A practical approach to the patient with chronic diarrhoea

Area of Science:

• Gastroenterology
• Internal Medicine
• Clinical Diagnostics

Background:

• Chronic diarrhoea is a prevalent condition affecting quality of life.
• It can be the initial symptom of various underlying diseases or a persistent disorder.
• Symptoms like increased stool frequency, urgency, and incontinence significantly impair daily living.

Purpose of the Study:

• To outline essential diagnostic approaches for chronic diarrhoea.
• To highlight common yet often overlooked causes of chronic diarrhoea.
• To emphasize the importance of specific therapies for treatable conditions.

Main Methods:

• Detailed patient history including symptom onset, duration, prior treatments, comorbidities, travel, and drug history.
• Laboratory investigations: blood and faecal screening.
• Endoscopic procedures: colonoscopy for excluding inflammatory bowel disease and colorectal neoplasia.

Main Results:

• Identification of common conditions such as coeliac disease, microscopic colitis, and bile acid diarrhoea.
• Recognition of the prevalence and overlap of functional bowel disorders with other treatable causes.
• Dietetic assessment and management, including low FODMAP diet strategies, are beneficial.

Conclusions:

• A systematic diagnostic approach is crucial for managing chronic diarrhoea.
• Excluding serious conditions and identifying specific treatable causes like coeliac disease is paramount.
• Dietary interventions, including FODMAP awareness, play a significant role in patient management.