What is the differential diagnosis (DDX) of chronic diarrhea?

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Differential Diagnosis for Chronic Diarrhea

Single Most Likely Diagnosis

  • Irritable Bowel Syndrome (IBS): This is often the most common cause of 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 due to inflammation in the gastrointestinal tract.
  • Gastroesophageal Reflux Disease (GERD): Although more commonly associated with heartburn, some patients with GERD may experience diarrhea.
  • Lactose Intolerance: The inability to digest lactose can lead to chronic diarrhea in individuals who consume lactose-containing products.
  • Small Intestine Bacterial Overgrowth (SIBO): An overgrowth of bacteria in the small intestine can lead to malabsorption and chronic diarrhea.
  • Celiac Disease: An autoimmune reaction to gluten can cause chronic diarrhea and malabsorption in affected individuals.

Do Not Miss Diagnoses

  • Colorectal Cancer: Although less common, colorectal cancer can present with chronic diarrhea and would be catastrophic if missed.
  • Thyroid Disorders: Hyperthyroidism can cause chronic diarrhea due to increased motility of the gastrointestinal tract.
  • Neuroendocrine Tumors: Certain tumors, like VIPomas, can produce hormones that lead to severe, chronic diarrhea.
  • Infectious Causes: Chronic infections such as giardiasis or chronic parasitic infections can cause diarrhea and must not be overlooked.

Rare Diagnoses

  • Whipple's Disease: A rare, systemic bacterial infection that can cause chronic diarrhea among other symptoms.
  • Short Bowel Syndrome: A condition that results from a significant loss of intestinal tissue, leading to malabsorption and chronic diarrhea.
  • Congenital Diarrheal Disorders: Rare genetic conditions that affect the intestines and can cause chronic diarrhea from birth.
  • Eosinophilic Gastroenteritis: A rare condition characterized by eosinophilic infiltration of the gastrointestinal tract, which can cause chronic diarrhea.

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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