What are the causes of chronic diarrhea?

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Last updated: May 16, 2025View editorial policy

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Differential Diagnosis for Chronic Diarrhea

Single Most Likely Diagnosis

  • Irritable Bowel Syndrome (IBS): This is often considered the most likely diagnosis for chronic diarrhea due to its high prevalence and the fact that it can present with a variety of gastrointestinal symptoms, including chronic diarrhea, without an identifiable cause.

Other Likely Diagnoses

  • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause chronic diarrhea, along with other symptoms such as abdominal pain and weight loss.
  • Lactose Intolerance: The inability to digest lactose, a sugar found in milk and other dairy products, can lead to chronic diarrhea in some individuals.
  • Gastroesophageal Reflux Disease (GERD): Although more commonly associated with heartburn, GERD can also cause chronic diarrhea in some cases.
  • Small Intestine Bacterial Overgrowth (SIBO): An overgrowth of bacteria in the small intestine can lead to chronic diarrhea, bloating, and abdominal pain.

Do Not Miss Diagnoses

  • Colon Cancer: While less common, colon cancer can present with chronic diarrhea, especially in older adults, making it crucial not to miss this diagnosis.
  • Celiac Disease: An autoimmune reaction to gluten can cause chronic diarrhea, malabsorption, and other systemic symptoms.
  • Thyrotoxicosis: Hyperthyroidism can cause chronic diarrhea due to the increased metabolic rate.
  • Whipple's Disease: A rare bacterial infection that can cause chronic diarrhea, weight loss, and malabsorption.

Rare Diagnoses

  • Microscopic Colitis: A condition characterized by inflammation of the colon lining, which can cause chronic diarrhea.
  • Eosinophilic Gastroenteritis: A rare condition involving eosinophilic infiltration of the gastrointestinal tract, leading to chronic diarrhea and other symptoms.
  • VIPoma: A rare pancreatic tumor that secretes vasoactive intestinal peptide (VIP), causing chronic diarrhea, hypokalemia, and achlorhydria.
  • Carcinoid Syndrome: A rare condition caused by a neuroendocrine tumor secreting serotonin, leading to chronic diarrhea, flushing, and wheezing.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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