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Diarrhea caused by circulating agents
Elisabeth Fabian1, Patrizia Kump, Guenter J Krejs
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
Gastroenterology Clinics of North America
|August 25, 2012
Summary
Secretory diarrhea, characterized by large, watery stools, occurs when circulating agents stimulate intestinal fluid secretion. Chloride is the primary ion driving this secretion, unlike in osmotic diarrhea.
Area of Science:
- Gastroenterology
- Physiology
Background:
- Secretory diarrhea involves increased intestinal fluid secretion, leading to large-volume, watery stools.
- It is distinguished from osmotic diarrhea by its persistence during fasting and specific stool osmolarity measurements.
Purpose of the Study:
- To elucidate the mechanisms underlying secretory diarrhea.
- To highlight the role of specific ions in intestinal fluid secretion.
Main Methods:
- Analysis of stool-water osmolarity and electrolyte content.
- Distinguishing secretory diarrhea from osmotic diarrhea based on clinical and laboratory features.
Main Results:
- Secretory diarrhea is characterized by large-volume, watery stools (>1 L/day).
- Diarrhea persists even when patients fast.
- Stool osmolarity matches calculated osmolarity from electrolytes.
- Chloride ions are identified as the major drivers of intestinal secretion.
Conclusions:
- Circulating agents can induce secretory diarrhea by altering intestinal secretion or motility.
- Chloride plays a critical role in the secretory processes of the intestine, contrasting with sodium's role in absorption.
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