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Raw Queries and Responses

1. Shard Calculation

Query:

Response:

Calculated Shard: 73 (from laksa176)

2. Crawled Status Check

Query:

curl -X POST \
  'http://laksa073.int.ahrefs:8124/' \
  -H 'Content-Type: text/plain' \
  -H 'X-ClickHouse-Database: crawler3' \
  -H 'Authorization: Basic YXBpOg==' \
  -d 'SELECT getAhrefsURLFromUnparsed(src_unparsed) AS found_url, ifNull(toUnixTimestamp(download_stamp), 0) AS crawl_time, ifNull(toUnixTimestamp(props_url_first_seen), 0) AS first_indexed_time, download_http_code AS http_code, src_unparsed AS src_unparsed, src_root_hash AS src_root_hash, history_drop_reason AS history_drop_reason, meta_title AS meta_title, meta_descriptions AS meta_descriptions, attrs_boilerpipe_text AS attrs_boilerpipe_text, attrs_markdown AS attrs_markdown, attrs_readable_markdown AS attrs_readable_markdown, meta_canonical AS meta_canonical FROM crawler3.page_info_local FINAL PREWHERE (src_root_hash, src_unparsed) IN ((getAhrefsRootHashFromUnparsed(getAhrefsUnparsedNoserviceFromURL(\'https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis\')), getAhrefsUnparsedNoserviceFromURL(\'https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis\'))) FORMAT JSONEachRow'

Response:

{"found_url":"https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis","crawl_time":1776270400,"first_indexed_time":1498025103,"http_code":200,"src_unparsed":"org,wikidoc!www,\/index.php\/Chronic_diarrhea_differential_diagnosis s443","src_root_hash":"4565807768880776073","history_drop_reason":null,"meta_title":"Chronic diarrhea differential diagnosis - wikidoc","meta_descriptions":[],"attrs_boilerpipe_text":"To review the differential diagnosis of diarrhea, click\nhere\n.\nEditor-In-Chief:\nC. Michael Gibson, M.S., M.D.\n[1]\n;\nAssociate Editor(s)-in-Chief:\nSadaf Sharfaei M.D.\n[2]\n,\nSeyedmahdi Pahlavani, M.D.\n[3]\nOverview\nThe\ndifferential diagnosis\nfor\nchronic diarrhea\nis enormous, with a large number of diagnostic tests available that can be used to evaluate these patients. Classifying a patient's\nchronic diarrhea\ninto a subcategory such as\nwatery\n, fatty and\ninflammatory\nhelps to direct the\ndiagnostic\nwork-up. Some\nwatery\ncauses of chronic diarrhea which should be differentiated from one another include\ncrohn's disease\n,\nhyperthyroidism\n,\nVIPoma\n,\nlactose intolerance\n,\nceliac disease\nand\nirritable bowel syndrome\n(IBS). The causes of fatty diarrhea that should be differentiated from one another include\nceliac sprue\n,\npancreatic insufficiency\n,\nbacterial overgrowth\nand\nmaldigestion\nproblems which results from\npancreatic exocrine insufficiency\n. Finally, the\ninflammatory\ncauses of chronic diarrhea such as\nulcerative colitis\nand\nentamoeba histolytica\nmust also be differentiated.\nDifferential Diagnosis of Chronic Diarrhea from other diseases\nThe following table outlines the major differential diagnoses of chronic diarrhea.\n[\n1\n]\n[\n2\n]\n[\n3\n]\n[\n4\n]\n[\n5\n]\n[\n6\n]\n[\n7\n]\n[\n8\n]\n[\n9\n]\n[\n10\n]\n[\n11\n]\n[\n12\n]\n[\n13\n]\n[\n14\n]\n[\n15\n]\n[\n16\n]\n[\n17\n]\n[\n18\n]\n[\n19\n]\n[\n20\n]\n[\n21\n]\n[\n22\n]\n[\n23\n]\n[\n24\n]\n[\n25\n]\n[\n26\n]\n[\n27\n]\n[\n28\n]\n[\n29\n]\n[\n30\n]\nAbbreviations:\nGI:\nGastrointestinal\n,\nCBC\n:\nComplete blood count\n,\nWBC:\nWhite blood cell\n,\nRBC\n:\nRed blood cell\n,\nPlt:\nPlatelet\n,\nHgb:\nHemoglobin\n,\nESR\n:\nErythrocyte sedimentation rate\n,\nCRP\n:\nC–reactive protein\n,\nIgE:\nImmunoglobulin E\n,\nIgA:\nImmunoglobulin A\n,\nETEC:\nEscherichia coli enteritis\n,\nEPEC\n:\nEnteropathogenic Escherichia coli\n,\nEIEC\n:\nEnteroinvasive Escherichia coli\n,\nEHEC\n:\nEnterohemorrhagic Escherichia coli\n,\nEAEC\n:\nEnteroaggregative Escherichia coli\n,\nNl\n: Normal,\nASCA\n:\nAnti saccharomyces cerevisiae antibodies\n,\nANCA\n:\nAnti–neutrophil cytoplasmic antibody\n,\nDNA\n:\nDeoxyribonucleic acid\n,\nCFTR\n:\nCystic fibrosis transmembrane conductance regulator\n,\nSLC10A2\n:\nSolute carrier family 10 member 2\n,\nSeHCAT\n:\nSelenium homocholic acid taurine or tauroselcholic acid\n,\nIEL\n: Intraepithelial\nlymphocytes\n,\nMRCP\n:\nMagnetic resonance cholangiopancreatography\n,\nANA\n:\nAntinuclear antibodies\n,\nAMA\n:\nAnti-mitochondrial antibody\n,\nLDH\n:\nLactate dehydrogenase\n,\nCPK\n:\nCreatine phosphokinase\n, \nPCR\n:\nPolymerase chain reaction\n,\nELISA\n:\nEnzyme–linked immunosorbent assay\n,\nLT\n: Heat–labile\nenterotoxin\n, ST: Heat–stable\nenterotoxin\n,\nRT-PCR\n: Reverse–transcriptase\npolymerase chain reaction\n,\nCD4:\nCluster of differentiation 4\n,\nHIV\n:\nHuman immunodeficiency virus\n,\nRUQ\n:\nRight-upper quadrant\n,\nVIP\n:\nVasoactive intestinal peptide\n,\nGI:\nGastrointestinal\n,\nFAP\n:\nFamilial adenomatous polyposis\n,\nHNPCC\n:\nHereditary nonpolyposis colorectal cancer\n,\nMTP\n:\nMicrosomal triglyceride transfer protein\n,\nScl‑70\n: Anti–\ntopoisomerase I\n,\nTSH\n:\nThyroid-stimulating hormone\n,\nT4\n:\nThyroxine\n,\nT3\n:\nTriiodothyronine\n,\nDTR\n:\nDeep tendon reflex\n,\nRNA\n:\nRibonucleic acid\nCause\nClinical manifestation\nLab findings\nExtra intestinal findings\nCause\/Pathogenesis\nGold standard diagnosis\nSymptoms\nGI signs\nDuration\nDiarrhea\nFever\nAbdominal pain\nWeight loss\nStool exam\nCBC\nOther lab findings\nAcute\nChronic\nWatery\nBloody\nFatty\nWBC\nRBC\nOva\/Parasite\nOsmotic gap\nOther\nWBC\nHgb\nPlt\nCrohn's disease\n–\n+\n+\n+\n+\n±\n+\n+\nAbdominal tenderness\nOral\nmucosal\nlesions\n+\n+\n–\nNl\n–\n↑\n↓\n↑\nAnti saccharomyces cerevisiae antibodies\n (ASCA)\nVitamin B12\ndeficiency\nElevated\nESR\nElevated\nCRP\nUveitis\nArthritis\nErythema nodosum\nPyoderma gangrenosum\nAmyloidosis\nVenous and arterial\nthromboembolism\nRenal stones\nBronchiectasis\nAbnormal immune response to self\nantigens\nColonoscopy\nwith\nbiopsy\nUlcerative colitis\n–\n+\n+\n+\n+\n±\n+\n+\nAbdominal tenderness\nBlood\non\nrectal examination\n+\n+\n–\nNl\n–\n↑\n↓\n↑\nAnti–neutrophil cytoplasmic antibody\n (\nP–ANCA\n)\nHypoalbuminemia\nHypokalemia\nHypomagnesemia\nElevated\nESR\nElevated\nCRP\nSkin rash\nIritis\nUveitis\nSeronegative\narthritis\nClubbing\nErythema nodosum\nAbnormal immune response to self\nantigens\nColonoscopy\nwith\nbiopsy\nCeliac disease\n–\n+\n±\n–\n±\n–\n+\n+\nAbdominal distention\nIncreased \nbowel\n sounds\nOral\nmucosal\nlesions\nHepatosplenomegaly\nAscites\n–\n–\n–\nNl\nFat droplets on \nsudan stain\nNl\n↓\nNl\nIgA\nendomysial\nantibody\nAnti–tissue\ntransglutaminase\nantibody\nAnti–gliadin antibody\nFat soluble vitamins\ndeficiency\nMalabsorption\nDementia\nDermatitis herpetiformis\nHLA–DQ2\nHLA–DQ8\nInnate responses to wheat\nproteins\nIgA\nendomysial\nantibody\nAnti–tissue\ntransglutaminase\nantibody\nCause\nDuration\nDiarrhea\nFever\nAbdominal pain\nWeight loss\nGI signs\nStool exam\nCBC\nOther lab findings\nExtra intestinal findings\nCause\/Pathogenesis\nGold standard diagnosis\nAcute\nChronic\nWatery\nBloody\nFatty\nWBC\nRBC\nOva\/Parasite\nOsmotic gap\nOther\nWBC\nHgb\nPlt\nCystic fibrosis\n–\n+\n–\n–\n+\n±\n+\n+\nAbdominal distention\nHepatosplenomegaly\nRectal prolapse\n–\n–\n–\nNl\nFat droplets on \nsudan stain\nNl\n↓\nNl\nPositive\nDNA\nanalysis for\ncystic fibrosis transmembrane conductance regulator\n(CFTR)\nNasal transepithelial potential difference\nFat soluble vitamins\ndeficiency\nMalabsorption\nRecurrent\nrespiratory tract infection\nBronchiectasis\nDiabetes mellitus\nScoliosis\nInfertility\nMutations in the\ncystic fibrosis transmembrane conductance regulator\n(\nCFTR\n) protein\nPositive\ngenetic testing\nElevated\nsweat chloride\n≥60 mmol\/L\nChronic pancreatitis\n–\n+\n+\n–\n+\n–\n+\n+\nAbdominal tenderness\n–\n–\n–\nNl\nFat droplets on \nsudan stain\nPositive\nfecal elastase\nmeasurement\nNl\nNl\nNl\nSlightly elevated\namylase\nand\nlipase\nAbnormal pancreatic function test\nSecretin\n stimulation test\nMalabsorption\nDiabetes mellitus\nPancreatic pseudocyst\nToxins\nRecurrent\nacute pancreatitis\nGenetic\npredesposition\nAutoimmune\nMagnetic resonance cholangiopancreatography\n(\nMRCP\n)\nBile acid malabsorption\n–\n+\n+\n–\n+\n–\n–\n+\n–\n–\n–\nNl\nFat droplets on \nsudan stain\nNl\nNl\nNl\nReduced\ncholesterol\nlevel\nMalabsorption\nHypotension\nTachycardia\nGenetic defects in \nSLC10A2\n \nSeHCAT\n test\nMicroscopic colitis\n–\n+\n+\n–\n–\n–\n+\n+\nAbdominal tenderness\nFecal\nincontinence\n–\n–\n–\nNl\n–\nNl\n↓\nNl\nHypokalemia\nElevated\nCRP\nPositive\nautoantibodies\ninclude:\nRF\nANA\nAMA\nANCA\nArthritis\nUveitis\nIdiopathic thrombocytopenic purpura\nPleuro\npericarditis\nHypothyroidism\nPsoriasis\nMucosal\nimmune responses\nto luminal factors in a genetically predisposed individual\nDrug–induced\nColonoscopy\nwith\nmucosal\nbiopsy\nwith\nmononuclear\ninfiltrates:\nCollagenous colitis\nis characterized by a colonic subepithelial\ncollagen\nband >10 micrometers in diameter\nLymphocytic\ncolitis\nis characterized by ≥20 intraepithelial\nlymphocytes\n(IEL) per 100 surface epithelial cells\nCause\nDuration\nDiarrhea\nFever\nAbdominal pain\nWeight loss\nGI signs\nStool exam\nCBC\nOther lab findings\nExtra intestinal findings\nCause\/Pathogenesis\nGold standard diagnosis\nAcute\nChronic\nWatery\nBloody\nFatty\nWBC\nRBC\nOva\/Parasite\nOsmotic gap\nOther\nWBC\nHgb\nPlt\nInfective colitis\n–\n+\n+\n+\n–\n+\n+\n+\nRebound\nabdominal tenderness\n+\n+\n+\nNl\nPositive\nstool culture\nPositive fecal calprotectin\nPositive fecal\nlactoferrin\n↑\n↓\n↑\nElevated\nCRP\nElevated\nESR\nArthritis\nUveitis\nSalmonella\nShigella\nCampylobacter\nE. coli 0157:H7\nClostridium difficile\nEntamoeba histolytica\nAdenovirus\nCytomegalovirus\nHerpes simplex virus\nStool culture\nBlood culture\nIschemic colitis\n+\n+\n+\n+\n–\n+\n+\n+\nHyperactive then absent\nbowel sounds\nAbdominal tenderness\n+\n+\n–\nNl\n–\n↑\n↓\n↑\nElevated\nCRP\nElevated\nESR\nElevated serum\nlactate\nElevated\nlactate dehydrogenase\n(\nLDH\n) \nElevated\ncreatine phosphokinase\n(\nCPK\n)\nElevated\namylase\nHypoalbuminemia\nIgA vasculitis\nHypercoagulability\n \nNonocclusive\ncolonic ischemia\nEmbolic\nand\nthrombotic\narterial occlusion\nMesenteric vein thrombosis\nAbdominal\nCT scan\nLactose intolerance\n+\n+\n+\n–\n–\n–\n+\n–\nAbdominal tenderness\nAbdominal distention\n–\n–\n–\n↑\n–\nNl\nNl\nNl\nLactose tolerance test\nGenetic testing\nHeadache\nVertigo\nMemory impairment\nLethargy\nReduction of lactase enzyme activity or inability to produce persistent\nlactase\nCongenital\nlactase deficiency\nSecondary lactose malabsorption\nSmall bowel\n \nbiopsy\n \nLactose breath hydrogen test\nIrritable bowel syndrome\n–\n+\n±\n–\n±\n–\n±\n–\nAbdominal tenderness\nAbdominal distention\nNormal\nbowel sounds\n–\n–\n–\nNl\n–\nNl\nNl\nNl\nNl\nAnxiety\nPalpitation\nUnknown\nDiagnosis of exclusion\nCause\nDuration\nDiarrhea\nFever\nAbdominal pain\nWeight loss\nGI signs\nStool exam\nCBC\nOther lab findings\nExtra intestinal findings\nCause\/Pathogenesis\nGold standard diagnosis\nAcute\nChronic\nWatery\nBloody\nFatty\nWBC\nRBC\nOva\/Parasite\nOsmotic gap\nOther\nWBC\nHgb\nPlt\nWhipple's disease\n–\n+\n+\n–\n+\n±\n+\n+\nHepatosplenomegaly\nAscites\n–\n–\n–\nNl\nPositive\nfecal fat\n↓\n↓\n↓\/↑\nHypoalbuminemia\nFat soluble vitamins\ndeficiency\nMalabsorption\nAbnormal extraocular movement\nLymphadenopathy\nHyperpigmentation\nUveitis\nEndocarditis\nEncephalitis\nDementia\nPleural effusion\nTropheryma whipplei\nSmall intestine\nbiopsy\nfor\nTropheryma whipplei\ntesting\nPCR\ntesting\nTropical sprue\n+\n+\n+\n–\n+\n+\n+\n+\nAngular\nstomatitis\nOral mucosal lesion\n+\n–\n–\nNl\nPositive\nstool culture\nNl\n↓\nNl\nFat soluble vitamins\ndeficiency\nVitamin B12 deficiency\nFolate deficiency\nHypokalemia\n \nMyalgia\nNeuropathy\nEdema\nEscherichia coli\nKlebsiella pneumoniae\nEnterobacter cloacae\nDiagnosis of exclusion\nSmall bowel bacterial overgrowth\n–\n+\n+\n–\n+\n–\n+\n+\nAbdominal distention\n+\n–\n–\nNl\nPositive\nstool culture\nPositive\nfecal fat\nNl\n↓\nNl\nHypoalbuminemia\nAbnormal\nhydrogen breath test\nLactic acidosis\nMalabsorption\nRosacea\n \nExcess bacteria in the\nsmall intestine\nAlterations in\nintestinal\nanatomy\nor GI motility\nDiagnosis of exclusion\nCause\nDuration\nDiarrhea\nFever\nAbdominal pain\nWeight loss\nGI signs\nStool exam\nCBC\nOther lab findings\nExtra intestinal findings\nCause\/Pathogenesis\nGold standard diagnosis\nAcute\nChronic\nWatery\nBloody\nFatty\nWBC\nRBC\nOva\/Parasite\nOsmotic gap\nOther\nWBC\nHgb\nPlt\nSalmonellosis\n+\n+\n+\n+\n–\n+\n+\n–\nAbdominal distention\nDiffuse \nabdominal tenderness\nHepatosplenomegaly\n+\n+\n–\nNl\nPositive\nstool culture\nPositive serologic testing\n↑\nNl\n↑\nHypokalemia\nHypernatremia\nHyponatremia\nHypercalciuria\nHypocitraturia\nPost–infectious arthritis\nObtundation\nBacteremia\nPericarditis\nPyelonephritis\nBrain abscess\nSalmonella\nStool culture\nEscherichia coli enteritis\nEPEC\n+\n+\n+\n+\n–\n+\n+\n+\nDiffuse \nabdominal tenderness\n+\n+\n–\nNl\nPositive\nstool culture\n↑\nNl\nNl\n–\n–\nEnteropathogenic E. coli\nDNA probe\nor\npolymerase chain reaction\n(\nPCR\n) of the\nEPEC\nadherence factor\nStool culture\nEAEC\n+\n+\n+\n+\n–\n–\n+\n–\nDiffuse \nabdominal tenderness\n+\n+\n–\nNl\nPositive\nstool culture\n↑\n↓\n↓\n–\nChronic infection in \nimmunocompromised\n patients\nEnteroaggregative E. coli\nStool culture\nAeromonas\n+\n+\n+\n+\n–\n+\n+\n–\nAbdominal distention\nHyperactive\nbowel sounds\nDiffuse \nabdominal tenderness\n+\n+\n–\nNl\nPositive\nstool culture\n↑\nNl\nNl\n–\nWound\ninfection\nBacteremia\nHemolytic uremic syndrome\n \nMeningitis\nOcular\ninfection\nPneumonia\n \nUrinary tract infection\nOsteomyelitis\nPeritonitis\nAcute cholecystitis\nOpportunistic infections\nin \nimmunocompromised\n patients\nAeromonas\nvirulence factors including \nendotoxins\n, \nhemolysins\n, \nenterotoxins\n, and adherence factors\nBlood culture\nWound\nculture\nCause\nDuration\nDiarrhea\nFever\nAbdominal pain\nWeight loss\nGI signs\nStool exam\nCBC\nOther lab findings\nExtra intestinal findings\nCause\/Pathogenesis\nGold standard diagnosis\nAcute\nChronic\nWatery\nBloody\nFatty\nWBC\nRBC\nOva\/Parasite\nOsmotic gap\nOther\nWBC\nHgb\nPlt\nMycobacterium avium complex\n+\n+\n+\n+\n–\n+\n+\n–\nAbdominal distention\nHepatosplenomegaly\n \n+\n+\n–\nNl\n–\n↓\n↓\nNl\nElevated\nliver enzymes\nOpportunistic infection\nin \nimmunocompromised\n patients\nPulmonary\ninfection\nAdenopathy\n \nNight sweats\nMycobacterium avium complex\nBlood culture\nCMV colitis\n+\n+\n–\n+\n–\n±\n+\n–\nDiffuse\nabdominal tenderness\n+\n+\n–\nNl\nViral antigen assay\n↓\nNl\nNl\nDecreased\nCD4\nlevel\nAbnormal\nliver function test\nEncephalitis\n \nGuillain–Barré syndrome\nPneumonia\n \nRetinitis\nPericarditis\nand\nmyocarditis\nAtherosclerosis\n \nVenous thrombosis\nCytomegalovirus\nQuantitative PCR\ntests \nHIV\n–\n+\n+\n–\n–\n+\n+\n+\nAbdominal distention\nDiffuse\nabdominal tenderness\n+\n–\n–\nNl\n–\n↓\n↓\nNl\nDecreased\nCD4\nlevel\nElectrolyte imbalance\nLymphadenopathy\nDisseminated\ninfection\nHIV\nHIV virologic (viral load) test\nImmunoassay \nCause\nDuration\nDiarrhea\nFever\nAbdominal pain\nWeight loss\nGI signs\nStool exam\nCBC\nOther lab findings\nExtra intestinal findings\nCause\/Pathogenesis\nGold standard diagnosis\nAcute\nChronic\nWatery\nBloody\nFatty\nWBC\nRBC\nOva\/Parasite\nOsmotic gap\nOther\nWBC\nHgb\nPlt\nEntamoeba histolytica\n+\n+\n+\n+\n–\n+\n+\n–\nAbdominal distention\nDiffuse\nabdominal tenderness\n+\n+\n+\nNl\n–\n↑\nNl\nNl\n–\nLiver abscess\nPleuropulmonary infection\nCardiac\ninfection\nBrain abscess\nCutaneous infection\nEntamoeba histolytica\nAntigen testing\nSerology \nGiardia\n–\n+\n+\n–\n+\n–\n+\n+\nAbdominal distention\nDiffuse\nabdominal tenderness\n–\n–\n+\nNl\n–\nNl\nNl\nNl\n–\nMalabsorption\nUrticaria\nDepression\nGiardia lamblia\nAntigen detection assays\nCryptosporidium\n–\n+\n+\n–\n–\n–\n+\n+\nAbdominal distention\nDiffuse\nabdominal tenderness\n–\n–\n+\nNl\nPositive stool microscopy\nNl\nNl\nNl\nElevated\nalkaline phosphatase\nChronic, life–threatening illness in\nimmunocompromised\npatients\nCryptosporidium\nPolymerase chain reaction\nMicrosporidia\n+\n+\n+\n–\n–\n+\n+\n–\nAbdominal distention\nDiffuse\nabdominal tenderness\n–\n–\n+\nNl\nPositive stool microscopy\nNl\nNl\nNl\nDecreased\nCD4\ncount\nMalabsorption\nKeratitis\n \nSeizure\nMyositis\n \nMicrosporidia\nAntigen detection assays\nIsospora\n+\n+\n+\n–\n+\n+\n+\n+\nAbdominal distention\nDiffuse\nabdominal tenderness\n+\n+\n+\nNl\nPositive stool microscopy\nPositive\nfecal fat\n↑\nNl\nNl\nElevated\neosinophils\n \nHypokalemia\nIncreased\ncreatinine\nChronic illness in\nimmunocompromised\npatients\nIsospora\nDetecting oocysts in the feces\nCause\nDuration\nDiarrhea\nFever\nAbdominal pain\nWeight loss\nGI signs\nStool exam\nCBC\nOther lab findings\nExtra intestinal findings\nCause\/Pathogenesis\nGold standard diagnosis\nAcute\nChronic\nWatery\nBloody\nFatty\nWBC\nRBC\nOva\/Parasite\nOsmotic gap\nOther\nWBC\nHgb\nPlt\nCarcinoid tumor\n–\n+\n+\n+\n–\n–\n+\n+\nAbdominal distention\n–\n+\n–\n↓\n–\nNl\nNl\nNl\nElevated urinary\n5–hydroxyindoleacetic acid\n(\n5–HIAA\n) level\nHigh\nchromogranin A\nFacial flushing\nJaundice\nEdema\nValvular heart disease\nRight–sided heart failure\nWell–differentiated\nneuroendocrine tumor\nBlood\nchromogranin A\nlevel\nVIPoma\n+\n+\n+\n–\n+\n–\n+\n+\nAbdominal distention\nAbdominal\nRUQ\ntenderness\nNausea\nVomiting\n–\n–\n–\n↓\n–\nNl\nNl\nNl\nElevated\nVIP\nlevel\nHypokalemia\nHypochlorhydria\nor\nachlorhydria\nLow osmotic gap (<50 mOsm\/kg)\nRash\nFacial flushing\nDehydration\nLethargy\nMuscle weakness\nPrimary secretory tumor\nBlood\nVIP\nlevels\nFollowed by imaging\nZollinger–Ellison syndrome\n–\n+\n+\n+\n+\n–\n+\n+\nEpigastric tenderness\n–\n–\n–\n↓\n–\nNl\n↓\nNl\nPositive\nsecretin\nstimulation test\nElevated serum\nchromogranin A\nJaundice\nGastrin\nproducing\ntumor\nmainly in\nduodenum\nSecretin\n stimulation test\nSomatostatinoma\n–\n+\n+\n–\n–\n–\n+\n+\nEpigastric tenderness\n–\n–\n–\n↓\n–\nNl\nNl\nNl\nElevated