[Diarrhea in intestinal inflammatory diseases].

Area of Science:

• Gastroenterology
• Internal Medicine
• Clinical Research

Context:

• Diarrhoea is a common and revealing symptom in both ulcerative colitis (UC) and Crohn's disease (CD).
• The clinical presentation, disease course, pathophysiology, and treatment of diarrhoea differ significantly between UC and CD.
• Inflammatory bowel disease (IBD) management requires understanding these nuances for optimal patient outcomes.

Purpose:

• To delineate the distinct characteristics of diarrhoea in UC and CD.
• To explore the diverse physiopathological mechanisms underlying diarrhoea in each condition.
• To highlight the tailored treatment approaches for diarrhoea in UC and CD.

Summary:

• Ulcerative colitis (UC) diarrhoea is typically imperative, bloody, diurnal/nocturnal, and linked to colonic absorption loss, exudative enteropathy, and motility disorders.
• Crohn's disease (CD) diarrhoea varies with lesion location (ileal, colonic, diffuse) and involves malabsorption, bacterial overgrowth, fistulae, reduced absorptive area, and motility issues.
• Treatment for UC diarrhoea focuses on exacerbations, while CD diarrhoea management requires addressing specific pathophysiological mechanisms alongside anti-inflammatory therapy, potentially including nutritional support.

Impact:

• Provides a clear distinction between diarrhoea in UC and CD, aiding in accurate diagnosis.
• Highlights the complex and varied mechanisms causing diarrhoea in IBD, informing targeted therapeutic strategies.
• Emphasizes the need for individualized treatment plans for diarrhoea in Crohn's disease based on its specific pathophysiology.