider CT Abdomen
      2. Consider Colonoscopy with biopsy
    2. Evaluate for pancreatic insufficiency
      1. Obtain stool chymotrypsin level
      2. Confirm a positive chymotrypsin level with a secretin test
  5. References
    1. Schiller in Feldman (2002) Sleisenger GI, p. 136

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