fasting plasma\nsomatostatin\nDiabetes mellitus\nCholelithiasis\nJaundice\nNeuroendocrine tumors\nof D–cell origin\nPlasma\nsomatostatin\nlevel\nFollowed by imaging\nCause\nDuration\nDiarrhea\nFever\nAbdominal pain\nWeight loss\nGI signs\nStool exam\nCBC\nOther lab findings\nExtra intestinal findings\nCause\/Pathogenesis\nGold standard diagnosis\nAcute\nChronic\nWatery\nBloody\nFatty\nWBC\nRBC\nOva\/Parasite\nOsmotic gap\nOther\nWBC\nHgb\nPlt\nLymphoma\n–\n+\n+\n+\n–\n+\n+\n+\nDiffuse\nabdominal tenderness\nHepatosplenomegaly\n–\n+\n–\nNl\n–\nNl\n↓\nNl\nParaproteinemia\n \nMalabsorption\nLactose intolerance\nAscites\nPrimary\ntumor\nof GI tract\nColonoscopy\nwith\nbiopsy\nColorectal cancer\n–\n+\n+\n+\n+\n–\n+\n+\nDiffuse\nabdominal tenderness\n–\n+\n–\nNl\n–\nNl\n↓\nNl\nPositive\ncarcinoembryonic antigen\nMetastasis\nFAP gene\nHNPCC gene\nColonoscopy\nand\nbiopsy\nMedications\nACE inhibitors\nDigoxin\nCephalosporins\nStatins\nThiazide diuretics\nTriptans\nLactulose\nAnti retroviral agents\nChemotherapeutic agents\nAntifungals\nMagnesium\n+\n+\n+\n–\n±\n±\n+\n+\nAbdominal distention\nDehydration\n–\n–\n–\n↑\/↓\n–\n↑\nNl\nNl\nElevated plasma level of drug\n–\nInflammation\nPseudomembranous colitis\nClinical evaluation after discontinuation of the drugs\nFactitious diarrhea\n+\n+\n+\n–\n–\n–\n+\n+\nAbdominal distention\n–\n–\n–\n↑\/↓\n–\nNl\nNl\nNl\nHypokalemia\n \nMetabolic alkalosis\nHypermagnesemia\n \nMalabsorption\nLethargy\nGeneralized weakness\nAcute renal failure\nMedications\nClinical evaluation after discontinuation of the drugs\nCause\nDuration\nDiarrhea\nFever\nAbdominal pain\nWeight loss\nGI signs\nStool exam\nCBC\nOther lab findings\nExtra intestinal findings\nCause\/Pathogenesis\nGold standard diagnosis\nAcute\nChronic\nWatery\nBloody\nFatty\nWBC\nRBC\nOva\/Parasite\nOsmotic gap\nOther\nWBC\nHgb\nPlt\nHeavy metal ingestion\n–\n+\n+\n–\n–\n–\n+\n+\nAbdominal distention\n–\n–\n–\nNl\n–\nNl\nNl\nNl\nElevated plasma heavy metal level\nHeadache\nNumbness\nAlopecia\nVertigo\nHeavy metal ingestion\nPlasma level of heavy metal\nOrganophosphate poisoning\n+\n+\n+\n–\n–\n–\n+\n–\nSalivation\nVomiting\n–\n–\n–\nNl\n–\nNl\nNl\nNl\nReduced RBC acetylcholinesterase\nPlasma\ncholinesterase\nactivity\nAutonomic dysfunction\nMotor deficit\nSensory deficit\nBronchospasm\nUrination\nMiosis\nBradycardia\nLacrimation\nSweating\nCardiac arrhythmias\nAcute renal injury\nNeurotoxins\nbind to\nacetylcholinesterase\n(AChE)\nClinical diagnosis\nOpium withdrawal\n+\n+\n+\n–\n–\n–\n+\n–\nHyperactive\nbowel sounds\n–\n–\n–\nNl\n–\nNl\nNl\nNl\nAzotemia\nHypokalemia\nMetabolic alkalosis\nDysphoria\n \nRestlessness\nSweating\nRhinorrhea\nLacrimation\nMyalgia\nArthralgia\nOpium withdrawal\nClinical diagnosis following\nopium withdrawal\nCause\nDuration\nDiarrhea\nFever\nAbdominal pain\nWeight loss\nGI signs\nStool exam\nCBC\nOther lab findings\nExtra intestinal findings\nCause\/Pathogenesis\nGold standard diagnosis\nAcute\nChronic\nWatery\nBloody\nFatty\nWBC\nRBC\nOva\/Parasite\nOsmotic gap\nOther\nWBC\nHgb\nPlt\nShort bowel syndrome\n+\n+\n+\n–\n+\n–\n–\n+\nAbdominal distention\nAbdominal tenderness\n–\n–\n–\nNl\nPositive\nfecal fat\nNl\n↓\n↑\nHypoalbuminemia\nHigh level of \nacute phase reactant\nAbnormal\nliver function tests\nPrior\nintestinal\nsurgery\nMalabsorption\nCrohn's disease\nMalignancy\nPeripheral\nedema\nMuscle atrophy\nSurgical\nbowel resection\nClinical diagnosis following\nbowel resection\nRadiation enteritis\n+\n+\n+\n+\n+\n–\n+\n+\nAbdominal tenderness\n+\n+\n–\nNl\nPositive\nfecal fat\nNl\n↓\nNl\nVitamin B12 deficiency\nHypoalbuminemia\nPrior history of\nmalignancy\nand\nradiation therapy\nMalabsorption\nTelangiectasias\n \nRadiation\nSegmental bowel\ninflammation\non\nendoscopy\nor\ncolonoscopy\nDumping syndrome\n–\n+\n+\n–\n+\n–\n–\n+\nHyperactive\nbowel sound\n–\n–\n–\nNl\n–\nNl\nNl\nNl\nHypoglycemia\nHydrogen breath test\nMalnutrition\nFat soluble vitamin\ndeficiency\nPostgastrectomy\nClinical diagnosis following\ngastrectomy\nCause\nDuration\nDiarrhea\nFever\nAbdominal pain\nWeight loss\nGI signs\nStool exam\nCBC\nOther lab findings\nExtra intestinal findings\nCause\/Pathogenesis\nGold standard diagnosis\nAcute\nChronic\nWatery\nBloody\nFatty\nWBC\nRBC\nOva\/Parasite\nOsmotic gap\nOther\nWBC\nHgb\nPlt\nAbetalipoproteinemia\n–\n+\n+\n–\n+\n–\n+\n+\nAbdominal distension\n–\n–\n–\nNl\n–\nNl\nNl\nNl\nLow\ntriglyceride\nLow total\ncholesterol\nlevels \nAcanthocytes\nLow\nvitamin E\n levels\nAtaxia\nVisual field defect\nDysarthria\nAutosomal recessive\ndisorder caused by mutations encoding the\nmicrosomal triglyceride transfer protein\n(MTP)\nClinical findings and low\ntriglyceride\nand\ncholesterol\nlevel\nHyperthyroidism\n–\n+\n+\n–\n–\n±\n+\n+\n–\n–\n–\n–\nNl\nPositive\nfecal fat\nNl\nNl\nNl\nElevated\nT4\nElevated\nT3\nDecreased\nTSH\nHigh serum\nalkaline phosphatase\nLump in the neck\nLid lag\nMalabsorption\nSweating\nHyperpigmentation\nProptosis\nTremor\nIncreased\nDTR\nGraves' disease\nHashimoto's thyroiditis\nToxic adenoma\nTSH\nDiabetic neuropathy\n–\n+\n+\n–\n+\n–\n+\n+\nFecal incontinence\n–\n–\n–\nNl\nPositive\nfecal fat\nNl\n↓\nNl\nHyperglycemia\nAzotemia\nHypokalemia\nMalabsorption\n \nUnclear\nDisordered\nmotility\nIncreased\nintestinal\nsecretion\nSmall intestinal bacterial overgrowth\nClinical diagnosis in a patient with long lasting\ndiabetes mellitus\nSystemic sclerosis\n–\n+\n+\n±\n+\n–\n+\n+\nEpigastric tenderness\nFecal incontinence\n–\n+\n–\nNl\nPositive\nfecal fat\nNl\n↓\nNl\nAnti–\ntopoisomerase I\n(Scl‑70) antibodies\nAntinuclear antibodies\n(\nANA\n)\nAnti–centromere antibodies\nAnti–\nRNA polymerase III\nantibody\nMalabsorption\nSkin changes\nRaynaud phenomenon\nPulmonary hypertension\nArthritis\nTelangiectasia\nChronic renal failure\nAutoimmune reaction\nClinical diagnosis\nFollowed by serologic tests\nReferences\n↑\nCasburn-Jones, Anna C; Farthing, Michael Jg (2004). \"Traveler's diarrhea\".\nJournal of Gastroenterology and Hepatology\n.\n19\n(6): 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(2017). \"Diagnóstico y tratamiento de la enfermedad inflamatoria intestinal: Primer Consenso Latinoamericano de la Pan American Crohn's and Colitis Organisation\".\nRevista de Gastroenterología de México\n.\n82\n(1): 46–84.\ndoi\n:\n10.1016\/j.rgmx.2016.07.003\n.\nISSN\n \n0375-0906\n.\n↑\nBorbély, Yves M; Osterwalder, Alice; Kröll, Dino; Nett, Philipp C; Inglin, Roman A (2017). \"Diarrhea after bariatric procedures: Diagnosis and therapy\".\nWorld Journal of Gastroenterology\n.\n23\n(26): 4689.\ndoi\n:\n10.3748\/wjg.v23.i26.4689\n.\nISSN\n \n1007-9327\n.\n↑\nCrawford, Sue E.; Ramani, Sasirekha; Tate, Jacqueline E.; Parashar, Umesh D.; Svensson, Lennart; Hagbom, Marie; Franco, Manuel A.; Greenberg, Harry B.; O'Ryan, Miguel; Kang, Gagandeep; Desselberger, Ulrich; Estes, Mary K. 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Med\n.\n78\n(6B): 91–8.\nPMID\n \n4014291\n.\n↑\nLópez-Vélez R, Turrientes MC, Garrón C, Montilla P, Navajas R, Fenoy S, del Aguila C (1999). \"Microsporidiosis in travelers with diarrhea from the tropics\".\nJ Travel Med\n.\n6\n(4): 223–7.\nPMID\n \n10575169\n.\n↑\nWahnschaffe, Ulrich; Ignatius, Ralf; Loddenkemper, Christoph; Liesenfeld, Oliver; Muehlen, Marion; Jelinek, Thomas; Burchard, Gerd Dieter; Weinke, Thomas; Harms, Gundel; Stein, Harald; Zeitz, Martin; Ullrich, Reiner; Schneider, Thomas (2009). \"Diagnostic value of endoscopy for the diagnosis of giardiasis and other intestinal diseases in patients with persistent diarrhea from tropical or subtropical areas\".\nScandinavian Journal of Gastroenterology\n.\n42\n(3): 391–396.\ndoi\n:\n10.1080\/00365520600881193\n.\nISSN\n \n0036-5521\n.\n↑\nMena Bares LM, Carmona Asenjo E, García Sánchez MV, Moreno Ortega E, Maza Muret FR, Guiote Moreno MV, Santos Bueno AM, Iglesias Flores E, Benítez Cantero JM, Vallejo Casas JA (2017). \"75SeHCAT scan in bile acid malabsorption in chronic diarrhoea\".\nRev Esp Med Nucl Imagen Mol\n.\n36\n(1): 37–47.\ndoi\n:\n10.1016\/j.remn.2016.08.005\n.\nPMID\n \n27765536\n.\n↑\nGibson RJ, Stringer AM (2009). \"Chemotherapy-induced diarrhoea\".\nCurr Opin Support Palliat Care\n.\n3\n(1): 31–5.\ndoi\n:\n10.1097\/SPC.0b013e32832531bb\n.\nPMID\n \n19365159\n.\n↑\nAbraham BP, Sellin JH (2012). \"Drug-induced, factitious, & idiopathic diarrhoea\".\nBest Pract Res Clin Gastroenterol\n.\n26\n(5): 633–48.\ndoi\n:\n10.1016\/j.bpg.2012.11.007\n.\nPMID\n \n23384808\n.\n↑\nReintam Blaser A, Deane AM, Fruhwald S (2015). \"Diarrhoea in the critically ill\".\nCurr Opin Crit Care\n.\n21\n(2): 142–53.\ndoi\n:\n10.1097\/MCC.0000000000000188\n.\nPMID\n \n25692805\n.\n↑\nMcMahan ZH, DuPont HL (2007). \"Review article: the history of acute infectious diarrhoea management--from poorly focused empiricism to fluid therapy and modern pharmacotherapy\".\nAliment. Pharmacol. Ther\n.\n25\n(7): 759–69.\ndoi\n:\n10.1111\/j.1365-2036.2007.03261.x\n.\nPMID\n \n17373914\n.\n↑\nSchiller LR (2012). \"Definitions, pathophysiology, and evaluation of chronic diarrhoea\".\nBest Pract Res Clin Gastroenterol\n.\n26\n(5): 551–62.\ndoi\n:\n10.1016\/j.bpg.2012.11.011\n.\nPMID\n \n23384801\n.\n↑\nGiannella RA (1986). \"Chronic diarrhea in travelers: diagnostic and therapeutic considerations\".\nRev. Infect. Dis\n. 8 Suppl 2: S223–6.\nPMID\n \n3523719\n.\n↑\nSilverberg MS, Satsangi J, Ahmad T, Arnott ID, Bernstein CN, Brant SR;  et al. (2005).\n\"Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a Working Party of the 2005 Montreal World Congress of Gastroenterology\"\n.\nCan J Gastroenterol\n. 19 Suppl A: 5A–36A.\nPMID\n \n16151544\n.\n↑\nSauter GH, Moussavian AC, Meyer G, Steitz HO, Parhofer KG, Jüngst D (2002).\n\"Bowel habits and bile acid malabsorption in the months after cholecystectomy\"\n.\nAm J Gastroenterol\n.\n97\n(7): 1732–5.\ndoi\n:\n10.1111\/j.1572-0241.2002.05779.x\n.\nPMID\n \n12135027\n.\n↑\nMaiuri L, Raia V, Potter J, Swallow D, Ho MW, Fiocca R;  et al. (1991).\n\"Mosaic pattern of lactase expression by villous enterocytes in human adult-type hypolactasia\"\n.\nGastroenterology\n.\n100\n(2): 359–69.\nPMID\n \n1702075\n.\n↑\nRUBIN CE, BRANDBORG LL, PHELPS PC, TAYLOR HC (1960).\n\"Studies of celiac disease. I. The apparent identical and specific nature of the duodenal and proximal jejunal lesion in celiac disease and idiopathic sprue\"\n.\nGastroenterology\n.\n38\n: 28–49.\nPMID\n \n14439871\n.\n↑\nKonvolinka CW (1994).\n\"Acute diverticulitis under age forty\"\n.\nAm J Surg\n.\n167\n(6): 562–5.\nPMID\n \n8209928\n.\n↑\nSatsangi J, Silverberg MS, Vermeire S, Colombel JF (2006).\n\"The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications\"\n.\nGut\n.\n55\n(6): 749–53.\ndoi\n:\n10.1136\/gut.2005.082909\n.\nPMC\n \n1856208\n.\nPMID\n \n16698746\n.\n↑\nHaque R, Huston CD, Hughes M, Houpt E, Petri WA (2003).\n\"Amebiasis\"\n.\nN Engl J Med\n.\n348\n(16): 1565–73.\ndoi\n:\n10.1056\/NEJMra022710\n.\nPMID\n \n12700377\n.\n↑\nHertzler SR, Savaiano DA (1996).\n\"Colonic adaptation to daily lactose feeding in lactose maldigesters reduces lactose intolerance\"\n.\nAm J Clin Nutr\n.\n64\n(2): 232–6.\nPMID\n \n8694025\n.\n↑\nBriet F, Pochart P, Marteau P, Flourie B, Arrigoni E, Rambaud JC (1997).\n\"Improved clinical tolerance to chronic lactose ingestion in subjects with lactose intolerance: a placebo effect?\"\n.\nGut\n.\n41\n(5): 632–5.\nPMC\n \n1891556\n.\nPMID\n \n9414969\n.\n↑\nBLACK-SCHAFFER B (1949).\n\"The tinctoral demonstration of a glycoprotein in Whipple's disease\"\n.\nProc Soc Exp Biol Med\n.\n72\n(1): 225–7.\nPMID\n \n15391722\n.","attrs_markdown":"# Chronic diarrhea differential diagnosis\n[Jump to navigation](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#mw-head) [Jump to search](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#searchInput)\n\n[![](https:\/\/www.wikidoc.org\/images\/1\/16\/Home_logo1.png)](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea)\n\n***To review the differential diagnosis of diarrhea, click [here](https:\/\/www.wikidoc.org\/index.php\/Diarrhea#Differential_Diagnosis_of_Diarrhea_of_other_diseases \"Diarrhea\").***\n\n**Editor-In-Chief:** [C. Michael Gibson, M.S., M.D.](https:\/\/www.wikidoc.org\/index.php\/User:C_Michael_Gibson \"User:C Michael Gibson\") [\\[1\\]](mailto:charlesmichaelgibson@gmail.com); **Associate Editor(s)-in-Chief:**  [Sadaf Sharfaei M.D.](https:\/\/www.wikidoc.org\/index.php\/User:Ssharfaei \"User:Ssharfaei\")[\\[2\\]](Mailto:sadaf.sharfaei@gmail.com), [Seyedmahdi Pahlavani, M.D.](https:\/\/www.wikidoc.org\/index.php\/User:Mehdi_Pahlavani \"User:Mehdi Pahlavani\") [\\[3\\]](mailto:spahlava@bidmc.harvard.edu)\n\n## Overview\nThe [differential diagnosis](https:\/\/www.wikidoc.org\/index.php\/Differential_diagnosis \"Differential diagnosis\") for [chronic diarrhea](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea \"Chronic diarrhea\") is enormous, with a large number of diagnostic tests available that can be used to evaluate these patients. Classifying a patient's [chronic diarrhea](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea \"Chronic diarrhea\") into a subcategory such as [watery](https:\/\/www.wikidoc.org\/index.php\/Watery_diarrhea \"Watery diarrhea\"), fatty and [inflammatory](https:\/\/www.wikidoc.org\/index.php\/Inflammatory \"Inflammatory\") helps to direct the [diagnostic](https:\/\/www.wikidoc.org\/index.php\/Diagnostic \"Diagnostic\") work-up. Some [watery](https:\/\/www.wikidoc.org\/index.php\/Watery_diarrhea \"Watery diarrhea\") causes of chronic diarrhea which should be differentiated from one another include [crohn's disease](https:\/\/www.wikidoc.org\/index.php\/Crohn%27s_disease \"Crohn's disease\"), [hyperthyroidism](https:\/\/www.wikidoc.org\/index.php\/Hyperthyroidism \"Hyperthyroidism\"), [VIPoma](https:\/\/www.wikidoc.org\/index.php\/VIPoma \"VIPoma\"), [lactose intolerance](https:\/\/www.wikidoc.org\/index.php\/Lactose_intolerance \"Lactose intolerance\"), [celiac disease](https:\/\/www.wikidoc.org\/index.php\/Celiac_disease \"Celiac disease\") and [irritable bowel syndrome](https:\/\/www.wikidoc.org\/index.php\/Irritable_bowel_syndrome \"Irritable bowel syndrome\") (IBS). The causes of fatty diarrhea that should be differentiated from one another include [celiac sprue](https:\/\/www.wikidoc.org\/index.php\/Celiac_sprue \"Celiac sprue\"), [pancreatic insufficiency](https:\/\/www.wikidoc.org\/index.php\/Pancreatic_insufficiency \"Pancreatic insufficiency\"), [bacterial overgrowth](https:\/\/www.wikidoc.org\/index.php\/Bacterial_overgrowth \"Bacterial overgrowth\") and [maldigestion](https:\/\/www.wikidoc.org\/index.php\/Maldigestion \"Maldigestion\") problems which results from [pancreatic exocrine insufficiency](https:\/\/www.wikidoc.org\/index.php\/Pancreatic_insufficiency \"Pancreatic insufficiency\"). Finally, the [inflammatory](https:\/\/www.wikidoc.org\/index.php\/Inflammatory \"Inflammatory\") causes of chronic diarrhea such as [ulcerative colitis](https:\/\/www.wikidoc.org\/index.php\/Ulcerative_colitis \"Ulcerative colitis\") and [entamoeba histolytica](https:\/\/www.wikidoc.org\/index.php\/Entamoeba_histolytica \"Entamoeba histolytica\") must also be differentiated.\n\n## Differential Diagnosis of Chronic Diarrhea from other diseases\n**The following table outlines the major differential diagnoses of chronic diarrhea.