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Stool composition in factitial diarrhea: a 6-year experience with stool analysis
S Phillips1, L Donaldson, K Geisler
1Mayo Clinic, Rochester, Minnesota, USA.
Annals of Internal Medicine
|July 15, 1995
Summary
Stool water analysis can help diagnose chronic diarrhea, especially factitial cases. While osmotic and secretory classifications are useful, individual patient variability limits their application.
Area of Science:
- Gastroenterology
- Clinical Chemistry
Background:
- Chronic diarrhea presents diagnostic challenges.
- Differentiating osmotic and secretory causes is key but complex.
Purpose of the Study:
- To assess the clinical utility of stool water analysis in managing chronic diarrhea.
- To determine the role of stool chemistry in identifying specific diarrhea etiologies.
Main Methods:
- Retrospective analysis of 6 years of data from a referral center.
- Reviewed records of 325 patients referred for stool chemistry analysis.
- Evaluated 202 patients with appropriate fecal samples.
Main Results:
- Stool analysis confirmed the utility of osmotic vs. secretory classification but noted limitations due to overlap and variability.
- Factitial diarrhea was diagnosed in 17% of patients (35/202), primarily due to laxative abuse (30) or fluid addition (5).
- Inappropriate sample collection affected one-third of initial analyses.
Conclusions:
- Chemical analysis of fresh stool is valuable for selected patients with obscure chronic diarrhea.
- This method is particularly effective in diagnosing factitial diarrhea.
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