Chronic Diarrhea - Differential Diagnosis Algorithm

Steatorrhea

 - Maldigestive

    • Pancreatic Insufficiency

 - Primary Malabsorption

    • Celiac Disease

    • Mucosal Disease

    • Ileal Crohn's Disease

 - Secondary Malabsorption

    • Bacterial Overgrowth

    • Liver Cholestasis

    • Mesenteric Ischemia

    • Short Bowel Resection

Large Bowel (Small Volume/ Bloody / Painful / Tenesmus / Urgency)

 - Motility

    • Irritable Bowel Syndrome 

    • Hyperthyroid

 - Inflammatory

    • Inflammatory Bowel Disease

    • Radiation CoIits

    • Ischemic Colitis

 - Secretory

    • Villous Adenoma

    • Colon Cancer

    • Microscopic Colitis

Disordered Motility

 • Irritable Bowel Syndrome (diagnosis of exclusion)

 • Diabetic Neuropathv

 • Hyperthyroidism

Osmotic

 • Magnesium, Phosphate, Sulfate

 • Carbohydrate Mala bsorption

 • Lactose Intolerance

Mucosal

 • Crohn's Disease (Screen with CBC, albumin, ESR, endoscopy)

 • Celiac Disease (screen with TTG)

 • Chronic Inflammation

 • Whipple's Disease

Mucosal Tumor

 • Gastrinoma

 • Carcinoid Syndrome

 • Mastocystosis

Neoplastic Tumor

 • Adenocarcinoma

 • Lymphoma



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