**[\\[1\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-Casburn-JonesFarthing2004-1)[\\[2\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-KamatMathur2006-2)[\\[3\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-PfeifferDuPont2012-3)[\\[4\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid24506120-4)[\\[5\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid29255768-5)[\\[6\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid29254859-6)[\\[7\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-Yamamoto-FurushoBosques-Padilla2017-7)[\\[8\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-Borb%C3%A9lyOsterwalder2017-8)[\\[9\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-CrawfordRamani2017-9)[\\[10\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid11068510-10)[\\[11\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid4014291-11)[\\[12\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid10575169-12)[\\[13\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-WahnschaffeIgnatius2009-13)[\\[14\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid27765536-14)[\\[15\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid19365159-15)[\\[16\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid23384808-16)[\\[17\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid25692805-17)[\\[18\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid17373914-18)[\\[19\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid23384801-19)[\\[20\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid3523719-20)[\\[21\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid16151544-21)[\\[22\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid12135027-22)[\\[23\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid1702075-23)[\\[24\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid14439871-24)[\\[25\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid8209928-25)[\\[26\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid16698746-26)[\\[27\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid12700377-27)[\\[28\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid8694025-28)[\\[29\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid9414969-29)[\\[30\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid15391722-30)\n\n**Abbreviations:** **GI:** [Gastrointestinal](https:\/\/www.wikidoc.org\/index.php\/Gastrointestinal_tract \"Gastrointestinal tract\"), **CBC**: [Complete blood count](https:\/\/www.wikidoc.org\/index.php\/Complete_blood_count \"Complete blood count\"), **WBC:** [White blood cell](https:\/\/www.wikidoc.org\/index.php\/White_blood_cells \"White blood cells\"), **RBC**: [Red blood cell](https:\/\/www.wikidoc.org\/index.php\/Red_blood_cell \"Red blood cell\"), **Plt:** [Platelet](https:\/\/www.wikidoc.org\/index.php\/Platelet \"Platelet\"), **Hgb:** [Hemoglobin](https:\/\/www.wikidoc.org\/index.php\/Hemoglobin \"Hemoglobin\"), **ESR**: [Erythrocyte sedimentation rate](https:\/\/www.wikidoc.org\/index.php\/Erythrocyte_sedimentation_rate \"Erythrocyte sedimentation rate\"), **CRP**: [C–reactive protein](https:\/\/www.wikidoc.org\/index.php\/C-reactive_protein \"C-reactive protein\"), **IgE:** [Immunoglobulin E](https:\/\/www.wikidoc.org\/index.php\/Immunoglobulin_E \"Immunoglobulin E\"), **IgA:** [Immunoglobulin A](https:\/\/www.wikidoc.org\/index.php\/Immunoglobulin_A \"Immunoglobulin A\"), **ETEC:** [Escherichia coli enteritis](https:\/\/www.wikidoc.org\/index.php\/Escherichia_coli_enteritis \"Escherichia coli enteritis\"), **EPEC**: [Enteropathogenic Escherichia coli](https:\/\/www.wikidoc.org\/index.php\/Escherichia_coli \"Escherichia coli\"), **EIEC**: [Enteroinvasive Escherichia coli](https:\/\/www.wikidoc.org\/index.php\/Escherichia_coli_enteritis \"Escherichia coli enteritis\"), **EHEC**: [Enterohemorrhagic Escherichia coli](https:\/\/www.wikidoc.org\/index.php\/Escherichia_coli \"Escherichia coli\"), **EAEC**: [Enteroaggregative Escherichia coli](https:\/\/www.wikidoc.org\/index.php\/Escherichia_coli_enteritis \"Escherichia coli enteritis\"), **Nl**: Normal, **ASCA**: [Anti saccharomyces cerevisiae antibodies](https:\/\/www.wikidoc.org\/index.php\/Anti_saccharomyces_cerevisiae_antibodies \"Anti saccharomyces cerevisiae antibodies\"), **ANCA**: [Anti–neutrophil cytoplasmic antibody](https:\/\/www.wikidoc.org\/index.php\/Anti-neutrophil_cytoplasmic_antibody \"Anti-neutrophil cytoplasmic antibody\"), **DNA**: [Deoxyribonucleic acid](https:\/\/www.wikidoc.org\/index.php\/DNA \"DNA\"), **CFTR**: [Cystic fibrosis transmembrane conductance regulator](https:\/\/www.wikidoc.org\/index.php\/Cystic_fibrosis_transmembrane_conductance_regulator \"Cystic fibrosis transmembrane conductance regulator\"), **SLC10A2**: [Solute carrier family 10 member 2](https:\/\/www.wikidoc.org\/index.php\/SLC10A2 \"SLC10A2\"), **SeHCAT**: [Selenium homocholic acid taurine or tauroselcholic acid](https:\/\/www.wikidoc.org\/index.php\/SeHCAT \"SeHCAT\"), **IEL**: Intraepithelial [lymphocytes](https:\/\/www.wikidoc.org\/index.php\/Lymphocyte \"Lymphocyte\"), **MRCP**: [Magnetic resonance cholangiopancreatography](https:\/\/www.wikidoc.org\/index.php\/Magnetic_resonance_cholangiopancreatography \"Magnetic resonance cholangiopancreatography\"), **ANA**: [Antinuclear antibodies](https:\/\/www.wikidoc.org\/index.php\/Antinuclear_antibodies \"Antinuclear antibodies\"), **AMA**: [Anti-mitochondrial antibody](https:\/\/www.wikidoc.org\/index.php\/Anti-mitochondrial_antibody \"Anti-mitochondrial antibody\"), **LDH**: [Lactate dehydrogenase](https:\/\/www.wikidoc.org\/index.php\/Lactate_dehydrogenase \"Lactate dehydrogenase\"), **CPK**: [Creatine phosphokinase](https:\/\/www.wikidoc.org\/index.php\/Creatine_phosphokinase \"Creatine phosphokinase\"), **PCR**: [Polymerase chain reaction](https:\/\/www.wikidoc.org\/index.php\/Polymerase_chain_reaction \"Polymerase chain reaction\"), **ELISA**: [Enzyme–linked immunosorbent assay](https:\/\/www.wikidoc.org\/index.php\/Enzyme_linked_immunosorbent_assay_\\(ELISA\\) \"Enzyme linked immunosorbent assay (ELISA)\"), **LT**: Heat–labile [enterotoxin](https:\/\/www.wikidoc.org\/index.php\/Enterotoxin \"Enterotoxin\"), ST: Heat–stable [enterotoxin](https:\/\/www.wikidoc.org\/index.php\/Enterotoxin \"Enterotoxin\"), **RT-PCR**: Reverse–transcriptase [polymerase chain reaction](https:\/\/www.wikidoc.org\/index.php\/Polymerase_chain_reaction \"Polymerase chain reaction\"), **CD4:** [Cluster of differentiation 4](https:\/\/www.wikidoc.org\/index.php\/CD4 \"CD4\"), **HIV**: [Human immunodeficiency virus](https:\/\/www.wikidoc.org\/index.php\/Human_Immunodeficiency_Virus_\\(HIV\\) \"Human Immunodeficiency Virus (HIV)\"), **RUQ**: [Right-upper quadrant](https:\/\/www.wikidoc.org\/index.php\/RUQ \"RUQ\"), **VIP**: [Vasoactive intestinal peptide](https:\/\/www.wikidoc.org\/index.php\/Vasoactive_intestinal_peptide \"Vasoactive intestinal peptide\"), **GI:** [Gastrointestinal](https:\/\/www.wikidoc.org\/index.php\/Gastrointestinal_tract \"Gastrointestinal tract\"), **FAP**: [Familial adenomatous polyposis](https:\/\/www.wikidoc.org\/index.php\/Familial_adenomatous_polyposis \"Familial adenomatous polyposis\"), **HNPCC**: [Hereditary nonpolyposis colorectal cancer](https:\/\/www.wikidoc.org\/index.php\/Hereditary_nonpolyposis_colorectal_cancer \"Hereditary nonpolyposis colorectal cancer\"), **MTP**: [Microsomal triglyceride transfer protein](https:\/\/www.wikidoc.org\/index.php\/Microsomal_triglyceride_transfer_protein \"Microsomal triglyceride transfer protein\"), **Scl‑70**: Anti–[topoisomerase I](https:\/\/www.wikidoc.org\/index.php\/Type_I_topoisomerase \"Type I topoisomerase\"), **TSH**: [Thyroid-stimulating hormone](https:\/\/www.wikidoc.org\/index.php\/Thyroid-stimulating_hormone \"Thyroid-stimulating hormone\"), **T4**: [Thyroxine](https:\/\/www.wikidoc.org\/index.php\/Thyroxine \"Thyroxine\"), **T3**: [Triiodothyronine](https:\/\/www.wikidoc.org\/index.php\/Triiodothyronine \"Triiodothyronine\"), **DTR**: [Deep tendon reflex](https:\/\/www.wikidoc.org\/index.php\/Deep_tendon_reflex \"Deep tendon reflex\"), **RNA**: [Ribonucleic acid](https:\/\/www.wikidoc.org\/index.php\/RNA \"RNA\")\n\n|   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |\n|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|\n| Cause | **Clinical manifestation** | **Lab findings** | Extra intestinal findings | Cause\/Pathogenesis | Gold standard diagnosis |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |\n| Symptoms | GI signs |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |\n| Duration | Diarrhea | Fever | Abdominal pain | Weight loss |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |\n| Stool exam | **CBC** | Other lab findings |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |\n| Acute | Chronic | Watery | Bloody | Fatty | WBC | RBC | Ova\/Parasite | Osmotic gap | Other | WBC | Hgb | Plt |   |   |   |   |   |   |   |   |   |   |\n| [Crohn's disease](https:\/\/www.wikidoc.org\/index.php\/Crohns_disease \"Crohns disease\") | – | \\+ | \\+ | \\+ | \\+ | ± | \\+ | \\+ | [Abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Abdominal_tenderness \"Abdominal tenderness\") Oral [mucosal](https:\/\/www.wikidoc.org\/index.php\/Mucosal \"Mucosal\") lesions | \\+ | \\+ | – | Nl | – | ↑ | ↓ | ↑ | [Anti saccharomyces cerevisiae antibodies](https:\/\/www.wikidoc.org\/index.php\/Anti_saccharomyces_cerevisiae_antibodies \"Anti saccharomyces cerevisiae antibodies\") (ASCA) [Vitamin B12](https:\/\/www.wikidoc.org\/index.php\/Vitamin_B12 \"Vitamin B12\") deficiency Elevated [ESR](https:\/\/www.wikidoc.org\/index.php\/Erythrocyte_sedimentation_rate \"Erythrocyte sedimentation rate\") Elevated [CRP](https:\/\/www.wikidoc.org\/index.php\/C-reactive_protein \"C-reactive protein\") | [Uveitis](https:\/\/www.wikidoc.org\/index.php\/Uveitis \"Uveitis\") [Arthritis](https:\/\/www.wikidoc.org\/index.php\/Arthritis \"Arthritis\") [Erythema nodosum](https:\/\/www.wikidoc.org\/index.php\/Erythema_nodosum \"Erythema nodosum\") [Pyoderma gangrenosum](https:\/\/www.wikidoc.org\/index.php\/Pyoderma_gangrenosum \"Pyoderma gangrenosum\") [Amyloidosis](https:\/\/www.wikidoc.org\/index.php\/Amyloidosis \"Amyloidosis\") Venous and arterial [thromboembolism](https:\/\/www.wikidoc.org\/index.php\/Thromboembolism \"Thromboembolism\") [Renal stones](https:\/\/www.wikidoc.org\/index.php\/Kidney_stone \"Kidney stone\") [Bronchiectasis](https:\/\/www.wikidoc.org\/index.php\/Bronchiectasis \"Bronchiectasis\") | Abnormal immune response to self [antigens](https:\/\/www.wikidoc.org\/index.php\/Antigens \"Antigens\") | [Colonoscopy](https:\/\/www.wikidoc.org\/index.php\/Colonoscopy \"Colonoscopy\") with [biopsy](https:\/\/www.wikidoc.org\/index.php\/Biopsy \"Biopsy\") |   |\n| [Ulcerative colitis](https:\/\/www.wikidoc.org\/index.php\/Ulcerative_colitis \"Ulcerative colitis\") | – | \\+ | \\+ | \\+ | \\+ | ± | \\+ | \\+ | [Abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Abdominal_tenderness \"Abdominal tenderness\") [Blood](https:\/\/www.wikidoc.org\/index.php\/Blood \"Blood\") on [rectal examination](https:\/\/www.wikidoc.org\/index.php\/Rectal_examination \"Rectal examination\") | \\+ | \\+ | – | Nl | – | ↑ | ↓ | ↑ | [Anti–neutrophil cytoplasmic antibody](https:\/\/www.wikidoc.org\/index.php\/Anti-neutrophil_cytoplasmic_antibody \"Anti-neutrophil cytoplasmic antibody\") ([P–ANCA](https:\/\/www.wikidoc.org\/index.php\/P-ANCA \"P-ANCA\")) [Hypoalbuminemia](https:\/\/www.wikidoc.org\/index.php\/Hypoalbuminemia \"Hypoalbuminemia\") [Hypokalemia](https:\/\/www.wikidoc.org\/index.php\/Hypokalemia \"Hypokalemia\") [Hypomagnesemia](https:\/\/www.wikidoc.org\/index.php\/Hypomagnesemia \"Hypomagnesemia\") Elevated [ESR](https:\/\/www.wikidoc.org\/index.php\/Erythrocyte_sedimentation_rate \"Erythrocyte sedimentation rate\") Elevated [CRP](https:\/\/www.wikidoc.org\/index.php\/C-reactive_protein \"C-reactive protein\") | [Skin rash](https:\/\/www.wikidoc.org\/index.php\/Skin_rash \"Skin rash\") [Iritis](https:\/\/www.wikidoc.org\/index.php\/Iritis \"Iritis\") [Uveitis](https:\/\/www.wikidoc.org\/index.php\/Uveitis \"Uveitis\") Seronegative [arthritis](https:\/\/www.wikidoc.org\/index.php\/Arthritis \"Arthritis\") [Clubbing](https:\/\/www.wikidoc.org\/index.php\/Clubbing \"Clubbing\") [Erythema nodosum](https:\/\/www.wikidoc.org\/index.php\/Erythema_nodosum \"Erythema nodosum\") | Abnormal immune response to self [antigens](https:\/\/www.wikidoc.org\/index.php\/Antigens \"Antigens\") | [Colonoscopy](https:\/\/www.wikidoc.org\/index.php\/Colonoscopy \"Colonoscopy\") with [biopsy](https:\/\/www.wikidoc.org\/index.php\/Biopsy \"Biopsy\") |   |\n| [Celiac disease](https:\/\/www.wikidoc.org\/index.php\/Celiac_disease \"Celiac disease\") | – | \\+ | ± | – | ± | – | \\+ | \\+ | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distention \"Abdominal distention\") Increased [bowel](https:\/\/www.wikidoc.org\/index.php\/Bowel \"Bowel\") sounds Oral [mucosal](https:\/\/www.wikidoc.org\/index.php\/Mucous_membrane \"Mucous membrane\") lesions [Hepatosplenomegaly](https:\/\/www.wikidoc.org\/index.php\/Hepatosplenomegaly \"Hepatosplenomegaly\") [Ascites](https:\/\/www.wikidoc.org\/index.php\/Ascites \"Ascites\") | – | – | – | Nl | Fat droplets on [sudan stain](https:\/\/www.wikidoc.org\/index.php\/Sudan_stain \"Sudan stain\") | Nl | ↓ | Nl | [IgA](https:\/\/www.wikidoc.org\/index.php\/IgA \"IgA\") endomysial [antibody](https:\/\/www.wikidoc.org\/index.php\/Antibody \"Antibody\") Anti–tissue [transglutaminase](https:\/\/www.wikidoc.org\/index.php\/Transglutaminase \"Transglutaminase\") [antibody](https:\/\/www.wikidoc.org\/index.php\/Antibody \"Antibody\") [Anti–gliadin antibody](https:\/\/www.wikidoc.org\/index.php\/Anti-gliadin_antibodies \"Anti-gliadin antibodies\") [Fat soluble vitamins](https:\/\/www.wikidoc.org\/index.php\/Fat_soluble_vitamins \"Fat soluble vitamins\") deficiency | [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") [Dementia](https:\/\/www.wikidoc.org\/index.php\/Dementia \"Dementia\") [Dermatitis herpetiformis](https:\/\/www.wikidoc.org\/index.php\/Dermatitis_herpetiformis \"Dermatitis herpetiformis\") | [HLA–DQ2](https:\/\/www.wikidoc.org\/index.php\/HLA-DQ2 \"HLA-DQ2\") [HLA–DQ8](https:\/\/www.wikidoc.org\/index.php\/HLA-DQ8 \"HLA-DQ8\") Innate responses to wheat [proteins](https:\/\/www.wikidoc.org\/index.php\/Protein \"Protein\") | [IgA](https:\/\/www.wikidoc.org\/index.php\/IgA \"IgA\") endomysial [antibody](https:\/\/www.wikidoc.org\/index.php\/Antibody \"Antibody\") Anti–tissue [transglutaminase](https:\/\/www.wikidoc.org\/index.php\/Transglutaminase \"Transglutaminase\") [antibody](https:\/\/www.wikidoc.org\/index.php\/Antibody \"Antibody\") |   |\n| Cause | Duration | Diarrhea | Fever | Abdominal pain | Weight loss | GI signs | Stool exam | CBC | Other lab findings | Extra intestinal findings | Cause\/Pathogenesis | Gold standard diagnosis |   |   |   |   |   |   |   |   |   |   |\n| Acute | Chronic | Watery | Bloody | Fatty | WBC | RBC | Ova\/Parasite | Osmotic gap | Other | WBC | Hgb | Plt |   |   |   |   |   |   |   |   |   |   |\n| [Cystic fibrosis](https:\/\/www.wikidoc.org\/index.php\/Cystic_fibrosis \"Cystic fibrosis\") | – | \\+ | – | – | \\+ | ± | \\+ | \\+ | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distension \"Abdominal distension\") [Hepatosplenomegaly](https:\/\/www.wikidoc.org\/index.php\/Hepatosplenomegaly \"Hepatosplenomegaly\") [Rectal prolapse](https:\/\/www.wikidoc.org\/index.php\/Rectal_prolapse \"Rectal prolapse\") | – | – | – | Nl | Fat droplets on [sudan stain](https:\/\/www.wikidoc.org\/index.php\/Sudan_stain \"Sudan stain\") | Nl | ↓ | Nl | Positive [DNA](https:\/\/www.wikidoc.org\/index.php\/DNA \"DNA\") analysis for [cystic fibrosis transmembrane conductance regulator](https:\/\/www.wikidoc.org\/index.php\/CFTR \"CFTR\") [(CFTR)](https:\/\/www.wikidoc.org\/index.php\/CFTR \"CFTR\") Nasal transepithelial potential difference [Fat soluble vitamins](https:\/\/www.wikidoc.org\/index.php\/Fat_soluble_vitamins \"Fat soluble vitamins\") deficiency | [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") Recurrent [respiratory tract infection](https:\/\/www.wikidoc.org\/index.php\/Respiratory_tract_infection \"Respiratory tract infection\") [Bronchiectasis](https:\/\/www.wikidoc.org\/index.php\/Bronchiectasis \"Bronchiectasis\") [Diabetes mellitus](https:\/\/www.wikidoc.org\/index.php\/Diabetes_mellitus \"Diabetes mellitus\") [Scoliosis](https:\/\/www.wikidoc.org\/index.php\/Scoliosis \"Scoliosis\") [Infertility](https:\/\/www.wikidoc.org\/index.php\/Infertility \"Infertility\") | Mutations in the [cystic fibrosis transmembrane conductance regulator](https:\/\/www.wikidoc.org\/index.php\/Cystic_fibrosis_transmembrane_conductance_regulator \"Cystic fibrosis transmembrane conductance regulator\") ([CFTR](https:\/\/www.wikidoc.org\/index.php\/CFTR \"CFTR\")) protein | Positive [genetic testing](https:\/\/www.wikidoc.org\/index.php\/Genetic_testing \"Genetic testing\") Elevated [sweat chloride](https:\/\/www.wikidoc.org\/index.php\/Sweat_chloride_test \"Sweat chloride test\") ≥60 mmol\/L |   |\n| [Chronic pancreatitis](https:\/\/www.wikidoc.org\/index.php\/Chronic_pancreatitis \"Chronic pancreatitis\") | – | \\+ | \\+ | – | \\+ | – | \\+ | \\+ | [Abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") | – | – | – | Nl | Fat droplets on [sudan stain](https:\/\/www.wikidoc.org\/index.php\/Sudan_stain \"Sudan stain\") Positive [fecal elastase](https:\/\/www.wikidoc.org\/index.php\/Fecal_elastase \"Fecal elastase\") measurement | Nl | Nl | Nl | Slightly elevated [amylase](https:\/\/www.wikidoc.org\/index.php\/Amylase \"Amylase\") and [lipase](https:\/\/www.wikidoc.org\/index.php\/Lipase \"Lipase\") Abnormal pancreatic function test [Secretin](https:\/\/www.wikidoc.org\/index.php\/Secretin \"Secretin\") stimulation test | [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") [Diabetes mellitus](https:\/\/www.wikidoc.org\/index.php\/Diabetes_mellitus \"Diabetes mellitus\") [Pancreatic pseudocyst](https:\/\/www.wikidoc.org\/index.php\/Pancreatic_pseudocyst \"Pancreatic pseudocyst\") | [Toxins](https:\/\/www.wikidoc.org\/index.php\/Toxin \"Toxin\") Recurrent [acute pancreatitis](https:\/\/www.wikidoc.org\/index.php\/Acute_pancreatitis \"Acute pancreatitis\") [Genetic](https:\/\/www.wikidoc.org\/index.php\/Genetics \"Genetics\") predesposition [Autoimmune](https:\/\/www.wikidoc.org\/index.php\/Autoimmunity \"Autoimmunity\") | [Magnetic resonance cholangiopancreatography](https:\/\/www.wikidoc.org\/index.php\/Magnetic_resonance_cholangiopancreatography \"Magnetic resonance cholangiopancreatography\") ([MRCP](https:\/\/www.wikidoc.org\/index.php\/Magnetic_resonance_cholangiopancreatography \"Magnetic resonance cholangiopancreatography\")) |   |\n| [Bile acid malabsorption](https:\/\/www.wikidoc.org\/index.php\/Bile_acid_malabsorption \"Bile acid malabsorption\") | – | \\+ | \\+ | – | \\+ | – | – | \\+ |   | – | – | – | Nl | Fat droplets on [sudan stain](https:\/\/www.wikidoc.org\/index.php\/Sudan_stain \"Sudan stain\") | Nl | Nl | Nl | Reduced [cholesterol](https:\/\/www.wikidoc.org\/index.php\/Cholesterol \"Cholesterol\") level | [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") [Hypotension](https:\/\/www.wikidoc.org\/index.php\/Hypotension \"Hypotension\") [Tachycardia](https:\/\/www.wikidoc.org\/index.php\/Tachycardia \"Tachycardia\") | Genetic defects in *[SLC10A2](https:\/\/www.wikidoc.org\/index.php\/SLC10A2 \"SLC10A2\")* | [SeHCAT](https:\/\/www.wikidoc.org\/index.php\/SeHCAT \"SeHCAT\") test |   |\n| [Microscopic colitis](https:\/\/www.wikidoc.org\/index.php\/Microscopic_colitis \"Microscopic colitis\") | – | \\+ | \\+ | – | – | – | \\+ | \\+ | [Abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Abdominal_tenderness \"Abdominal tenderness\") Fecal [incontinence](https:\/\/www.wikidoc.org\/index.php\/Incontinence \"Incontinence\") | – | – | – | Nl | – | Nl | ↓ | Nl | [Hypokalemia](https:\/\/www.wikidoc.org\/index.php\/Hypokalemia \"Hypokalemia\") Elevated [CRP](https:\/\/www.wikidoc.org\/index.php\/C-reactive_protein \"C-reactive protein\") Positive [autoantibodies](https:\/\/www.wikidoc.org\/index.php\/Autoantibodies \"Autoantibodies\") include: RF [ANA](https:\/\/www.wikidoc.org\/index.php\/ANA \"ANA\") [AMA](https:\/\/www.wikidoc.org\/index.php\/Anti-mitochondrial_antibody \"Anti-mitochondrial antibody\") [ANCA](https:\/\/www.wikidoc.org\/index.php\/ANCA \"ANCA\") | [Arthritis](https:\/\/www.wikidoc.org\/index.php\/Arthritis \"Arthritis\") [Uveitis](https:\/\/www.wikidoc.org\/index.php\/Uveitis \"Uveitis\") [Idiopathic