What Causes Persistent Diarrhea?
Diarrhea has many causes, but chronic diarrhea should always be investigated further. It is defined as diarrhea occurring for more than two weeks and has many causes. This form of diarrhea accounts for significant financial implications both to the sufferer and to the wider health care services and has a knock on for industry itself. In one study in America, it was estimated that the cost of healthcare for a single sufferer with chronic diarrhea was 6140 US dollars and for industry accounts for billions of dollars each year.So, with this in mind, what causes persistent diarrhea? 1) Irritable Bowel SyndromeThe single biggest cause of chronic diarrhea worldwide is the Irritable Bowel Syndrome. It is estimated that 1:4 people will develop this disorder in the western world at some point in their lives. It causes a wide spectrum of symptoms including abdominal pain, diarrhea, constipation or a combination of the two. You can learn more about IBS by going to the what is Irritable Bowel Syndrome page. 2) Inflammatory Bowel diseaseThe inflammatory bowel diseases are another big group that causes persistent diarrhea. The two main forms are Crohns disease and Ulcerative colitis. The diarrhea results from a chronically inflamed bowel, the cause of which is unclear. Symptoms depend on the extent of the disease and where the problem occurs. With Ulcerative colitis, the inflammation occurs in the colon or large bowel and can cause frequent, bloody diarrhea. Crohns disease can affect anywhere from the mouth to the anus and can equally cause diarrhea as well as other symptoms such as abdominal pain, weight loss, mouth ulceration and systemic problems such as rashes, joint pains and iritis (an eye condition). Microscopic colitis is a microscopic inflammation of the bowel picked up when you have biopsies taken during a colonoscopy procedure. In 60% of cases it is self limiting, but chronic diarrhea can still be an issue in 40% of cases. Treatment for this is similar to the other forms of inflammatory bowel disease. 3) Coeliac diseaseCoeliac disease is a condition that affects up to 1 in 300 of us. It’s a condition that affects the small bowel giving rise to celiac disease symptoms including chronic, watery diarrhea in some sufferers. It can be associated with anaemia, abdominal pain, weight loss, tiredness and other systemic effects. It is caused by gluten, a protein in wheat, rye and barley that affects the “villi” of the small bowel where your nutrients are absorbed. It is this loss of villi that causes persistent diarrhea. It can be associated with other autoimmune diseases such as diabetes, thyroid disease, pernicious anaemia, Addisons disease, vitiligo and rheumatoid arthritis. 4) Bowel cancerThe 3rd main cancer worldwide and a cause for chronic diarrhea that can be bloody. It is associated with other symptoms such as abdominal pain, night sweats, anorexia and weight loss. A condition that can be treated, particularly if bowel cancer symptoms are picked up early. 5) Surgical causesSurgery on the bowel causes persistent diarrhea in two different ways. This can be either as a direct effect of the surgery on the bowel or through repopulation of the small bowel with bacteria that can promote diarrhea. This is called small bowel bacterial overgrowth and is a condition that I believe is under diagnosed in someone with IBS symptoms. 6) DrugsThere are many drugs that can cause chronic diarrhea – too numerous to list here! If you are taking medications and have diarrhea, it is vital that you discuss these with your doctor as this could be the underlying cause for your symptoms. 7) Lactose intoleranceLactose intolerance is a common condition and is said to be present in up to 75% of the worlds population to some degree. It is caused by inactive or inappropriate levels of lactase, the enzyme the digests lactose sugar in the small bowel. Lactose is a disaccharide sugar that is found in milk and milk products such as yoghurt, butter and cheese. The only treatment is avoidance in the diet. Because it is so common, alternative causes for persistent diarrhea should always be considered. 8) Chronic infectionsChronic infection can occur, particularly campylobacter and salmonella infection, but also infections such as chronic clostridium infection. 9) Pancreatic insufficiencyPancreatic insufficiency is not an uncommon cause for chronic diarrhea. It has many causes, but results in fat malabsorption due to the lack of pancreatic lipase enzymes that digest fat. Investigation of Persistent diarrheaInvestigations really depend on the history and examination of the individual. Tests can be vast including simple blood tests such as coeliac antibody testing and stool tests to look for infection plus biochemical markers such as calprotectin for inflammatory bowel disease and faecal elastase for pancreatic insufficiency. Other tests may include a lactose tolerance test, hydrogen breath testing for small bowel bacterial overgrowth and a colonoscopy procedure to look for evidence on inflammatory bowel disease and cancers. Treatment of Persistent diarrheaAgain treatment depends on the underlying cause. Medications that reduce stool frequency such as Codeine phosphate and Loperamide can be helpful. Dietary manipulation, particularly in lactose intolerance and coeliac disease is vital. Pancreatic enzyme replacement therapy can be useful if pancreatic insufficiency is an issue and cholestyramine medicine for persistent diarrhea particularly in bile salt malabsorption conditions, but also in other chronic conditions such as IBS-D or diarrhea-predominant Irritable Bowel Syndrome. In small bowel bacterial overgrowth, pulsed antibiotic therapy and the best probiotics may be helpful and drugs specifically designed for conditions such as inflammatory bowel disease.
|
Follow Me
Follow Me On:
Site Search
My New eBook
Its here, the answer to all your questions. Learn strategies to relieve your pain and change the way you think about your Irritable Bowel Syndrome today.
Find Out More By Clicking Here
Welcome! I'm Dr Peter Thatcher
Hi, I'm Peter Thatcher, a Medical Physician and Gastroenterologist in the UK. Welcome to my website. I'm here to give you helpful and comprehensive advice on everything to do with your Irritable Bowel Syndrome. I'm also your personal online physician. If you have any medical problems you would like help with, you can book an appointment online with me. To find out more click on my image or go to the
Dr Peter Thatcher about me page
. If you would like to book an appointment with me for an online consultation or telephone appointment, please go to the
about Dr Peter Thatchers online doctor service
page! |
Keep Up To Date With The Online Newsletter
Spread The Word, Download A Free Flyer!