thrombocytopenic purpura](https:\/\/www.wikidoc.org\/index.php\/Idiopathic_thrombocytopenic_purpura \"Idiopathic thrombocytopenic purpura\") Pleuro [pericarditis](https:\/\/www.wikidoc.org\/index.php\/Pericarditis \"Pericarditis\") [Hypothyroidism](https:\/\/www.wikidoc.org\/index.php\/Hypothyroidism \"Hypothyroidism\") [Psoriasis](https:\/\/www.wikidoc.org\/index.php\/Psoriasis \"Psoriasis\") | [Mucosal](https:\/\/www.wikidoc.org\/index.php\/Mucosal \"Mucosal\") [immune responses](https:\/\/www.wikidoc.org\/index.php\/Immune_responses \"Immune responses\") to luminal factors in a genetically predisposed individual Drug–induced | [Colonoscopy](https:\/\/www.wikidoc.org\/index.php\/Colonoscopy \"Colonoscopy\") with [mucosal](https:\/\/www.wikidoc.org\/index.php\/Mucosal \"Mucosal\") [biopsy](https:\/\/www.wikidoc.org\/index.php\/Biopsy \"Biopsy\") with [mononuclear](https:\/\/www.wikidoc.org\/index.php\/Mononuclear \"Mononuclear\") infiltrates: [Collagenous colitis](https:\/\/www.wikidoc.org\/index.php\/Collagenous_colitis \"Collagenous colitis\") is characterized by a colonic subepithelial [collagen](https:\/\/www.wikidoc.org\/index.php\/Collagen \"Collagen\") band \\>10 micrometers in diameter [Lymphocytic](https:\/\/www.wikidoc.org\/index.php\/Lymphocytic \"Lymphocytic\") [colitis](https:\/\/www.wikidoc.org\/index.php\/Colitis \"Colitis\") is characterized by ≥20 intraepithelial [lymphocytes](https:\/\/www.wikidoc.org\/index.php\/Lymphocytes \"Lymphocytes\") (IEL) per 100 surface epithelial cells |   |\n| Cause | Duration | Diarrhea | Fever | Abdominal pain | Weight loss | GI signs | Stool exam | CBC | Other lab findings | Extra intestinal findings | Cause\/Pathogenesis | Gold standard diagnosis |   |   |   |   |   |   |   |   |   |   |\n| Acute | Chronic | Watery | Bloody | Fatty | WBC | RBC | Ova\/Parasite | Osmotic gap | Other | WBC | Hgb | Plt |   |   |   |   |   |   |   |   |   |   |\n| [Infective colitis](https:\/\/www.wikidoc.org\/index.php\/Infective_colitis \"Infective colitis\") | – | \\+ | \\+ | \\+ | – | \\+ | \\+ | \\+ | Rebound [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") | \\+ | \\+ | \\+ | Nl | Positive [stool culture](https:\/\/www.wikidoc.org\/index.php\/Stool_culture \"Stool culture\") Positive fecal calprotectin Positive fecal [lactoferrin](https:\/\/www.wikidoc.org\/index.php\/Lactoferrin \"Lactoferrin\") | ↑ | ↓ | ↑ | Elevated [CRP](https:\/\/www.wikidoc.org\/index.php\/C-reactive_protein \"C-reactive protein\") Elevated [ESR](https:\/\/www.wikidoc.org\/index.php\/Erythrocyte_sedimentation_rate \"Erythrocyte sedimentation rate\") | [Arthritis](https:\/\/www.wikidoc.org\/index.php\/Arthritis \"Arthritis\") [Uveitis](https:\/\/www.wikidoc.org\/index.php\/Uveitis \"Uveitis\") | [*Salmonella*](https:\/\/www.wikidoc.org\/index.php\/Salmonella \"Salmonella\") [*Shigella*](https:\/\/www.wikidoc.org\/index.php\/Shigella \"Shigella\") [*Campylobacter*](https:\/\/www.wikidoc.org\/index.php\/Campylobacter \"Campylobacter\") *[E. coli 0157:H7](https:\/\/www.wikidoc.org\/index.php\/Escherichia_coli \"Escherichia coli\")* [*Clostridium difficile*](https:\/\/www.wikidoc.org\/index.php\/Clostridium_difficile \"Clostridium difficile\") [*Entamoeba histolytica*](https:\/\/www.wikidoc.org\/index.php\/Entamoeba_histolytica \"Entamoeba histolytica\") [*Adenovirus*](https:\/\/www.wikidoc.org\/index.php\/Adenoviridae \"Adenoviridae\") [*Cytomegalovirus*](https:\/\/www.wikidoc.org\/index.php\/Cytomegalovirus \"Cytomegalovirus\") [*Herpes simplex virus*](https:\/\/www.wikidoc.org\/index.php\/Herpes_simplex_virus \"Herpes simplex virus\") | [Stool culture](https:\/\/www.wikidoc.org\/index.php\/Stool_culture \"Stool culture\") [Blood culture](https:\/\/www.wikidoc.org\/index.php\/Blood_culture \"Blood culture\") |   |\n| [Ischemic colitis](https:\/\/www.wikidoc.org\/index.php\/Ischemic_colitis \"Ischemic colitis\") | \\+ | \\+ | \\+ | \\+ | – | \\+ | \\+ | \\+ | Hyperactive then absent [bowel sounds](https:\/\/www.wikidoc.org\/index.php\/Stomach_rumble \"Stomach rumble\") [Abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") | \\+ | \\+ | – | Nl | – | ↑ | ↓ | ↑ | Elevated [CRP](https:\/\/www.wikidoc.org\/index.php\/C-reactive_protein \"C-reactive protein\") Elevated [ESR](https:\/\/www.wikidoc.org\/index.php\/Erythrocyte_sedimentation_rate \"Erythrocyte sedimentation rate\") Elevated serum [lactate](https:\/\/www.wikidoc.org\/index.php\/Lactic_acid \"Lactic acid\") Elevated [lactate dehydrogenase](https:\/\/www.wikidoc.org\/index.php\/Lactate_dehydrogenase \"Lactate dehydrogenase\") ([LDH](https:\/\/www.wikidoc.org\/index.php\/Lactate_dehydrogenase \"Lactate dehydrogenase\")) Elevated [creatine phosphokinase](https:\/\/www.wikidoc.org\/index.php\/Creatine_kinase \"Creatine kinase\") ([CPK](https:\/\/www.wikidoc.org\/index.php\/Creatine_kinase \"Creatine kinase\")) Elevated [amylase](https:\/\/www.wikidoc.org\/index.php\/Amylase \"Amylase\") [Hypoalbuminemia](https:\/\/www.wikidoc.org\/index.php\/Hypoalbuminemia \"Hypoalbuminemia\") | [IgA vasculitis](https:\/\/www.wikidoc.org\/index.php\/Henoch-Sch%C3%B6nlein_purpura \"Henoch-Schönlein purpura\") | [Hypercoagulability](https:\/\/www.wikidoc.org\/index.php\/Thrombophilia \"Thrombophilia\") Nonocclusive [colonic ischemia](https:\/\/www.wikidoc.org\/index.php\/Ischemic_colitis \"Ischemic colitis\") [Embolic](https:\/\/www.wikidoc.org\/index.php\/Embolism \"Embolism\") and [thrombotic](https:\/\/www.wikidoc.org\/index.php\/Thrombosis \"Thrombosis\") arterial occlusion [Mesenteric vein thrombosis](https:\/\/www.wikidoc.org\/index.php\/Mesenteric_vein_thrombosis \"Mesenteric vein thrombosis\") | Abdominal [CT scan](https:\/\/www.wikidoc.org\/index.php\/Computed_tomography \"Computed tomography\") |   |\n| [Lactose intolerance](https:\/\/www.wikidoc.org\/index.php\/Lactose_intolerance \"Lactose intolerance\") | \\+ | \\+ | \\+ | – | – | – | \\+ | – | [Abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Abdominal_tenderness \"Abdominal tenderness\") [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distention \"Abdominal distention\") | – | – | – | ↑ | – | Nl | Nl | Nl | Lactose tolerance test Genetic testing | [Headache](https:\/\/www.wikidoc.org\/index.php\/Headache \"Headache\") [Vertigo](https:\/\/www.wikidoc.org\/index.php\/Vertigo \"Vertigo\") [Memory impairment](https:\/\/www.wikidoc.org\/index.php\/Memory_impairment \"Memory impairment\") [Lethargy](https:\/\/www.wikidoc.org\/index.php\/Lethargy \"Lethargy\") | Reduction of lactase enzyme activity or inability to produce persistent [lactase](https:\/\/www.wikidoc.org\/index.php\/Lactase \"Lactase\") Congenital [lactase deficiency](https:\/\/www.wikidoc.org\/index.php\/Lactase_deficiency \"Lactase deficiency\") Secondary lactose malabsorption | [Small bowel](https:\/\/www.wikidoc.org\/index.php\/Small_bowel \"Small bowel\") [biopsy](https:\/\/www.wikidoc.org\/index.php\/Biopsy \"Biopsy\") Lactose breath hydrogen test |   |\n| [Irritable bowel syndrome](https:\/\/www.wikidoc.org\/index.php\/Irritable_bowel_syndrome \"Irritable bowel syndrome\") | – | \\+ | ± | – | ± | – | ± | – | [Abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Abdominal_tenderness \"Abdominal tenderness\") [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distention \"Abdominal distention\") Normal [bowel sounds](https:\/\/www.wikidoc.org\/index.php\/Stomach_rumble \"Stomach rumble\") | – | – | – | Nl | – | Nl | Nl | Nl | Nl | [Anxiety](https:\/\/www.wikidoc.org\/index.php\/Anxiety \"Anxiety\") [Palpitation](https:\/\/www.wikidoc.org\/index.php\/Palpitation \"Palpitation\") | Unknown | Diagnosis of exclusion |   |\n| Cause | Duration | Diarrhea | Fever | Abdominal pain | Weight loss | GI signs | Stool exam | CBC | Other lab findings | Extra intestinal findings | Cause\/Pathogenesis | Gold standard diagnosis |   |   |   |   |   |   |   |   |   |   |\n| Acute | Chronic | Watery | Bloody | Fatty | WBC | RBC | Ova\/Parasite | Osmotic gap | Other | WBC | Hgb | Plt |   |   |   |   |   |   |   |   |   |   |\n| [Whipple's disease](https:\/\/www.wikidoc.org\/index.php\/Whipple%27s_disease \"Whipple's disease\") | – | \\+ | \\+ | – | \\+ | ± | \\+ | \\+ | [Hepatosplenomegaly](https:\/\/www.wikidoc.org\/index.php\/Hepatosplenomegaly \"Hepatosplenomegaly\") [Ascites](https:\/\/www.wikidoc.org\/index.php\/Ascites \"Ascites\") | – | – | – | Nl | Positive [fecal fat](https:\/\/www.wikidoc.org\/index.php\/Fecal_fat \"Fecal fat\") | ↓ | ↓ | ↓\/↑ | [Hypoalbuminemia](https:\/\/www.wikidoc.org\/index.php\/Hypoalbuminemia \"Hypoalbuminemia\") [Fat soluble vitamins](https:\/\/www.wikidoc.org\/index.php\/Fat_soluble_vitamins \"Fat soluble vitamins\") deficiency | [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") [Abnormal extraocular movement](https:\/\/www.wikidoc.org\/index.php\/Ocular_motility_disorders \"Ocular motility disorders\") [Lymphadenopathy](https:\/\/www.wikidoc.org\/index.php\/Lymphadenopathy \"Lymphadenopathy\") [Hyperpigmentation](https:\/\/www.wikidoc.org\/index.php\/Hyperpigmentation \"Hyperpigmentation\") [Uveitis](https:\/\/www.wikidoc.org\/index.php\/Uveitis \"Uveitis\") [Endocarditis](https:\/\/www.wikidoc.org\/index.php\/Endocarditis \"Endocarditis\") [Encephalitis](https:\/\/www.wikidoc.org\/index.php\/Encephalitis \"Encephalitis\") [Dementia](https:\/\/www.wikidoc.org\/index.php\/Dementia \"Dementia\") [Pleural effusion](https:\/\/www.wikidoc.org\/index.php\/Pleural_effusion \"Pleural effusion\") | [*Tropheryma whipplei*](https:\/\/www.wikidoc.org\/index.php\/Tropheryma_whipplei \"Tropheryma whipplei\") | [Small intestine](https:\/\/www.wikidoc.org\/index.php\/Small_intestine \"Small intestine\") [biopsy](https:\/\/www.wikidoc.org\/index.php\/Biopsy \"Biopsy\") for [Tropheryma whipplei](https:\/\/www.wikidoc.org\/index.php\/Tropheryma_whipplei \"Tropheryma whipplei\") testing [PCR](https:\/\/www.wikidoc.org\/index.php\/PCR \"PCR\") testing |   |\n| [Tropical sprue](https:\/\/www.wikidoc.org\/index.php\/Tropical_sprue \"Tropical sprue\") | \\+ | \\+ | \\+ | – | \\+ | \\+ | \\+ | \\+ | Angular [stomatitis](https:\/\/www.wikidoc.org\/index.php\/Stomatitis \"Stomatitis\") Oral mucosal lesion | \\+ | – | – | Nl | Positive [stool culture](https:\/\/www.wikidoc.org\/index.php\/Stool_culture \"Stool culture\") | Nl | ↓ | Nl | [Fat soluble vitamins](https:\/\/www.wikidoc.org\/index.php\/Fat_soluble_vitamins \"Fat soluble vitamins\") deficiency [Vitamin B12 deficiency](https:\/\/www.wikidoc.org\/index.php\/Vitamin_B12_deficiency \"Vitamin B12 deficiency\") [Folate deficiency](https:\/\/www.wikidoc.org\/index.php\/Folate_deficiency \"Folate deficiency\") [Hypokalemia](https:\/\/www.wikidoc.org\/index.php\/Hypokalemia \"Hypokalemia\") | [Myalgia](https:\/\/www.wikidoc.org\/index.php\/Myalgia \"Myalgia\") [Neuropathy](https:\/\/www.wikidoc.org\/index.php\/Neuropathy \"Neuropathy\") [Edema](https:\/\/www.wikidoc.org\/index.php\/Edema \"Edema\") | *[Escherichia coli](https:\/\/www.wikidoc.org\/index.php\/Escherichia_coli \"Escherichia coli\")* *[Klebsiella pneumoniae](https:\/\/www.wikidoc.org\/index.php\/Klebsiella_pneumoniae \"Klebsiella pneumoniae\")* *[Enterobacter cloacae](https:\/\/www.wikidoc.org\/index.php\/Enterobacter_cloacae \"Enterobacter cloacae\")* | Diagnosis of exclusion |   |\n| [Small bowel bacterial overgrowth](https:\/\/www.wikidoc.org\/index.php\/Small_bowel_bacterial_overgrowth_syndrome \"Small bowel bacterial overgrowth syndrome\") | – | \\+ | \\+ | – | \\+ | – | \\+ | \\+ | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distension \"Abdominal distension\") | \\+ | – | – | Nl | Positive [stool culture](https:\/\/www.wikidoc.org\/index.php\/Stool_culture \"Stool culture\") Positive [fecal fat](https:\/\/www.wikidoc.org\/index.php\/Fecal_fat \"Fecal fat\") | Nl | ↓ | Nl | [Hypoalbuminemia](https:\/\/www.wikidoc.org\/index.php\/Hypoalbuminemia \"Hypoalbuminemia\") Abnormal [hydrogen breath test](https:\/\/www.wikidoc.org\/index.php\/Hydrogen_Breath_Test \"Hydrogen Breath Test\") [Lactic acidosis](https:\/\/www.wikidoc.org\/index.php\/Lactic_acidosis \"Lactic acidosis\") | [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") [Rosacea](https:\/\/www.wikidoc.org\/index.php\/Rosacea \"Rosacea\") | Excess bacteria in the [small intestine](https:\/\/www.wikidoc.org\/index.php\/Small_intestine \"Small intestine\") Alterations in [intestinal](https:\/\/www.wikidoc.org\/index.php\/Intestine \"Intestine\") [anatomy](https:\/\/www.wikidoc.org\/index.php\/Anatomy \"Anatomy\") or GI motility | Diagnosis of exclusion |   |\n| Cause | Duration | Diarrhea | Fever | Abdominal pain | Weight loss | GI signs | Stool exam | CBC | Other lab findings | Extra intestinal findings | Cause\/Pathogenesis | Gold standard diagnosis |   |   |   |   |   |   |   |   |   |   |\n| Acute | Chronic | Watery | Bloody | Fatty | WBC | RBC | Ova\/Parasite | Osmotic gap | Other | WBC | Hgb | Plt |   |   |   |   |   |   |   |   |   |   |\n| [Salmonellosis](https:\/\/www.wikidoc.org\/index.php\/Salmonellosis \"Salmonellosis\") | \\+ | \\+ | \\+ | \\+ | – | \\+ | \\+ | – | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distention \"Abdominal distention\") Diffuse [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Abdominal_tenderness \"Abdominal tenderness\") [Hepatosplenomegaly](https:\/\/www.wikidoc.org\/index.php\/Hepatosplenomegaly \"Hepatosplenomegaly\") | \\+ | \\+ | – | Nl | Positive [stool culture](https:\/\/www.wikidoc.org\/index.php\/Stool_culture \"Stool culture\") Positive serologic testing | ↑ | Nl | ↑ | [Hypokalemia](https:\/\/www.wikidoc.org\/index.php\/Hypokalemia \"Hypokalemia\") [Hypernatremia](https:\/\/www.wikidoc.org\/index.php\/Hypernatremia \"Hypernatremia\") [Hyponatremia](https:\/\/www.wikidoc.org\/index.php\/Hyponatremia \"Hyponatremia\") [Hypercalciuria](https:\/\/www.wikidoc.org\/index.php\/Hypercalciuria \"Hypercalciuria\") [Hypocitraturia](https:\/\/www.wikidoc.org\/index.php\/Hypocitraturia \"Hypocitraturia\") | [Post–infectious arthritis](https:\/\/www.wikidoc.org\/index.php\/Post-infectious_arthritis \"Post-infectious arthritis\") [Obtundation](https:\/\/www.wikidoc.org\/index.php\/Obtundation \"Obtundation\") [Bacteremia](https:\/\/www.wikidoc.org\/index.php\/Bacteremia \"Bacteremia\") [Pericarditis](https:\/\/www.wikidoc.org\/index.php\/Pericarditis \"Pericarditis\") [Pyelonephritis](https:\/\/www.wikidoc.org\/index.php\/Pyelonephritis \"Pyelonephritis\") [Brain abscess](https:\/\/www.wikidoc.org\/index.php\/Brain_abscess \"Brain abscess\") | [*Salmonella*](https:\/\/www.wikidoc.org\/index.php\/Salmonella \"Salmonella\") | [Stool culture](https:\/\/www.wikidoc.org\/index.php\/Stool_culture \"Stool culture\") |   |\n| [Escherichia coli enteritis](https:\/\/www.wikidoc.org\/index.php\/Escherichia_coli_enteritis \"Escherichia coli enteritis\") | [**EPEC**](https:\/\/www.wikidoc.org\/index.php\/EPEC \"EPEC\") | \\+ | \\+ | \\+ | \\+ | – | \\+ | \\+ | \\+ | Diffuse [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Abdominal_tenderness \"Abdominal tenderness\") | \\+ | \\+ | – | Nl | Positive [stool culture](https:\/\/www.wikidoc.org\/index.php\/Stool_culture \"Stool culture\") | ↑ | Nl | Nl | – | – | *[Enteropathogenic E. coli](https:\/\/www.wikidoc.org\/index.php\/Enteropathogenic_E._coli \"Enteropathogenic E. coli\")* | [DNA probe](https:\/\/www.wikidoc.org\/index.php\/Hybridization_probe \"Hybridization probe\") or [polymerase chain reaction](https:\/\/www.wikidoc.org\/index.php\/Polymerase_chain_reaction \"Polymerase chain reaction\") ([PCR](https:\/\/www.wikidoc.org\/index.php\/Polymerase_chain_reaction \"Polymerase chain reaction\")) of the *EPEC* adherence factor [Stool culture](https:\/\/www.wikidoc.org\/index.php\/Stool_culture \"Stool culture\") |\n| [**EAEC**](https:\/\/www.wikidoc.org\/index.php\/EAEC \"EAEC\") | \\+ | \\+ | \\+ | \\+ | – | – | \\+ | – | Diffuse [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Abdominal_tenderness \"Abdominal tenderness\") | \\+ | \\+ | – | Nl | Positive [stool culture](https:\/\/www.wikidoc.org\/index.php\/Stool_culture \"Stool culture\") | ↑ | ↓ | ↓ | – | Chronic infection in [immunocompromised](https:\/\/www.wikidoc.org\/index.php\/Immunodeficiency \"Immunodeficiency\") patients | [*Enteroaggregative E. coli*](https:\/\/www.wikidoc.org\/index.php\/Escherichia_coli_enteritis \"Escherichia coli enteritis\") | [Stool culture](https:\/\/www.wikidoc.org\/index.php\/Stool_culture \"Stool culture\") |   |\n| [Aeromonas](https:\/\/www.wikidoc.org\/index.php\/Aeromonas \"Aeromonas\") | \\+ | \\+ | \\+ | \\+ | – | \\+ | \\+ | – | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distention \"Abdominal distention\") Hyperactive [bowel sounds](https:\/\/www.wikidoc.org\/index.php\/Stomach_rumble \"Stomach rumble\") Diffuse [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Abdominal_tenderness \"Abdominal tenderness\") | \\+ | \\+ | – | Nl | Positive [stool culture](https:\/\/www.wikidoc.org\/index.php\/Stool_culture \"Stool culture\") | ↑ | Nl | Nl | – | Wound [infection](https:\/\/www.wikidoc.org\/index.php\/Infection \"Infection\") [Bacteremia](https:\/\/www.wikidoc.org\/index.php\/Bacteremia \"Bacteremia\") [Hemolytic uremic syndrome](https:\/\/www.wikidoc.org\/index.php\/Hemolytic-uremic_syndrome \"Hemolytic-uremic syndrome\") [Meningitis](https:\/\/www.wikidoc.org\/index.php\/Meningitis \"Meningitis\") [Ocular](https:\/\/www.wikidoc.org\/index.php\/Ocular \"Ocular\") infection [Pneumonia](https:\/\/www.wikidoc.org\/index.php\/Pneumonia \"Pneumonia\") [Urinary tract infection](https:\/\/www.wikidoc.org\/index.php\/Urinary_tract_infection \"Urinary tract infection\") [Osteomyelitis](https:\/\/www.wikidoc.org\/index.php\/Osteomyelitis \"Osteomyelitis\") [Peritonitis](https:\/\/www.wikidoc.org\/index.php\/Peritonitis \"Peritonitis\") [Acute cholecystitis](https:\/\/www.wikidoc.org\/index.php\/Acute_cholecystitis \"Acute cholecystitis\") [Opportunistic infections](https:\/\/www.wikidoc.org\/index.php\/Opportunistic_infection \"Opportunistic infection\") in [immunocompromised](https:\/\/www.wikidoc.org\/index.php\/Immunodeficiency \"Immunodeficiency\") patients | *[Aeromonas](https:\/\/www.wikidoc.org\/index.php\/Aeromonas \"Aeromonas\")* virulence factors including [endotoxins](https:\/\/www.wikidoc.org\/index.php\/Endotoxin \"Endotoxin\"), [hemolysins](https:\/\/www.wikidoc.org\/index.php\/Hemolysin \"Hemolysin\"), [enterotoxins](https:\/\/www.wikidoc.org\/index.php\/Enterotoxin \"Enterotoxin\"), and adherence factors | [Blood culture](https:\/\/www.wikidoc.org\/index.php\/Blood_culture \"Blood culture\") Wound [culture](https:\/\/www.wikidoc.org\/index.php\/Culture_collection \"Culture collection\") |   |\n| Cause | Duration | Diarrhea | Fever | Abdominal pain | Weight loss | GI signs | Stool exam | CBC | Other lab findings | Extra intestinal findings | Cause\/Pathogenesis | Gold standard diagnosis |   |   |   |   |   |   |   |   |   |   |\n| Acute | Chronic | Watery | Bloody | Fatty | WBC | RBC | Ova\/Parasite | Osmotic gap | Other | WBC | Hgb | Plt |   |   |   |   |   |   |   |   |   |   |\n| [Mycobacterium avium complex](https:\/\/www.wikidoc.org\/index.php\/Mycobacterium_avium_complex \"Mycobacterium avium complex\") | \\+ | \\+ | \\+ | \\+ | – | \\+ | \\+ | – | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distension \"Abdominal distension\") [Hepatosplenomegaly](https:\/\/www.wikidoc.org\/index.php\/Hepatosplenomegaly \"Hepatosplenomegaly\") | \\+ | \\+ | – | Nl | – | ↓ | ↓ | Nl | Elevated [liver enzymes](https:\/\/www.wikidoc.org\/index.php\/Liver_function_tests \"Liver function tests\") | [Opportunistic infection](https:\/\/www.wikidoc.org\/index.php\/Opportunistic_infection \"Opportunistic infection\") in [immunocompromised](https:\/\/www.wikidoc.org\/index.php\/Immunodeficiency \"Immunodeficiency\") patients [Pulmonary](https:\/\/www.wikidoc.org\/index.php\/Pulmonary \"Pulmonary\") [infection](https:\/\/www.wikidoc.org\/index.php\/Infection \"Infection\") [Adenopathy](https:\/\/www.wikidoc.org\/index.php\/Lymphadenopathy \"Lymphadenopathy\") [Night sweats](https:\/\/www.wikidoc.org\/index.php\/Sleep_hyperhidrosis \"Sleep hyperhidrosis\") | [*Mycobacterium avium complex*](https:\/\/www.wikidoc.org\/index.php\/Mycobacterium_avium_complex \"Mycobacterium avium complex\") | [Blood culture](https:\/\/www.wikidoc.org\/index.php\/Blood_culture \"Blood culture\") |   |\n| [CMV colitis](https:\/\/www.wikidoc.org\/index.php\/CMV_colitis \"CMV colitis\") | \\+ | \\+ | – | \\+ | – | ± | \\+ | – | Diffuse [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") | \\+ | \\+ | – | Nl | Viral antigen assay | ↓ | Nl | Nl | Decreased [CD4](https:\/\/www.wikidoc.org\/index.php\/CD4 \"CD4\") level Abnormal [liver function test](https:\/\/www.wikidoc.org\/index.php\/Liver_function_tests \"Liver function tests\") | [Encephalitis](https:\/\/www.wikidoc.org\/index.php\/Encephalitis \"Encephalitis\") [Guillain–Barré syndrome](https:\/\/www.wikidoc.org\/index.php\/Guillain-Barr%C3%A9_syndrome \"Guillain-Barré syndrome\") [Pneumonia](https:\/\/www.wikidoc.org\/index.php\/Pneumonia \"Pneumonia\") [Retinitis](https:\/\/www.wikidoc.org\/index.php\/Retinitis \"Retinitis\") [Pericarditis](https:\/\/www.wikidoc.org\/index.php\/Pericarditis \"Pericarditis\") and [myocarditis](https:\/\/www.wikidoc.org\/index.php\/Myocarditis \"Myocarditis\") [Atherosclerosis](https:\/\/www.wikidoc.org\/index.php\/Atherosclerosis \"Atherosclerosis\") [Venous thrombosis](https:\/\/www.wikidoc.org\/index.php\/Venous_thromboembolism \"Venous thromboembolism\") | [*Cytomegalovirus*](https:\/\/www.wikidoc.org\/index.php\/Cytomegalovirus \"Cytomegalovirus\") | [Quantitative PCR](https:\/\/www.wikidoc.org\/index.php\/Quantitative_polymerase_chain_reaction \"Quantitative polymerase chain reaction\") tests |   |\n| [HIV](https:\/\/www.wikidoc.org\/index.php\/Human_Immunodeficiency_Virus_\\(HIV\\) \"Human Immunodeficiency Virus (HIV)\") | – | \\+ | \\+ | – | – | \\+ | \\+ | \\+ | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distension \"Abdominal distension\") Diffuse [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") | \\+ | – | – | Nl | – | ↓ | ↓ | Nl | Decreased [CD4](https:\/\/www.wikidoc.org\/index.php\/CD4 \"CD4\") level [Electrolyte imbalance](https:\/\/www.wikidoc.org\/index.php\/Electrolyte_disturbance \"Electrolyte disturbance\") | [Lymphadenopathy](https:\/\/www.wikidoc.org\/index.php\/Lymphadenopathy \"Lymphadenopathy\") Disseminated [infection](https:\/\/www.wikidoc.org\/index.php\/Infection \"Infection\") | [*HIV*](https:\/\/www.wikidoc.org\/index.php\/Human_Immunodeficiency_Virus_\\(HIV\\) \"Human Immunodeficiency Virus (HIV)\") | HIV virologic (viral load) test Immunoassay |   |\n| Cause | Duration | Diarrhea | Fever | Abdominal pain | Weight loss | GI signs | Stool exam | CBC | Other lab findings | Extra intestinal findings | Cause\/Pathogenesis | Gold standard diagnosis |   |   |   |   |   |   |   |   |   |   |\n| Acute | Chronic | Watery | Bloody | Fatty | WBC | RBC | Ova\/Parasite | Osmotic gap | Other | WBC | Hgb | Plt |   |   |   |   |   |   |   |   |   |   |\n| [Entamoeba histolytica](https:\/\/www.wikidoc.org\/index.php\/Entamoeba_histolytica \"Entamoeba histolytica\") | \\+ | \\+ | \\+ | \\+ | – | \\+ | \\+ | – | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distension \"Abdominal distension\") Diffuse [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") | \\+ | \\+ | \\+ | Nl | – | ↑ | Nl | Nl | – | [Liver abscess](https:\/\/www.wikidoc.org\/index.php\/Liver_abscess \"Liver abscess\") Pleuropulmonary infection [Cardiac](https:\/\/www.wikidoc.org\/index.php\/Cardiac \"Cardiac\") [infection](https:\/\/www.wikidoc.org\/index.php\/Infection \"Infection\") [Brain abscess](https:\/\/www.wikidoc.org\/index.php\/Brain_abscess \"Brain abscess\") [Cutaneous infection](https:\/\/www.wikidoc.org\/index.php\/Skin_and_soft-tissue_infections \"Skin and soft-tissue infections\") | [*Entamoeba histolytica*](https:\/\/www.wikidoc.org\/index.php\/Entamoeba_histolytica \"Entamoeba histolytica\") | Antigen testing Serology |   |\n| [Giardia](https:\/\/www.wikidoc.org\/index.php\/Giardia_lamblia \"Giardia lamblia\") | – | \\+ | \\+ | – | \\+ | – | \\+ | \\+ | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distension \"Abdominal distension\") Diffuse [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") | – | – | \\+ | Nl | – | Nl | Nl | Nl | – | [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") [Urticaria](https:\/\/www.wikidoc.org\/index.php\/Urticaria \"Urticaria\") [Depression](https:\/\/www.wikidoc.org\/index.php\/Depression \"Depression\") | *[Giardia lamblia](https:\/\/www.wikidoc.org\/index.php\/Giardia_lamblia \"Giardia lamblia\")* | Antigen detection assays |   |\n| [Cryptosporidium](https:\/\/www.wikidoc.org\/index.php\/Cryptosporidium \"Cryptosporidium\") | – | \\+ | \\+ | – | – | – | \\+ | \\+ | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distension \"Abdominal distension\") Diffuse [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") | – | – | \\+ | Nl | Positive stool microscopy | Nl | Nl | Nl | Elevated [alkaline phosphatase](https:\/\/www.wikidoc.org\/index.php\/Alkaline_phosphatase \"Alkaline phosphatase\") | Chronic, life–threatening illness in [immunocompromised](https:\/\/www.wikidoc.org\/index.php\/Immunodeficiency \"Immunodeficiency\") patients | [*Cryptosporidium*](https:\/\/www.wikidoc.org\/index.php\/Cryptosporidium \"Cryptosporidium\") | Polymerase chain reaction |   |\n| [Microsporidia](https:\/\/www.wikidoc.org\/index.php\/Microsporidia \"Microsporidia\") | \\+ | \\+ | \\+ | – | – | \\+ | \\+ | – | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distension \"Abdominal distension\") Diffuse [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") | – | – | \\+ | Nl | Positive stool microscopy | Nl | Nl | Nl | Decreased [CD4](https:\/\/www.wikidoc.org\/index.php\/CD4 \"CD4\") count | [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") [Keratitis](https:\/\/www.wikidoc.org\/index.php\/Keratitis \"Keratitis\") [Seizure](https:\/\/www.wikidoc.org\/index.php\/Seizure \"Seizure\") [Myositis](https:\/\/www.wikidoc.org\/index.php\/Myositis \"Myositis\") | [Microsporidia](https:\/\/www.wikidoc.org\/index.php\/Microsporidia \"Microsporidia\") | Antigen detection assays |   |\n| [Isospora](https:\/\/www.wikidoc.org\/index.php\/Isospora \"Isospora\") | \\+ | \\+ | \\+ | – | \\+ | \\+ | \\+ | \\+ | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distension \"Abdominal distension\") Diffuse [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") | \\+ | \\+ | \\+ | Nl | Positive stool microscopy Positive [fecal fat](https:\/\/www.wikidoc.org\/index.php\/Fecal_fat \"Fecal fat\") | ↑ | Nl | Nl | Elevated [eosinophils](https:\/\/www.wikidoc.org\/index.php\/Eosinophil_granulocyte \"Eosinophil granulocyte\") [Hypokalemia](https:\/\/www.wikidoc.org\/index.php\/Hypokalemia \"Hypokalemia\") Increased [creatinine](https:\/\/www.wikidoc.org\/index.php\/Creatinine \"Creatinine\") | Chronic illness in [immunocompromised](https:\/\/www.wikidoc.org\/index.php\/Immunodeficiency \"Immunodeficiency\") patients | [*Isospora*](https:\/\/www.wikidoc.org\/index.php\/Isospora \"Isospora\") | Detecting oocysts in the feces |   |\n| Cause | Duration | Diarrhea | Fever | Abdominal pain | Weight loss | GI signs | Stool exam | CBC | Other lab findings | Extra intestinal findings | Cause\/Pathogenesis | Gold standard diagnosis |   |   |   |   |   |   |   |   |   |   |\n| Acute | Chronic | Watery | Bloody | Fatty | WBC | RBC | Ova\/Parasite | Osmotic gap | Other | WBC | Hgb | Plt |   |   |   |   |   |   |   |   |   |   |\n| [Carcinoid tumor](https:\/\/www.wikidoc.org\/index.php\/Carcinoid_syndrome \"Carcinoid syndrome\") | – | \\+ | \\+ | \\+ | – | – | \\+ | \\+ | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distention \"Abdominal distention\") | – | \\+ | – | ↓ | – | Nl | Nl | Nl | Elevated urinary [5–hydroxyindoleacetic acid](https:\/\/www.wikidoc.org\/index.php\/5-Hydroxyindoleacetic_acid \"5-Hydroxyindoleacetic acid\") ([5–HIAA](https:\/\/www.wikidoc.org\/index.php\/5-Hydroxyindoleacetic_acid \"5-Hydroxyindoleacetic acid\")) level High [chromogranin A](https:\/\/www.wikidoc.org\/index.php\/Chromogranin_A \"Chromogranin A\") | [Facial flushing](https:\/\/www.wikidoc.org\/index.php\/Flushing \"Flushing\") [Jaundice](https:\/\/www.wikidoc.org\/index.php\/Jaundice \"Jaundice\") [Edema](https:\/\/www.wikidoc.org\/index.php\/Edema \"Edema\") [Valvular heart disease](https:\/\/www.wikidoc.org\/index.php\/Valvular_heart_disease \"Valvular heart disease\") [Right–sided heart failure](https:\/\/www.wikidoc.org\/index.php\/Congestive_heart_failure \"Congestive heart failure\") | Well–differentiated [neuroendocrine tumor](https:\/\/www.wikidoc.org\/index.php\/Neuroendocrine_tumors \"Neuroendocrine tumors\") | Blood [chromogranin A](https:\/\/www.wikidoc.org\/index.php\/Chromogranin_A \"Chromogranin A\") level |   |\n| [VIPoma](https:\/\/www.wikidoc.org\/index.php\/VIPoma \"VIPoma\") | \\+ | \\+ | \\+ | – | \\+ | – | \\+ | \\+ | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distention \"Abdominal distention\") Abdominal [RUQ](https:\/\/www.wikidoc.org\/index.php\/RUQ \"RUQ\") [tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness \"Tenderness\") [Nausea](https:\/\/www.wikidoc.org\/index.php\/Nausea \"Nausea\") [Vomiting](https:\/\/www.wikidoc.org\/index.php\/Vomiting \"Vomiting\") | – | – | – | ↓ | – | Nl | Nl | Nl | Elevated [VIP](https:\/\/www.wikidoc.org\/index.php\/VIP \"VIP\") level [Hypokalemia](https:\/\/www.wikidoc.org\/index.php\/Hypokalemia \"Hypokalemia\") [Hypochlorhydria](https:\/\/www.wikidoc.org\/index.php\/Hypochlorhydria \"Hypochlorhydria\") or [achlorhydria](https:\/\/www.wikidoc.org\/index.php\/Achlorhydria \"Achlorhydria\") Low osmotic gap (\\<50 mOsm\/kg) | [Rash](https:\/\/www.wikidoc.org\/index.php\/Rash \"Rash\") [Facial flushing](https:\/\/www.wikidoc.org\/index.php\/Facial_flushing \"Facial flushing\") [Dehydration](https:\/\/www.wikidoc.org\/index.php\/Dehydration \"Dehydration\") [Lethargy](https:\/\/www.wikidoc.org\/index.php\/Lethargy \"Lethargy\") [Muscle weakness](https:\/\/www.wikidoc.org\/index.php\/Muscle_weakness \"Muscle weakness\") | Primary secretory tumor | Blood [VIP](https:\/\/www.wikidoc.org\/index.php\/VIP \"VIP\") levels Followed by imaging |   |\n| [Zollinger–Ellison syndrome](https:\/\/www.wikidoc.org\/index.php\/Zollinger-Ellison_syndrome \"Zollinger-Ellison syndrome\") | – | \\+ | \\+ | \\+ | \\+ | – | \\+ | \\+ | [Epigastric tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness \"Tenderness\") | – | – | – | ↓ | – | Nl | ↓ | Nl | Positive [secretin](https:\/\/www.wikidoc.org\/index.php\/Secretin \"Secretin\") stimulation test Elevated serum [chromogranin A](https:\/\/www.wikidoc.org\/index.php\/Chromogranin_A \"Chromogranin A\") | [Jaundice](https:\/\/www.wikidoc.org\/index.php\/Jaundice \"Jaundice\") | [Gastrin](https:\/\/www.wikidoc.org\/index.php\/Gastrin \"Gastrin\") producing [tumor](https:\/\/www.wikidoc.org\/index.php\/Tumor \"Tumor\") mainly in [duodenum](https:\/\/www.wikidoc.org\/index.php\/Duodenum \"Duodenum\") | [Secretin](https:\/\/www.wikidoc.org\/index.php\/Secretin \"Secretin\") stimulation test |   |\n| [Somatostatinoma](https:\/\/www.wikidoc.org\/index.php\/Neuroendocrine_tumors \"Neuroendocrine tumors\") | – | \\+ | \\+ | – | – | – | \\+ | \\+ | [Epigastric tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness \"Tenderness\") | – | – | – | ↓ | – | Nl | Nl | Nl | Elevated fasting plasma [somatostatin](https:\/\/www.wikidoc.org\/index.php\/Somatostatin \"Somatostatin\") | [Diabetes mellitus](https:\/\/www.wikidoc.org\/index.php\/Diabetes_mellitus \"Diabetes mellitus\") [Cholelithiasis](https:\/\/www.wikidoc.org\/index.php\/Gallstone_disease \"Gallstone disease\") [Jaundice](https:\/\/www.wikidoc.org\/index.php\/Jaundice \"Jaundice\") | [Neuroendocrine tumors](https:\/\/www.wikidoc.org\/index.php\/Neuroendocrine_tumors \"Neuroendocrine tumors\") of D–cell origin | Plasma [somatostatin](https:\/\/www.wikidoc.org\/index.php\/Somatostatin \"Somatostatin\") level Followed by imaging |   |\n| Cause | Duration | Diarrhea | Fever | Abdominal pain | Weight loss | GI signs | Stool exam | CBC | Other lab findings | Extra intestinal findings | Cause\/Pathogenesis | Gold standard diagnosis |   |   |   |   |   |   |   |   |   |   |\n| Acute | Chronic | Watery | Bloody | Fatty | WBC | RBC | Ova\/Parasite | Osmotic gap | Other | WBC | Hgb | Plt |   |   |   |   |   |   |   |   |   |   |\n| [Lymphoma](https:\/\/www.wikidoc.org\/index.php\/Lymphoma \"Lymphoma\") | – | \\+ | \\+ | \\+ | – | \\+ | \\+ | \\+ | Diffuse [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") [Hepatosplenomegaly](https:\/\/www.wikidoc.org\/index.php\/Hepatosplenomegaly \"Hepatosplenomegaly\") | – | \\+ | – | Nl | – | Nl | ↓ | Nl | [Paraproteinemia](https:\/\/www.wikidoc.org\/index.php\/Paraproteinemia \"Paraproteinemia\") | [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") [Lactose intolerance](https:\/\/www.wikidoc.org\/index.php\/Lactose_intolerance \"Lactose intolerance\") [Ascites](https:\/\/www.wikidoc.org\/index.php\/Ascites \"Ascites\") | Primary [tumor](https:\/\/www.wikidoc.org\/index.php\/Tumor \"Tumor\") of GI tract | [Colonoscopy](https:\/\/www.wikidoc.org\/index.php\/Colonoscopy \"Colonoscopy\") with [biopsy](https:\/\/www.wikidoc.org\/index.php\/Biopsy \"Biopsy\") |   |\n| [Colorectal cancer](https:\/\/www.wikidoc.org\/index.php\/Colorectal_cancer \"Colorectal cancer\") | – | \\+ | \\+ | \\+ | \\+ | – | \\+ | \\+ | Diffuse [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") | – | \\+ | – | Nl | – | Nl | ↓ | Nl | Positive [carcinoembryonic antigen](https:\/\/www.wikidoc.org\/index.php\/Carcinoembryonic_antigen \"Carcinoembryonic antigen\") | [Metastasis](https:\/\/www.wikidoc.org\/index.php\/Metastasis \"Metastasis\") | [FAP gene](https:\/\/www.wikidoc.org\/index.php\/FAP \"FAP\") [HNPCC gene](https:\/\/www.wikidoc.org\/index.php\/Hereditary_nonpolyposis_colorectal_cancer \"Hereditary nonpolyposis colorectal cancer\") | [Colonoscopy](https:\/\/www.wikidoc.org\/index.php\/Colonoscopy \"Colonoscopy\") and [biopsy](https:\/\/www.wikidoc.org\/index.php\/Biopsy \"Biopsy\") |   |\n| Medications [ACE inhibitors](https:\/\/www.wikidoc.org\/index.php\/ACE_inhibitor \"ACE inhibitor\") [Digoxin](https:\/\/www.wikidoc.org\/index.php\/Digoxin \"Digoxin\") [Cephalosporins](https:\/\/www.wikidoc.org\/index.php\/Cephalosporin \"Cephalosporin\") [Statins](https:\/\/www.wikidoc.org\/index.php\/Statins \"Statins\") [Thiazide diuretics](https:\/\/www.wikidoc.org\/index.php\/Thiazide \"Thiazide\") [Triptans](https:\/\/www.wikidoc.org\/index.php\/Triptans \"Triptans\") [Lactulose](https:\/\/www.wikidoc.org\/index.php\/Lactulose \"Lactulose\") [Anti retroviral agents](https:\/\/www.wikidoc.org\/index.php\/HIV_AIDS_medical_therapy \"HIV AIDS medical therapy\") [Chemotherapeutic agents](https:\/\/www.wikidoc.org\/index.php\/Chemotherapy \"Chemotherapy\") [Antifungals](https:\/\/www.wikidoc.org\/index.php\/Antifungal_drug \"Antifungal drug\") [Magnesium](https:\/\/www.wikidoc.org\/index.php\/Magnesium \"Magnesium\") | \\+ | \\+ | \\+ | – | ± | ± | \\+ | \\+ | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distention \"Abdominal distention\") [Dehydration](https:\/\/www.wikidoc.org\/index.php\/Dehydration \"Dehydration\") | – | – | – | ↑\/↓ | – | ↑ | Nl | Nl | Elevated plasma level of drug | – | [Inflammation](https:\/\/www.wikidoc.org\/index.php\/Inflammation \"Inflammation\") [Pseudomembranous colitis](https:\/\/www.wikidoc.org\/index.php\/Pseudomembranous_enterocolitis \"Pseudomembranous enterocolitis\") | Clinical evaluation after discontinuation of the drugs |   |\n| Factitious diarrhea | \\+ | \\+ | \\+ | – | – | – | \\+ | \\+ | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distention \"Abdominal distention\") | – | – | – | ↑\/↓ | – | Nl | Nl | Nl | [Hypokalemia](https:\/\/www.wikidoc.org\/index.php\/Hypokalemia \"Hypokalemia\") [Metabolic alkalosis](https:\/\/www.wikidoc.org\/index.php\/Metabolic_alkalosis \"Metabolic alkalosis\") [Hypermagnesemia](https:\/\/www.wikidoc.org\/index.php\/Hypermagnesemia \"Hypermagnesemia\") | [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") [Lethargy](https:\/\/www.wikidoc.org\/index.php\/Lethargy \"Lethargy\") [Generalized weakness](https:\/\/www.wikidoc.org\/index.php\/Generalized_weakness \"Generalized weakness\") [Acute renal failure](https:\/\/www.wikidoc.org\/index.php\/Acute_kidney_injury \"Acute kidney injury\") | [Medications](https:\/\/www.wikidoc.org\/index.php\/Medication \"Medication\") | Clinical evaluation after discontinuation of the drugs |   |\n| Cause | Duration | Diarrhea | Fever | Abdominal pain | Weight loss | GI signs | Stool exam | CBC | Other lab findings | Extra intestinal findings | Cause\/Pathogenesis | Gold standard diagnosis |   |   |   |   |   |   |   |   |   |   |\n| Acute | Chronic | Watery | Bloody | Fatty | WBC | RBC | Ova\/Parasite | Osmotic gap | Other | WBC | Hgb | Plt |   |   |   |   |   |   |   |   |   |   |\n| [Heavy metal ingestion](https:\/\/www.wikidoc.org\/index.php\/Heavy_metal_ingestion \"Heavy metal ingestion\") | – | \\+ | \\+ | – | – | – | \\+ | \\+ | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distention \"Abdominal distention\") | – | – | – | Nl | – | Nl | Nl | Nl | Elevated plasma heavy metal level | [Headache](https:\/\/www.wikidoc.org\/index.php\/Headache \"Headache\") [Numbness](https:\/\/www.wikidoc.org\/index.php\/Paresthesia \"Paresthesia\") [Alopecia](https:\/\/www.wikidoc.org\/index.php\/Alopecia \"Alopecia\") [Vertigo](https:\/\/www.wikidoc.org\/index.php\/Vertigo \"Vertigo\") | [Heavy metal ingestion](https:\/\/www.wikidoc.org\/index.php\/Heavy_metal_ingestion \"Heavy metal ingestion\") | Plasma level of heavy metal |   |\n| [Organophosphate poisoning](https:\/\/www.wikidoc.org\/index.php\/Organophosphate_poisoning \"Organophosphate poisoning\") | \\+ | \\+ | \\+ | – | – | – | \\+ | – | [Salivation](https:\/\/www.wikidoc.org\/index.php\/Saliva \"Saliva\") [Vomiting](https:\/\/www.wikidoc.org\/index.php\/Nausea_and_vomiting \"Nausea and vomiting\") | – | – | – | Nl | – | Nl | Nl | Nl | Reduced RBC acetylcholinesterase Plasma [cholinesterase](https:\/\/www.wikidoc.org\/index.php\/Cholinesterase \"Cholinesterase\") activity | [Autonomic dysfunction](https:\/\/www.wikidoc.org\/index.php\/Dysautonomia \"Dysautonomia\") Motor deficit Sensory deficit [Bronchospasm](https:\/\/www.wikidoc.org\/index.php\/Bronchospasm \"Bronchospasm\") [Urination](https:\/\/www.wikidoc.org\/index.php\/Urination \"Urination\") [Miosis](https:\/\/www.wikidoc.org\/index.php\/Miosis \"Miosis\") [Bradycardia](https:\/\/www.wikidoc.org\/index.php\/Bradycardia \"Bradycardia\") [Lacrimation](https:\/\/www.wikidoc.org\/index.php\/Lacrimation \"Lacrimation\") [Sweating](https:\/\/www.wikidoc.org\/index.php\/Sweating \"Sweating\") [Cardiac arrhythmias](https:\/\/www.wikidoc.org\/index.php\/Cardiac_arrhythmia \"Cardiac arrhythmia\") [Acute renal injury](https:\/\/www.wikidoc.org\/index.php\/Acute_kidney_injury \"Acute kidney injury\") | [Neurotoxins](https:\/\/www.wikidoc.org\/index.php\/Neurotoxin \"Neurotoxin\") bind to [acetylcholinesterase](https:\/\/www.wikidoc.org\/index.php\/ACHE \"ACHE\") (AChE) | Clinical diagnosis |   |\n| [Opium withdrawal](https:\/\/www.wikidoc.org\/index.php\/Opium_withdrawal \"Opium withdrawal\") | \\+ | \\+ | \\+ | – | – | – | \\+ | – | Hyperactive [bowel sounds](https:\/\/www.wikidoc.org\/index.php\/Stomach_rumble \"Stomach rumble\") | – | – | – | Nl | – | Nl | Nl | Nl | [Azotemia](https:\/\/www.wikidoc.org\/index.php\/Azotemia \"Azotemia\") [Hypokalemia](https:\/\/www.wikidoc.org\/index.php\/Hypokalemia \"Hypokalemia\") [Metabolic alkalosis](https:\/\/www.wikidoc.org\/index.php\/Metabolic_alkalosis \"Metabolic alkalosis\") | [Dysphoria](https:\/\/www.wikidoc.org\/index.php\/Dysphoria \"Dysphoria\") [Restlessness](https:\/\/www.wikidoc.org\/index.php\/Agitation_\\(emotion\\) \"Agitation (emotion)\") [Sweating](https:\/\/www.wikidoc.org\/index.php\/Perspiration \"Perspiration\") [Rhinorrhea](https:\/\/www.wikidoc.org\/index.php\/Rhinorrhea \"Rhinorrhea\") [Lacrimation](https:\/\/www.wikidoc.org\/index.php\/Tears \"Tears\") [Myalgia](https:\/\/www.wikidoc.org\/index.php\/Myalgia \"Myalgia\") [Arthralgia](https:\/\/www.wikidoc.org\/index.php\/Arthralgia \"Arthralgia\") | [Opium withdrawal](https:\/\/www.wikidoc.org\/index.php\/Opium \"Opium\") | Clinical diagnosis following [opium withdrawal](https:\/\/www.wikidoc.org\/index.php\/Opium_withdrawal \"Opium withdrawal\") |   |\n| Cause | Duration | Diarrhea | Fever | Abdominal pain | Weight loss | GI signs | Stool exam | CBC | Other lab findings | Extra intestinal findings | Cause\/Pathogenesis | Gold standard diagnosis |   |   |   |   |   |   |   |   |   |   |\n| Acute | Chronic | Watery | Bloody | Fatty | WBC | RBC | Ova\/Parasite | Osmotic gap | Other | WBC | Hgb | Plt |   |   |   |   |   |   |   |   |   |   |\n| [Short bowel syndrome](https:\/\/www.wikidoc.org\/index.php\/Short_bowel_syndrome \"Short bowel syndrome\") | \\+ | \\+ | \\+ | – | \\+ | – | – | \\+ | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distension \"Abdominal distension\") [Abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") | – | – | – | Nl | Positive [fecal fat](https:\/\/www.wikidoc.org\/index.php\/Fecal_fat \"Fecal fat\") | Nl | ↓ | ↑ | [Hypoalbuminemia](https:\/\/www.wikidoc.org\/index.php\/Hypoalbuminemia \"Hypoalbuminemia\") High level of [acute phase reactant](https:\/\/www.wikidoc.org\/index.php\/Acute_phase_protein \"Acute phase protein\") Abnormal [liver function tests](https:\/\/www.wikidoc.org\/index.php\/Liver_function_tests \"Liver function tests\") | Prior [intestinal](https:\/\/www.wikidoc.org\/index.php\/Intestine \"Intestine\") surgery [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") [Crohn's disease](https:\/\/www.wikidoc.org\/index.php\/Crohn%27s_disease \"Crohn's disease\") [Malignancy](https:\/\/www.wikidoc.org\/index.php\/Cancer \"Cancer\") Peripheral [edema](https:\/\/www.wikidoc.org\/index.php\/Edema \"Edema\") [Muscle atrophy](https:\/\/www.wikidoc.org\/index.php\/Muscle_atrophy \"Muscle atrophy\") | Surgical [bowel resection](https:\/\/www.wikidoc.org\/index.php\/Bowel_resection \"Bowel resection\") | Clinical diagnosis following [bowel resection](https:\/\/www.wikidoc.org\/index.php\/Bowel_resection \"Bowel resection\") |   |\n| [Radiation enteritis](https:\/\/www.wikidoc.org\/index.php\/Radiation_enteropathy \"Radiation enteropathy\") | \\+ | \\+ | \\+ | \\+ | \\+ | – | \\+ | \\+ | [Abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") | \\+ | \\+ | – | Nl | Positive [fecal fat](https:\/\/www.wikidoc.org\/index.php\/Fecal_fat \"Fecal fat\") | Nl | ↓ | Nl | Vitamin B12 deficiency [Hypoalbuminemia](https:\/\/www.wikidoc.org\/index.php\/Hypoalbuminemia \"Hypoalbuminemia\") | Prior history of [malignancy](https:\/\/www.wikidoc.org\/index.php\/Cancer \"Cancer\") and [radiation therapy](https:\/\/www.wikidoc.org\/index.php\/Radiation_therapy \"Radiation therapy\") [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") [Telangiectasias](https:\/\/www.wikidoc.org\/index.php\/Telangiectasia \"Telangiectasia\") | [Radiation](https:\/\/www.wikidoc.org\/index.php\/Radiation_therapy \"Radiation therapy\") | Segmental bowel [inflammation](https:\/\/www.wikidoc.org\/index.php\/Inflammation \"Inflammation\") on [endoscopy](https:\/\/www.wikidoc.org\/index.php\/Endoscopy \"Endoscopy\") or [colonoscopy](https:\/\/www.wikidoc.org\/index.php\/Colonoscopy \"Colonoscopy\") |   |\n| [Dumping syndrome](https:\/\/www.wikidoc.org\/index.php\/Gastric_dumping_syndrome \"Gastric dumping syndrome\") | – | \\+ | \\+ | – | \\+ | – | – | \\+ | Hyperactive [bowel sound](https:\/\/www.wikidoc.org\/index.php\/Bowel_sound \"Bowel sound\") | – | – | – | Nl | – | Nl | Nl | Nl | [Hypoglycemia](https:\/\/www.wikidoc.org\/index.php\/Hypoglycemia \"Hypoglycemia\") [Hydrogen breath test](https:\/\/www.wikidoc.org\/index.php\/Hydrogen_Breath_Test \"Hydrogen Breath Test\") | [Malnutrition](https:\/\/www.wikidoc.org\/index.php\/Malnutrition \"Malnutrition\") [Fat soluble vitamin](https:\/\/www.wikidoc.org\/index.php\/Fat_soluble_vitamins \"Fat soluble vitamins\") deficiency | [Postgastrectomy](https:\/\/www.wikidoc.org\/index.php\/Post_operative_complications \"Post operative complications\") | Clinical diagnosis following [gastrectomy](https:\/\/www.wikidoc.org\/index.php\/Gastrectomy \"Gastrectomy\") |   |\n| Cause | Duration | Diarrhea | Fever | Abdominal pain | Weight loss | GI signs | Stool exam | CBC | Other lab findings | Extra intestinal findings | Cause\/Pathogenesis | Gold standard diagnosis |   |   |   |   |   |   |   |   |   |   |\n| Acute | Chronic | Watery | Bloody | Fatty | WBC | RBC | Ova\/Parasite | Osmotic gap | Other | WBC | Hgb | Plt |   |   |   |   |   |   |   |   |   |   |\n| [Abetalipoproteinemia](https:\/\/www.wikidoc.org\/index.php\/Abetalipoproteinemia \"Abetalipoproteinemia\") | – | \\+ | \\+ | – | \\+ | – | \\+ | \\+ | [Abdominal distension](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distension \"Abdominal distension\") | – | – | – | Nl | – | Nl | Nl | Nl | Low [triglyceride](https:\/\/www.wikidoc.org\/index.php\/Triglyceride \"Triglyceride\") Low total [cholesterol](https:\/\/www.wikidoc.org\/index.php\/Cholesterol \"Cholesterol\") levels [Acanthocytes](https:\/\/www.wikidoc.org\/index.php\/Acanthocytes \"Acanthocytes\") Low [vitamin E](https:\/\/www.wikidoc.org\/index.php\/Vitamin_E \"Vitamin E\") levels | [Ataxia](https:\/\/www.wikidoc.org\/index.php\/Ataxia \"Ataxia\") [Visual field defect](https:\/\/www.wikidoc.org\/index.php\/Visual_field_defect \"Visual field defect\") [Dysarthria](https:\/\/www.wikidoc.org\/index.php\/Dysarthria \"Dysarthria\") | [Autosomal recessive](https:\/\/www.wikidoc.org\/index.php\/Autosomal_recessive \"Autosomal recessive\") disorder caused by mutations encoding the [microsomal triglyceride transfer protein](https:\/\/www.wikidoc.org\/index.php\/Microsomal_triglyceride_transfer_protein \"Microsomal triglyceride transfer protein\") (MTP) | Clinical findings and low [triglyceride](https:\/\/www.wikidoc.org\/index.php\/Triglyceride \"Triglyceride\") and [cholesterol](https:\/\/www.wikidoc.org\/index.php\/Cholesterol \"Cholesterol\") level |   |\n| [Hyperthyroidism](https:\/\/www.wikidoc.org\/index.php\/Hyperthyroidism \"Hyperthyroidism\") | – | \\+ | \\+ | – | – | ± | \\+ | \\+ | – | – | – | – | Nl | Positive [fecal fat](https:\/\/www.wikidoc.org\/index.php\/Fecal_fat \"Fecal fat\") | Nl | Nl | Nl | Elevated [T4](https:\/\/www.wikidoc.org\/index.php\/T4 \"T4\") Elevated [T3](https:\/\/www.wikidoc.org\/index.php\/T3 \"T3\") Decreased [TSH](https:\/\/www.wikidoc.org\/index.php\/TSH \"TSH\") High serum [alkaline phosphatase](https:\/\/www.wikidoc.org\/index.php\/Alkaline_phosphatase \"Alkaline phosphatase\") | Lump in the neck Lid lag [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") [Sweating](https:\/\/www.wikidoc.org\/index.php\/Sweating \"Sweating\") [Hyperpigmentation](https:\/\/www.wikidoc.org\/index.php\/Hyperpigmentation \"Hyperpigmentation\") [Proptosis](https:\/\/www.wikidoc.org\/index.php\/Proptosis \"Proptosis\") [Tremor](https:\/\/www.wikidoc.org\/index.php\/Tremor \"Tremor\") Increased [DTR](https:\/\/www.wikidoc.org\/index.php\/Deep_tendon_reflex \"Deep tendon reflex\") | [Graves' disease](https:\/\/www.wikidoc.org\/index.php\/Graves%27_disease \"Graves' disease\") [Hashimoto's thyroiditis](https:\/\/www.wikidoc.org\/index.php\/Hashimoto%27s_thyroiditis \"Hashimoto's thyroiditis\") [Toxic adenoma](https:\/\/www.wikidoc.org\/index.php\/Toxic_adenoma \"Toxic adenoma\") | [TSH](https:\/\/www.wikidoc.org\/index.php\/TSH \"TSH\") |   |\n| [Diabetic neuropathy](https:\/\/www.wikidoc.org\/index.php\/Diabetic_neuropathy \"Diabetic neuropathy\") | – | \\+ | \\+ | – | \\+ | – | \\+ | \\+ | [Fecal incontinence](https:\/\/www.wikidoc.org\/index.php\/Fecal_incontinence \"Fecal incontinence\") | – | – | – | Nl | Positive [fecal fat](https:\/\/www.wikidoc.org\/index.php\/Fecal_fat \"Fecal fat\") | Nl | ↓ | Nl | [Hyperglycemia](https:\/\/www.wikidoc.org\/index.php\/Hyperglycemia \"Hyperglycemia\") [Azotemia](https:\/\/www.wikidoc.org\/index.php\/Azotemia \"Azotemia\") [Hypokalemia](https:\/\/www.wikidoc.org\/index.php\/Hypokalemia \"Hypokalemia\") | [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") | Unclear Disordered [motility](https:\/\/www.wikidoc.org\/index.php\/Motility \"Motility\") Increased [intestinal](https:\/\/www.wikidoc.org\/index.php\/Intestine \"Intestine\") secretion [Small intestinal bacterial overgrowth](https:\/\/www.wikidoc.org\/index.php\/Small_intestinal_bacterial_overgrowth \"Small intestinal bacterial overgrowth\") | Clinical diagnosis in a patient with long lasting [diabetes mellitus](https:\/\/www.wikidoc.org\/index.php\/Diabetes_mellitus \"Diabetes mellitus\") |   |\n| [Systemic sclerosis](https:\/\/www.wikidoc.org\/index.php\/Scleroderma \"Scleroderma\") | – | \\+ | \\+ | ± | \\+ | – | \\+ | \\+ | [Epigastric tenderness](https:\/\/www.wikidoc.org\/index.php\/Abdominal_pain \"Abdominal pain\") [Fecal incontinence](https:\/\/www.wikidoc.org\/index.php\/Fecal_incontinence \"Fecal incontinence\") | – | \\+ | – | Nl | Positive [fecal fat](https:\/\/www.wikidoc.org\/index.php\/Fecal_fat \"Fecal fat\") | Nl | ↓ | Nl | Anti–[topoisomerase I](https:\/\/www.wikidoc.org\/index.php\/Type_I_topoisomerase \"Type I topoisomerase\") (Scl‑70) antibodies [Antinuclear antibodies](https:\/\/www.wikidoc.org\/index.php\/Antinuclear_antibodies \"Antinuclear antibodies\") ([ANA](https:\/\/www.wikidoc.org\/index.php\/Antinuclear_antibodies \"Antinuclear antibodies\")) [Anti–centromere antibodies](https:\/\/www.wikidoc.org\/index.php\/Anti-centromere_antibodies \"Anti-centromere antibodies\") Anti–[RNA polymerase III](https:\/\/www.wikidoc.org\/index.php\/RNA_polymerase_III \"RNA polymerase III\") antibody | [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") [Skin changes](https:\/\/www.wikidoc.org\/index.php\/Skin_changes \"Skin changes\") [Raynaud phenomenon](https:\/\/www.wikidoc.org\/index.php\/Raynaud%27s_phenomenon \"Raynaud's phenomenon\") [Pulmonary hypertension](https:\/\/www.wikidoc.org\/index.php\/Pulmonary_hypertension \"Pulmonary hypertension\") [Arthritis](https:\/\/www.wikidoc.org\/index.php\/Arthritis \"Arthritis\") [Telangiectasia](https:\/\/www.wikidoc.org\/index.php\/Telangiectasia \"Telangiectasia\") [Chronic renal failure](https:\/\/www.wikidoc.org\/index.php\/Chronic_renal_failure \"Chronic renal failure\") | [Autoimmune reaction](https:\/\/www.wikidoc.org\/index.php\/Autoimmunity \"Autoimmunity\") | Clinical diagnosis Followed by serologic tests |   |\n## References\n1. [↑](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_ref-Casburn-JonesFarthing2004_1-0)\n   Casburn-Jones, Anna C; Farthing, Michael Jg (2004). \"Traveler's diarrhea\". *Journal of Gastroenterology and Hepatology*. **19** (6): 610–618. [doi](https:\/\/www.wikidoc.org\/index.php\/Digital_object_identifier \"Digital object identifier\"):[10\\.1111\/j.1440-1746.2003.03287.x](https:\/\/doi.org\/10.1111%2Fj.1440-1746.2003.03287.x). [ISSN](https:\/\/www.wikidoc.org\/index.php\/International_Standard_Serial_Number \"International Standard Serial Number\") [0815-9319](https:\/\/www.worldcat.org\/issn\/0815-9319).\n2. [↑](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_ref-KamatMathur2006_2-0)\n   Kamat, Deepak; Mathur, Ambika (2006). \"Prevention and Management of Travelers' Diarrhea\". *Disease-a-Month*. **52** (7): 289–302. [doi](https:\/\/www.wikidoc.org\/index.php\/Digital_object_identifier \"Digital object identifier\"):[10\\.1016\/j.disamonth.2006.08.003](https:\/\/doi.org\/10.1016%2Fj.disamonth.2006.08.003). [ISSN](https:\/\/www.wikidoc.org\/index.php\/International_Standard_Serial_Number \"International Standard Serial Number\") [0011-5029](https:\/\/www.worldcat.org\/issn\/0011-5029).\n3. [↑](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_ref-PfeifferDuPont2012_3-0)\n   Pfeiffer, Margaret L.; DuPont, Herbert L.; Ochoa, Theresa J. (2012). \"The patient presenting with acute dysentery – A systematic review\". *Journal of Infection*. **64** (4): 374–386. [doi](https:\/\/www.wikidoc.org\/index.php\/Digital_object_identifier \"Digital object identifier\"):[10\\.1016\/j.jinf.2012.01.006](https:\/\/doi.org\/10.1016%2Fj.jinf.2012.01.006). [ISSN](https:\/\/www.wikidoc.org\/index.php\/International_Standard_Serial_Number \"International Standard Serial Number\") [0163-4453](https:\/\/www.worldcat.org\/issn\/0163-4453).\n4. [↑](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_ref-pmid24506120_4-0)\n   Barr W, Smith A (2014). \"Acute diarrhea\". *Am Fam Physician*. **89** (3): 180–9. [PMID](https:\/\/www.wikidoc.org\/index.php?title=PubMed_Identifier&action=edit&redlink=1 \"PubMed Identifier (page does not exist)\") [24506120](https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/24506120).\n5. [↑](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_ref-pmid29255768_5-0)\n   Amil Dias J (2017). \"Celiac Disease: What Do We Know in 2017?\". *GE Port J Gastroenterol*. **24** (6): 275–278. [doi](https:\/\/www.wikidoc.org\/index.php\/Digital_object_identifier \"Digital object identifier\"):[10\\.1159\/000479881](https:\/\/doi.org\/10.1159%2F000479881). [PMID](https:\/\/www.wikidoc.org\/index.php?title=PubMed_Identifier&action=edit&redlink=1 \"PubMed Identifier (page does not exist)\") [29255768](https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/29255768).\n6. [↑](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_ref-pmid29254859_6-0)\n   Kotloff KL, Riddle MS, Platts-Mills JA, Pavlinac P, Zaidi A (2017). \"Shigellosis\". *Lancet*. [doi](https:\/\/www.wikidoc.org\/index.php\/Digital_object_identifier \"Digital object identifier\"):[10\\.1016\/S0140-6736(17)33296-8](https:\/\/doi.org\/10.1016%2FS0140-6736%2817%2933296-8). [PMID](https:\/\/www.wikidoc.org\/index.php?title=PubMed_Identifier&action=edit&redlink=1 \"PubMed Identifier (page does not exist)\") [29254859](https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/29254859).\n   \n   Vancouver style error: initials ([help](https:\/\/www.wikidoc.org\/index.php?title=Help:CS1_errors&action=edit&redlink=1 \"Help:CS1 errors (page does not exist)\"))\n7. [↑](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_ref-Yamamoto-FurushoBosques-Padilla2017_7-0)\n   Yamamoto-Furusho, J.K.; Bosques-Padilla, F.; de-Paula, J.; Galiano, M.T.; Ibañez, P.; Juliao, F.; Kotze, P.G.; Rocha, J.L.; Steinwurz, F.; Veitia, G.; Zaltman, C. (2017). \"Diagnóstico y tratamiento de la enfermedad inflamatoria intestinal: Primer Consenso Latinoamericano de la Pan American Crohn's and Colitis Organisation\". *Revista de Gastroenterología de México*. **82** (1): 46–84. [doi](https:\/\/www.wikidoc.org\/index.php\/Digital_object_identifier \"Digital object identifier\"):[10\\.1016\/j.rgmx.2016.07.003](https:\/\/doi.org\/10.1016%2Fj.rgmx.2016.07.003). [ISSN](https:\/\/www.wikidoc.org\/index.php\/International_Standard_Serial_Number \"International Standard Serial Number\") [0375-0906](https:\/\/www.worldcat.org\/issn\/0375-0906).\n8. [↑](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_ref-Borb%C3%A9lyOsterwalder2017_8-0)\n   Borbély, Yves M; Osterwalder, Alice; Kröll, Dino; Nett, Philipp C; Inglin, Roman A (2017). \"Diarrhea after bariatric procedures: Diagnosis and therapy\". *World Journal of Gastroenterology*. **23** (26): 4689. [doi](https:\/\/www.wikidoc.org\/index.php\/Digital_object_identifier \"Digital object identifier\"):[10\\.3748\/wjg.v23.i26.4689](https:\/\/doi.org\/10.3748%2Fwjg.v23.i26.4689). [ISSN](https:\/\/www.wikidoc.org\/index.php\/International_Standard_Serial_Number \"International Standard Serial Number\") [1007-9327](https:\/\/www.worldcat.org\/issn\/1007-9327).\n9. [↑](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_ref-CrawfordRamani2017_9-0)\n   Crawford, Sue E.; Ramani, Sasirekha; Tate, Jacqueline E.; Parashar, Umesh D.; Svensson, Lennart; Hagbom, Marie; Franco, Manuel A.; Greenberg, Harry B.; O'Ryan, Miguel; Kang, Gagandeep; Desselberger, Ulrich; Estes, Mary K. (2017). \"Rotavirus infection\". *Nature Reviews Disease Primers*. **3**: 17083. [doi](https:\/\/www.wikidoc.org\/index.php\/Digital_object_identifier \"Digital object identifier\"):[10\\.1038\/nrdp.2017.83](https:\/\/doi.org\/10.1038%2Fnrdp.2017.83). [ISSN](https:\/\/www.wikidoc.org\/index.php\/International_Standard_Serial_Number \"International Standard Serial Number\") [2056-676X](https:\/\/www.worldcat.org\/issn\/2056-676X).\n10. [↑](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_ref-pmid11068510_10-0)\n    Kist M (2000). \"\\[Chronic diarrhea: value of microbiology in diagnosis\\]\". *Praxis (Bern 1994)* (in German). **89** (39): 1559–65. [PMID](https:\/\/www.wikidoc.org\/index.php?title=PubMed_Identifier&action=edit&redlink=1 \"PubMed Identifier (page does not exist)\") [11068510](https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/11068510).\n    \n    CS1 maint: Unrecognized language ([link](https:\/\/www.wikidoc.org\/index.php?title=Category:CS1_maint:_Unrecognized_language&action=edit&redlink=1 \"Category:CS1 maint: Unrecognized language (page does not exist)\"))\n11. [↑](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_ref-pmid4014291_11-0)\n    Guerrant RL, Shields DS, Thorson SM, Schorling JB, Gröschel DH (1985). \"Evaluation and diagnosis of acute infectious diarrhea\". *Am. J. Med*. **78** (6B): 91–8. 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Based on work by\n  [Sadaf Sharfaei](https:\/\/www.wikidoc.org\/index.php\/User:Ssharfaei \"User:Ssharfaei\")\n  ,\n  [mahshid mir](https:\/\/www.wikidoc.org\/index.php\/User:Mmir \"User:Mmir\")\n  ,\n  [Omodamola Aje](https:\/\/www.wikidoc.org\/index.php\/User:Damola \"User:Damola\")\n  ,\n  [Allison Tu](https:\/\/www.wikidoc.org\/index.php\/User:Allisontu \"User:Allisontu\")\n  ,\n  [Akshun Kalia](https:\/\/www.wikidoc.org\/index.php\/User:Akshun_Kalia \"User:Akshun Kalia\")\n  ,\n  [adityapavankumarganti@gmail.com](https:\/\/www.wikidoc.org\/index.php\/User:Aditya_Ganti \"User:Aditya Ganti\")\n  ,\n  [Ahmed Elsaiey](https:\/\/www.wikidoc.org\/index.php\/User:Aelsaiey \"User:Aelsaiey\")\n  and\n  [Usama Talib](https:\/\/www.wikidoc.org\/index.php\/User:Usama_Talib \"User:Usama Talib\")\n  .\n- Content is available under [Creative Commons Attribution\/Share-Alike License](http:\/\/creativecommons.org\/licenses\/by-sa\/3.0\/) unless otherwise noted.\n\n- [Privacy policy](https:\/\/www.wikidoc.org\/index.php\/wikidoc:Privacy_policy)\n- [About wikidoc](https:\/\/www.wikidoc.org\/index.php\/wikidoc:About)\n- [Disclaimers](https:\/\/www.wikidoc.org\/index.php\/wikidoc:General_disclaimer)\n\n- [![Creative Commons Attribution\/Share-Alike License](http:\/\/i.creativecommons.org\/l\/by-sa\/3.0\/80x15.png)](http:\/\/creativecommons.org\/licenses\/by-sa\/3.0\/)\n- [![Powered by MediaWiki](https:\/\/www.wikidoc.org\/resources\/assets\/mediawiki_compact.svg)](https:\/\/www.mediawiki.org\/)","attrs_readable_markdown":"[![](https:\/\/www.wikidoc.org\/images\/1\/16\/Home_logo1.png)](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea)\n\n***To review the differential diagnosis of diarrhea, click [here](https:\/\/www.wikidoc.org\/index.php\/Diarrhea#Differential_Diagnosis_of_Diarrhea_of_other_diseases \"Diarrhea\").***\n\n**Editor-In-Chief:** [C. Michael Gibson, M.S., M.D.](https:\/\/www.wikidoc.org\/index.php\/User:C_Michael_Gibson \"User:C Michael Gibson\") [\\[1\\]](mailto:charlesmichaelgibson@gmail.com); **Associate Editor(s)-in-Chief:**  [Sadaf Sharfaei M.D.](https:\/\/www.wikidoc.org\/index.php\/User:Ssharfaei \"User:Ssharfaei\")[\\[2\\]](Mailto:sadaf.sharfaei@gmail.com), [Seyedmahdi Pahlavani, M.D.](https:\/\/www.wikidoc.org\/index.php\/User:Mehdi_Pahlavani \"User:Mehdi Pahlavani\") [\\[3\\]](mailto:spahlava@bidmc.harvard.edu)\n\nOverview\n\nThe [differential diagnosis](https:\/\/www.wikidoc.org\/index.php\/Differential_diagnosis \"Differential diagnosis\") for [chronic diarrhea](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea \"Chronic diarrhea\") is enormous, with a large number of diagnostic tests available that can be used to evaluate these patients. Classifying a patient's [chronic diarrhea](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea \"Chronic diarrhea\") into a subcategory such as [watery](https:\/\/www.wikidoc.org\/index.php\/Watery_diarrhea \"Watery diarrhea\"), fatty and [inflammatory](https:\/\/www.wikidoc.org\/index.php\/Inflammatory \"Inflammatory\") helps to direct the [diagnostic](https:\/\/www.wikidoc.org\/index.php\/Diagnostic \"Diagnostic\") work-up. Some [watery](https:\/\/www.wikidoc.org\/index.php\/Watery_diarrhea \"Watery diarrhea\") causes of chronic diarrhea which should be differentiated from one another include [crohn's disease](https:\/\/www.wikidoc.org\/index.php\/Crohn%27s_disease \"Crohn's disease\"), [hyperthyroidism](https:\/\/www.wikidoc.org\/index.php\/Hyperthyroidism \"Hyperthyroidism\"), [VIPoma](https:\/\/www.wikidoc.org\/index.php\/VIPoma \"VIPoma\"), [lactose intolerance](https:\/\/www.wikidoc.org\/index.php\/Lactose_intolerance \"Lactose intolerance\"), [celiac disease](https:\/\/www.wikidoc.org\/index.php\/Celiac_disease \"Celiac disease\") and [irritable bowel syndrome](https:\/\/www.wikidoc.org\/index.php\/Irritable_bowel_syndrome \"Irritable bowel syndrome\") (IBS). The causes of fatty diarrhea that should be differentiated from one another include [celiac sprue](https:\/\/www.wikidoc.org\/index.php\/Celiac_sprue \"Celiac sprue\"), [pancreatic insufficiency](https:\/\/www.wikidoc.org\/index.php\/Pancreatic_insufficiency \"Pancreatic insufficiency\"), [bacterial overgrowth](https:\/\/www.wikidoc.org\/index.php\/Bacterial_overgrowth \"Bacterial overgrowth\") and [maldigestion](https:\/\/www.wikidoc.org\/index.php\/Maldigestion \"Maldigestion\") problems which results from [pancreatic exocrine insufficiency](https:\/\/www.wikidoc.org\/index.php\/Pancreatic_insufficiency \"Pancreatic insufficiency\"). Finally, the [inflammatory](https:\/\/www.wikidoc.org\/index.php\/Inflammatory \"Inflammatory\") causes of chronic diarrhea such as [ulcerative colitis](https:\/\/www.wikidoc.org\/index.php\/Ulcerative_colitis \"Ulcerative colitis\") and [entamoeba histolytica](https:\/\/www.wikidoc.org\/index.php\/Entamoeba_histolytica \"Entamoeba histolytica\") must also be differentiated.\n\nDifferential Diagnosis of Chronic Diarrhea from other diseases\n\n**The following table outlines the major differential diagnoses of chronic diarrhea.**[\\[1\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-Casburn-JonesFarthing2004-1)[\\[2\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-KamatMathur2006-2)[\\[3\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-PfeifferDuPont2012-3)[\\[4\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid24506120-4)[\\[5\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid29255768-5)[\\[6\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid29254859-6)[\\[7\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-Yamamoto-FurushoBosques-Padilla2017-7)[\\[8\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-Borb%C3%A9lyOsterwalder2017-8)[\\[9\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-CrawfordRamani2017-9)[\\[10\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid11068510-10)[\\[11\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid4014291-11)[\\[12\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid10575169-12)[\\[13\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-WahnschaffeIgnatius2009-13)[\\[14\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid27765536-14)[\\[15\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid19365159-15)[\\[16\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid23384808-16)[\\[17\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid25692805-17)[\\[18\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid17373914-18)[\\[19\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid23384801-19)[\\[20\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid3523719-20)[\\[21\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid16151544-21)[\\[22\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid12135027-22)[\\[23\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid1702075-23)[\\[24\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid14439871-24)[\\[25\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid8209928-25)[\\[26\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid16698746-26)[\\[27\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid12700377-27)[\\[28\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid8694025-28)[\\[29\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid9414969-29)[\\[30\\]](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_note-pmid15391722-30)\n\n**Abbreviations:** **GI:** [Gastrointestinal](https:\/\/www.wikidoc.org\/index.php\/Gastrointestinal_tract \"Gastrointestinal tract\"), **CBC**: [Complete blood count](https:\/\/www.wikidoc.org\/index.php\/Complete_blood_count \"Complete blood count\"), **WBC:** [White blood cell](https:\/\/www.wikidoc.org\/index.php\/White_blood_cells \"White blood cells\"), **RBC**: [Red blood cell](https:\/\/www.wikidoc.org\/index.php\/Red_blood_cell \"Red blood cell\"), **Plt:** [Platelet](https:\/\/www.wikidoc.org\/index.php\/Platelet \"Platelet\"), **Hgb:** [Hemoglobin](https:\/\/www.wikidoc.org\/index.php\/Hemoglobin \"Hemoglobin\"), **ESR**: [Erythrocyte sedimentation rate](https:\/\/www.wikidoc.org\/index.php\/Erythrocyte_sedimentation_rate \"Erythrocyte sedimentation rate\"), **CRP**: [C–reactive protein](https:\/\/www.wikidoc.org\/index.php\/C-reactive_protein \"C-reactive protein\"), **IgE:** [Immunoglobulin E](https:\/\/www.wikidoc.org\/index.php\/Immunoglobulin_E \"Immunoglobulin E\"), **IgA:** [Immunoglobulin A](https:\/\/www.wikidoc.org\/index.php\/Immunoglobulin_A \"Immunoglobulin A\"), **ETEC:** [Escherichia coli enteritis](https:\/\/www.wikidoc.org\/index.php\/Escherichia_coli_enteritis \"Escherichia coli enteritis\"), **EPEC**: [Enteropathogenic Escherichia coli](https:\/\/www.wikidoc.org\/index.php\/Escherichia_coli \"Escherichia coli\"), **EIEC**: [Enteroinvasive Escherichia coli](https:\/\/www.wikidoc.org\/index.php\/Escherichia_coli_enteritis \"Escherichia coli enteritis\"), **EHEC**: [Enterohemorrhagic Escherichia coli](https:\/\/www.wikidoc.org\/index.php\/Escherichia_coli \"Escherichia coli\"), **EAEC**: [Enteroaggregative Escherichia coli](https:\/\/www.wikidoc.org\/index.php\/Escherichia_coli_enteritis \"Escherichia coli enteritis\"), **Nl**: Normal, **ASCA**: [Anti saccharomyces cerevisiae antibodies](https:\/\/www.wikidoc.org\/index.php\/Anti_saccharomyces_cerevisiae_antibodies \"Anti saccharomyces cerevisiae antibodies\"), **ANCA**: [Anti–neutrophil cytoplasmic antibody](https:\/\/www.wikidoc.org\/index.php\/Anti-neutrophil_cytoplasmic_antibody \"Anti-neutrophil cytoplasmic antibody\"), **DNA**: [Deoxyribonucleic acid](https:\/\/www.wikidoc.org\/index.php\/DNA \"DNA\"), **CFTR**: [Cystic fibrosis transmembrane conductance regulator](https:\/\/www.wikidoc.org\/index.php\/Cystic_fibrosis_transmembrane_conductance_regulator \"Cystic fibrosis transmembrane conductance regulator\"), **SLC10A2**: [Solute carrier family 10 member 2](https:\/\/www.wikidoc.org\/index.php\/SLC10A2 \"SLC10A2\"), **SeHCAT**: [Selenium homocholic acid taurine or tauroselcholic acid](https:\/\/www.wikidoc.org\/index.php\/SeHCAT \"SeHCAT\"), **IEL**: Intraepithelial [lymphocytes](https:\/\/www.wikidoc.org\/index.php\/Lymphocyte \"Lymphocyte\"), **MRCP**: [Magnetic resonance cholangiopancreatography](https:\/\/www.wikidoc.org\/index.php\/Magnetic_resonance_cholangiopancreatography \"Magnetic resonance cholangiopancreatography\"), **ANA**: [Antinuclear antibodies](https:\/\/www.wikidoc.org\/index.php\/Antinuclear_antibodies \"Antinuclear antibodies\"), **AMA**: [Anti-mitochondrial antibody](https:\/\/www.wikidoc.org\/index.php\/Anti-mitochondrial_antibody \"Anti-mitochondrial antibody\"), **LDH**: [Lactate dehydrogenase](https:\/\/www.wikidoc.org\/index.php\/Lactate_dehydrogenase \"Lactate dehydrogenase\"), **CPK**: [Creatine phosphokinase](https:\/\/www.wikidoc.org\/index.php\/Creatine_phosphokinase \"Creatine phosphokinase\"), **PCR**: [Polymerase chain reaction](https:\/\/www.wikidoc.org\/index.php\/Polymerase_chain_reaction \"Polymerase chain reaction\"), **ELISA**: [Enzyme–linked immunosorbent assay](https:\/\/www.wikidoc.org\/index.php\/Enzyme_linked_immunosorbent_assay_\\(ELISA\\) \"Enzyme linked immunosorbent assay (ELISA)\"), **LT**: Heat–labile [enterotoxin](https:\/\/www.wikidoc.org\/index.php\/Enterotoxin \"Enterotoxin\"), ST: Heat–stable [enterotoxin](https:\/\/www.wikidoc.org\/index.php\/Enterotoxin \"Enterotoxin\"), **RT-PCR**: Reverse–transcriptase [polymerase chain reaction](https:\/\/www.wikidoc.org\/index.php\/Polymerase_chain_reaction \"Polymerase chain reaction\"), **CD4:** [Cluster of differentiation 4](https:\/\/www.wikidoc.org\/index.php\/CD4 \"CD4\"), **HIV**: [Human immunodeficiency virus](https:\/\/www.wikidoc.org\/index.php\/Human_Immunodeficiency_Virus_\\(HIV\\) \"Human Immunodeficiency Virus (HIV)\"), **RUQ**: [Right-upper quadrant](https:\/\/www.wikidoc.org\/index.php\/RUQ \"RUQ\"), **VIP**: [Vasoactive intestinal peptide](https:\/\/www.wikidoc.org\/index.php\/Vasoactive_intestinal_peptide \"Vasoactive intestinal peptide\"), **GI:** [Gastrointestinal](https:\/\/www.wikidoc.org\/index.php\/Gastrointestinal_tract \"Gastrointestinal tract\"), **FAP**: [Familial adenomatous polyposis](https:\/\/www.wikidoc.org\/index.php\/Familial_adenomatous_polyposis \"Familial adenomatous polyposis\"), **HNPCC**: [Hereditary nonpolyposis colorectal cancer](https:\/\/www.wikidoc.org\/index.php\/Hereditary_nonpolyposis_colorectal_cancer \"Hereditary nonpolyposis colorectal cancer\"), **MTP**: [Microsomal triglyceride transfer protein](https:\/\/www.wikidoc.org\/index.php\/Microsomal_triglyceride_transfer_protein \"Microsomal triglyceride transfer protein\"), **Scl‑70**: Anti–[topoisomerase I](https:\/\/www.wikidoc.org\/index.php\/Type_I_topoisomerase \"Type I topoisomerase\"), **TSH**: [Thyroid-stimulating hormone](https:\/\/www.wikidoc.org\/index.php\/Thyroid-stimulating_hormone \"Thyroid-stimulating hormone\"), **T4**: [Thyroxine](https:\/\/www.wikidoc.org\/index.php\/Thyroxine \"Thyroxine\"), **T3**: [Triiodothyronine](https:\/\/www.wikidoc.org\/index.php\/Triiodothyronine \"Triiodothyronine\"), **DTR**: [Deep tendon reflex](https:\/\/www.wikidoc.org\/index.php\/Deep_tendon_reflex \"Deep tendon reflex\"), **RNA**: [Ribonucleic acid](https:\/\/www.wikidoc.org\/index.php\/RNA \"RNA\")\n\n|   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |\n|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|\n| Cause | **Clinical manifestation** | **Lab findings** | Extra intestinal findings | Cause\/Pathogenesis | Gold standard diagnosis |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |\n| Symptoms | GI signs |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |\n| Duration | Diarrhea | Fever | Abdominal pain | Weight loss |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |\n| Stool exam | **CBC** | Other lab findings |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |\n| Acute | Chronic | Watery | Bloody | Fatty | WBC | RBC | Ova\/Parasite | Osmotic gap | Other | WBC | Hgb | Plt |   |   |   |   |   |   |   |   |   |   |\n| [Crohn's disease](https:\/\/www.wikidoc.org\/index.php\/Crohns_disease \"Crohns disease\") | – | \\+ | \\+ | \\+ | \\+ | ± | \\+ | \\+ | [Abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Abdominal_tenderness \"Abdominal tenderness\") Oral [mucosal](https:\/\/www.wikidoc.org\/index.php\/Mucosal \"Mucosal\") lesions | \\+ | \\+ | – | Nl | – | ↑ | ↓ | ↑ | [Anti saccharomyces cerevisiae antibodies](https:\/\/www.wikidoc.org\/index.php\/Anti_saccharomyces_cerevisiae_antibodies \"Anti saccharomyces cerevisiae antibodies\") (ASCA) [Vitamin B12](https:\/\/www.wikidoc.org\/index.php\/Vitamin_B12 \"Vitamin B12\") deficiency Elevated [ESR](https:\/\/www.wikidoc.org\/index.php\/Erythrocyte_sedimentation_rate \"Erythrocyte sedimentation rate\") Elevated [CRP](https:\/\/www.wikidoc.org\/index.php\/C-reactive_protein \"C-reactive protein\") | [Uveitis](https:\/\/www.wikidoc.org\/index.php\/Uveitis \"Uveitis\") [Arthritis](https:\/\/www.wikidoc.org\/index.php\/Arthritis \"Arthritis\") [Erythema nodosum](https:\/\/www.wikidoc.org\/index.php\/Erythema_nodosum \"Erythema nodosum\") [Pyoderma gangrenosum](https:\/\/www.wikidoc.org\/index.php\/Pyoderma_gangrenosum \"Pyoderma gangrenosum\") [Amyloidosis](https:\/\/www.wikidoc.org\/index.php\/Amyloidosis \"Amyloidosis\") Venous and arterial [thromboembolism](https:\/\/www.wikidoc.org\/index.php\/Thromboembolism \"Thromboembolism\") [Renal stones](https:\/\/www.wikidoc.org\/index.php\/Kidney_stone \"Kidney stone\") [Bronchiectasis](https:\/\/www.wikidoc.org\/index.php\/Bronchiectasis \"Bronchiectasis\") | Abnormal immune response to self [antigens](https:\/\/www.wikidoc.org\/index.php\/Antigens \"Antigens\") | [Colonoscopy](https:\/\/www.wikidoc.org\/index.php\/Colonoscopy \"Colonoscopy\") with [biopsy](https:\/\/www.wikidoc.org\/index.php\/Biopsy \"Biopsy\") |   |\n| [Ulcerative colitis](https:\/\/www.wikidoc.org\/index.php\/Ulcerative_colitis \"Ulcerative colitis\") | – | \\+ | \\+ | \\+ | \\+ | ± | \\+ | \\+ | [Abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Abdominal_tenderness \"Abdominal tenderness\") [Blood](https:\/\/www.wikidoc.org\/index.php\/Blood \"Blood\") on [rectal examination](https:\/\/www.wikidoc.org\/index.php\/Rectal_examination \"Rectal examination\") | \\+ | \\+ | – | Nl | – | ↑ | ↓ | ↑ | [Anti–neutrophil cytoplasmic antibody](https:\/\/www.wikidoc.org\/index.php\/Anti-neutrophil_cytoplasmic_antibody \"Anti-neutrophil cytoplasmic antibody\") ([P–ANCA](https:\/\/www.wikidoc.org\/index.php\/P-ANCA \"P-ANCA\")) [Hypoalbuminemia](https:\/\/www.wikidoc.org\/index.php\/Hypoalbuminemia \"Hypoalbuminemia\") [Hypokalemia](https:\/\/www.wikidoc.org\/index.php\/Hypokalemia \"Hypokalemia\") [Hypomagnesemia](https:\/\/www.wikidoc.org\/index.php\/Hypomagnesemia \"Hypomagnesemia\") Elevated [ESR](https:\/\/www.wikidoc.org\/index.php\/Erythrocyte_sedimentation_rate \"Erythrocyte sedimentation rate\") Elevated [CRP](https:\/\/www.wikidoc.org\/index.php\/C-reactive_protein \"C-reactive protein\") | [Skin rash](https:\/\/www.wikidoc.org\/index.php\/Skin_rash \"Skin rash\") [Iritis](https:\/\/www.wikidoc.org\/index.php\/Iritis \"Iritis\") [Uveitis](https:\/\/www.wikidoc.org\/index.php\/Uveitis \"Uveitis\") Seronegative [arthritis](https:\/\/www.wikidoc.org\/index.php\/Arthritis \"Arthritis\") [Clubbing](https:\/\/www.wikidoc.org\/index.php\/Clubbing \"Clubbing\") [Erythema nodosum](https:\/\/www.wikidoc.org\/index.php\/Erythema_nodosum \"Erythema nodosum\") | Abnormal immune response to self [antigens](https:\/\/www.wikidoc.org\/index.php\/Antigens \"Antigens\") | [Colonoscopy](https:\/\/www.wikidoc.org\/index.php\/Colonoscopy \"Colonoscopy\") with [biopsy](https:\/\/www.wikidoc.org\/index.php\/Biopsy \"Biopsy\") |   |\n| [Celiac disease](https:\/\/www.wikidoc.org\/index.php\/Celiac_disease \"Celiac disease\") | – | \\+ | ± | – | ± | – | \\+ | \\+ | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distention \"Abdominal distention\") Increased [bowel](https:\/\/www.wikidoc.org\/index.php\/Bowel \"Bowel\") sounds Oral [mucosal](https:\/\/www.wikidoc.org\/index.php\/Mucous_membrane \"Mucous membrane\") lesions [Hepatosplenomegaly](https:\/\/www.wikidoc.org\/index.php\/Hepatosplenomegaly \"Hepatosplenomegaly\") [Ascites](https:\/\/www.wikidoc.org\/index.php\/Ascites \"Ascites\") | – | – | – | Nl | Fat droplets on [sudan stain](https:\/\/www.wikidoc.org\/index.php\/Sudan_stain \"Sudan stain\") | Nl | ↓ | Nl | [IgA](https:\/\/www.wikidoc.org\/index.php\/IgA \"IgA\") endomysial [antibody](https:\/\/www.wikidoc.org\/index.php\/Antibody \"Antibody\") Anti–tissue [transglutaminase](https:\/\/www.wikidoc.org\/index.php\/Transglutaminase \"Transglutaminase\") [antibody](https:\/\/www.wikidoc.org\/index.php\/Antibody \"Antibody\") [Anti–gliadin antibody](https:\/\/www.wikidoc.org\/index.php\/Anti-gliadin_antibodies \"Anti-gliadin antibodies\") [Fat soluble vitamins](https:\/\/www.wikidoc.org\/index.php\/Fat_soluble_vitamins \"Fat soluble vitamins\") deficiency | [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") [Dementia](https:\/\/www.wikidoc.org\/index.php\/Dementia \"Dementia\") [Dermatitis herpetiformis](https:\/\/www.wikidoc.org\/index.php\/Dermatitis_herpetiformis \"Dermatitis herpetiformis\") | [HLA–DQ2](https:\/\/www.wikidoc.org\/index.php\/HLA-DQ2 \"HLA-DQ2\") [HLA–DQ8](https:\/\/www.wikidoc.org\/index.php\/HLA-DQ8 \"HLA-DQ8\") Innate responses to wheat [proteins](https:\/\/www.wikidoc.org\/index.php\/Protein \"Protein\") | [IgA](https:\/\/www.wikidoc.org\/index.php\/IgA \"IgA\") endomysial [antibody](https:\/\/www.wikidoc.org\/index.php\/Antibody \"Antibody\") Anti–tissue [transglutaminase](https:\/\/www.wikidoc.org\/index.php\/Transglutaminase \"Transglutaminase\") [antibody](https:\/\/www.wikidoc.org\/index.php\/Antibody \"Antibody\") |   |\n| Cause | Duration | Diarrhea | Fever | Abdominal pain | Weight loss | GI signs | Stool exam | CBC | Other lab findings | Extra intestinal findings | Cause\/Pathogenesis | Gold standard diagnosis |   |   |   |   |   |   |   |   |   |   |\n| Acute | Chronic | Watery | Bloody | Fatty | WBC | RBC | Ova\/Parasite | Osmotic gap | Other | WBC | Hgb | Plt |   |   |   |   |   |   |   |   |   |   |\n| [Cystic fibrosis](https:\/\/www.wikidoc.org\/index.php\/Cystic_fibrosis \"Cystic fibrosis\") | – | \\+ | – | – | \\+ | ± | \\+ | \\+ | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distension \"Abdominal distension\") [Hepatosplenomegaly](https:\/\/www.wikidoc.org\/index.php\/Hepatosplenomegaly \"Hepatosplenomegaly\") [Rectal prolapse](https:\/\/www.wikidoc.org\/index.php\/Rectal_prolapse \"Rectal prolapse\") | – | – | – | Nl | Fat droplets on [sudan stain](https:\/\/www.wikidoc.org\/index.php\/Sudan_stain \"Sudan stain\") | Nl | ↓ | Nl | Positive [DNA](https:\/\/www.wikidoc.org\/index.php\/DNA \"DNA\") analysis for [cystic fibrosis transmembrane conductance regulator](https:\/\/www.wikidoc.org\/index.php\/CFTR \"CFTR\") [(CFTR)](https:\/\/www.wikidoc.org\/index.php\/CFTR \"CFTR\") Nasal transepithelial potential difference [Fat soluble vitamins](https:\/\/www.wikidoc.org\/index.php\/Fat_soluble_vitamins \"Fat soluble vitamins\") deficiency | [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") Recurrent [respiratory tract infection](https:\/\/www.wikidoc.org\/index.php\/Respiratory_tract_infection \"Respiratory tract infection\") [Bronchiectasis](https:\/\/www.wikidoc.org\/index.php\/Bronchiectasis \"Bronchiectasis\") [Diabetes mellitus](https:\/\/www.wikidoc.org\/index.php\/Diabetes_mellitus \"Diabetes mellitus\") [Scoliosis](https:\/\/www.wikidoc.org\/index.php\/Scoliosis \"Scoliosis\") [Infertility](https:\/\/www.wikidoc.org\/index.php\/Infertility \"Infertility\") | Mutations in the [cystic fibrosis transmembrane conductance regulator](https:\/\/www.wikidoc.org\/index.php\/Cystic_fibrosis_transmembrane_conductance_regulator \"Cystic fibrosis transmembrane conductance regulator\") ([CFTR](https:\/\/www.wikidoc.org\/index.php\/CFTR \"CFTR\")) protein | Positive [genetic testing](https:\/\/www.wikidoc.org\/index.php\/Genetic_testing \"Genetic testing\") Elevated [sweat chloride](https:\/\/www.wikidoc.org\/index.php\/Sweat_chloride_test \"Sweat chloride test\") ≥60 mmol\/L |   |\n| [Chronic pancreatitis](https:\/\/www.wikidoc.org\/index.php\/Chronic_pancreatitis \"Chronic pancreatitis\") | – | \\+ | \\+ | – | \\+ | – | \\+ | \\+ | [Abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") | – | – | – | Nl | Fat droplets on [sudan stain](https:\/\/www.wikidoc.org\/index.php\/Sudan_stain \"Sudan stain\") Positive [fecal elastase](https:\/\/www.wikidoc.org\/index.php\/Fecal_elastase \"Fecal elastase\") measurement | Nl | Nl | Nl | Slightly elevated [amylase](https:\/\/www.wikidoc.org\/index.php\/Amylase \"Amylase\") and [lipase](https:\/\/www.wikidoc.org\/index.php\/Lipase \"Lipase\") Abnormal pancreatic function test [Secretin](https:\/\/www.wikidoc.org\/index.php\/Secretin \"Secretin\") stimulation test | [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") [Diabetes mellitus](https:\/\/www.wikidoc.org\/index.php\/Diabetes_mellitus \"Diabetes mellitus\") [Pancreatic pseudocyst](https:\/\/www.wikidoc.org\/index.php\/Pancreatic_pseudocyst \"Pancreatic pseudocyst\") | [Toxins](https:\/\/www.wikidoc.org\/index.php\/Toxin \"Toxin\") Recurrent [acute pancreatitis](https:\/\/www.wikidoc.org\/index.php\/Acute_pancreatitis \"Acute pancreatitis\") [Genetic](https:\/\/www.wikidoc.org\/index.php\/Genetics \"Genetics\") predesposition [Autoimmune](https:\/\/www.wikidoc.org\/index.php\/Autoimmunity \"Autoimmunity\") | [Magnetic resonance cholangiopancreatography](https:\/\/www.wikidoc.org\/index.php\/Magnetic_resonance_cholangiopancreatography \"Magnetic resonance cholangiopancreatography\") ([MRCP](https:\/\/www.wikidoc.org\/index.php\/Magnetic_resonance_cholangiopancreatography \"Magnetic resonance cholangiopancreatography\")) |   |\n| [Bile acid malabsorption](https:\/\/www.wikidoc.org\/index.php\/Bile_acid_malabsorption \"Bile acid malabsorption\") | – | \\+ | \\+ | – | \\+ | – | – | \\+ |   | – | – | – | Nl | Fat droplets on [sudan stain](https:\/\/www.wikidoc.org\/index.php\/Sudan_stain \"Sudan stain\") | Nl | Nl | Nl | Reduced [cholesterol](https:\/\/www.wikidoc.org\/index.php\/Cholesterol \"Cholesterol\") level | [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") [Hypotension](https:\/\/www.wikidoc.org\/index.php\/Hypotension \"Hypotension\") [Tachycardia](https:\/\/www.wikidoc.org\/index.php\/Tachycardia \"Tachycardia\") | Genetic defects in *[SLC10A2](https:\/\/www.wikidoc.org\/index.php\/SLC10A2 \"SLC10A2\")* | [SeHCAT](https:\/\/www.wikidoc.org\/index.php\/SeHCAT \"SeHCAT\") test |   |\n| [Microscopic colitis](https:\/\/www.wikidoc.org\/index.php\/Microscopic_colitis \"Microscopic colitis\") | – | \\+ | \\+ | – | – | – | \\+ | \\+ | [Abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Abdominal_tenderness \"Abdominal tenderness\") Fecal [incontinence](https:\/\/www.wikidoc.org\/index.php\/Incontinence \"Incontinence\") | – | – | – | Nl | – | Nl | ↓ | Nl | [Hypokalemia](https:\/\/www.wikidoc.org\/index.php\/Hypokalemia \"Hypokalemia\") Elevated [CRP](https:\/\/www.wikidoc.org\/index.php\/C-reactive_protein \"C-reactive protein\") Positive [autoantibodies](https:\/\/www.wikidoc.org\/index.php\/Autoantibodies \"Autoantibodies\") include: RF [ANA](https:\/\/www.wikidoc.org\/index.php\/ANA \"ANA\") [AMA](https:\/\/www.wikidoc.org\/index.php\/Anti-mitochondrial_antibody \"Anti-mitochondrial antibody\") [ANCA](https:\/\/www.wikidoc.org\/index.php\/ANCA \"ANCA\") | [Arthritis](https:\/\/www.wikidoc.org\/index.php\/Arthritis \"Arthritis\") [Uveitis](https:\/\/www.wikidoc.org\/index.php\/Uveitis \"Uveitis\") [Idiopathic thrombocytopenic purpura](https:\/\/www.wikidoc.org\/index.php\/Idiopathic_thrombocytopenic_purpura \"Idiopathic thrombocytopenic purpura\") Pleuro [pericarditis](https:\/\/www.wikidoc.org\/index.php\/Pericarditis \"Pericarditis\") [Hypothyroidism](https:\/\/www.wikidoc.org\/index.php\/Hypothyroidism \"Hypothyroidism\") [Psoriasis](https:\/\/www.wikidoc.org\/index.php\/Psoriasis \"Psoriasis\") | [Mucosal](https:\/\/www.wikidoc.org\/index.php\/Mucosal \"Mucosal\") [immune responses](https:\/\/www.wikidoc.org\/index.php\/Immune_responses \"Immune responses\") to luminal factors in a genetically predisposed individual Drug–induced | [Colonoscopy](https:\/\/www.wikidoc.org\/index.php\/Colonoscopy \"Colonoscopy\") with [mucosal](https:\/\/www.wikidoc.org\/index.php\/Mucosal \"Mucosal\") [biopsy](https:\/\/www.wikidoc.org\/index.php\/Biopsy \"Biopsy\") with [mononuclear](https:\/\/www.wikidoc.org\/index.php\/Mononuclear \"Mononuclear\") infiltrates: [Collagenous colitis](https:\/\/www.wikidoc.org\/index.php\/Collagenous_colitis \"Collagenous colitis\") is characterized by a colonic subepithelial [collagen](https:\/\/www.wikidoc.org\/index.php\/Collagen \"Collagen\") band \\>10 micrometers in diameter [Lymphocytic](https:\/\/www.wikidoc.org\/index.php\/Lymphocytic \"Lymphocytic\") [colitis](https:\/\/www.wikidoc.org\/index.php\/Colitis \"Colitis\") is characterized by ≥20 intraepithelial [lymphocytes](https:\/\/www.wikidoc.org\/index.php\/Lymphocytes \"Lymphocytes\") (IEL) per 100 surface epithelial cells |   |\n| Cause | Duration | Diarrhea | Fever | Abdominal pain | Weight loss | GI signs | Stool exam | CBC | Other lab findings | Extra intestinal findings | Cause\/Pathogenesis | Gold standard diagnosis |   |   |   |   |   |   |   |   |   |   |\n| Acute | Chronic | Watery | Bloody | Fatty | WBC | RBC | Ova\/Parasite | Osmotic gap | Other | WBC | Hgb | Plt |   |   |   |   |   |   |   |   |   |   |\n| [Infective colitis](https:\/\/www.wikidoc.org\/index.php\/Infective_colitis \"Infective colitis\") | – | \\+ | \\+ | \\+ | – | \\+ | \\+ | \\+ | Rebound [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") | \\+ | \\+ | \\+ | Nl | Positive [stool culture](https:\/\/www.wikidoc.org\/index.php\/Stool_culture \"Stool culture\") Positive fecal calprotectin Positive fecal [lactoferrin](https:\/\/www.wikidoc.org\/index.php\/Lactoferrin \"Lactoferrin\") | ↑ | ↓ | ↑ | Elevated [CRP](https:\/\/www.wikidoc.org\/index.php\/C-reactive_protein \"C-reactive protein\") Elevated [ESR](https:\/\/www.wikidoc.org\/index.php\/Erythrocyte_sedimentation_rate \"Erythrocyte sedimentation rate\") | [Arthritis](https:\/\/www.wikidoc.org\/index.php\/Arthritis \"Arthritis\") [Uveitis](https:\/\/www.wikidoc.org\/index.php\/Uveitis \"Uveitis\") | [*Salmonella*](https:\/\/www.wikidoc.org\/index.php\/Salmonella \"Salmonella\") [*Shigella*](https:\/\/www.wikidoc.org\/index.php\/Shigella \"Shigella\") [*Campylobacter*](https:\/\/www.wikidoc.org\/index.php\/Campylobacter \"Campylobacter\") *[E. coli 0157:H7](https:\/\/www.wikidoc.org\/index.php\/Escherichia_coli \"Escherichia coli\")* [*Clostridium difficile*](https:\/\/www.wikidoc.org\/index.php\/Clostridium_difficile \"Clostridium difficile\") [*Entamoeba histolytica*](https:\/\/www.wikidoc.org\/index.php\/Entamoeba_histolytica \"Entamoeba histolytica\") [*Adenovirus*](https:\/\/www.wikidoc.org\/index.php\/Adenoviridae \"Adenoviridae\") [*Cytomegalovirus*](https:\/\/www.wikidoc.org\/index.php\/Cytomegalovirus \"Cytomegalovirus\") [*Herpes simplex virus*](https:\/\/www.wikidoc.org\/index.php\/Herpes_simplex_virus \"Herpes simplex virus\") | [Stool culture](https:\/\/www.wikidoc.org\/index.php\/Stool_culture \"Stool culture\") [Blood culture](https:\/\/www.wikidoc.org\/index.php\/Blood_culture \"Blood culture\") |   |\n| [Ischemic colitis](https:\/\/www.wikidoc.org\/index.php\/Ischemic_colitis \"Ischemic colitis\") | \\+ | \\+ | \\+ | \\+ | – | \\+ | \\+ | \\+ | Hyperactive then absent [bowel sounds](https:\/\/www.wikidoc.org\/index.php\/Stomach_rumble \"Stomach rumble\") [Abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") | \\+ | \\+ | – | Nl | – | ↑ | ↓ | ↑ | Elevated [CRP](https:\/\/www.wikidoc.org\/index.php\/C-reactive_protein \"C-reactive protein\") Elevated [ESR](https:\/\/www.wikidoc.org\/index.php\/Erythrocyte_sedimentation_rate \"Erythrocyte sedimentation rate\") Elevated serum [lactate](https:\/\/www.wikidoc.org\/index.php\/Lactic_acid \"Lactic acid\") Elevated [lactate dehydrogenase](https:\/\/www.wikidoc.org\/index.php\/Lactate_dehydrogenase \"Lactate dehydrogenase\") ([LDH](https:\/\/www.wikidoc.org\/index.php\/Lactate_dehydrogenase \"Lactate dehydrogenase\")) Elevated [creatine phosphokinase](https:\/\/www.wikidoc.org\/index.php\/Creatine_kinase \"Creatine kinase\") ([CPK](https:\/\/www.wikidoc.org\/index.php\/Creatine_kinase \"Creatine kinase\")) Elevated [amylase](https:\/\/www.wikidoc.org\/index.php\/Amylase \"Amylase\") [Hypoalbuminemia](https:\/\/www.wikidoc.org\/index.php\/Hypoalbuminemia \"Hypoalbuminemia\") | [IgA vasculitis](https:\/\/www.wikidoc.org\/index.php\/Henoch-Sch%C3%B6nlein_purpura \"Henoch-Schönlein purpura\") | [Hypercoagulability](https:\/\/www.wikidoc.org\/index.php\/Thrombophilia \"Thrombophilia\") Nonocclusive [colonic ischemia](https:\/\/www.wikidoc.org\/index.php\/Ischemic_colitis \"Ischemic colitis\") [Embolic](https:\/\/www.wikidoc.org\/index.php\/Embolism \"Embolism\") and [thrombotic](https:\/\/www.wikidoc.org\/index.php\/Thrombosis \"Thrombosis\") arterial occlusion [Mesenteric vein thrombosis](https:\/\/www.wikidoc.org\/index.php\/Mesenteric_vein_thrombosis \"Mesenteric vein thrombosis\") | Abdominal [CT scan](https:\/\/www.wikidoc.org\/index.php\/Computed_tomography \"Computed tomography\") |   |\n| [Lactose intolerance](https:\/\/www.wikidoc.org\/index.php\/Lactose_intolerance \"Lactose intolerance\") | \\+ | \\+ | \\+ | – | – | – | \\+ | – | [Abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Abdominal_tenderness \"Abdominal tenderness\") [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distention \"Abdominal distention\") | – | – | – | ↑ | – | Nl | Nl | Nl | Lactose tolerance test Genetic testing | [Headache](https:\/\/www.wikidoc.org\/index.php\/Headache \"Headache\") [Vertigo](https:\/\/www.wikidoc.org\/index.php\/Vertigo \"Vertigo\") [Memory impairment](https:\/\/www.wikidoc.org\/index.php\/Memory_impairment \"Memory impairment\") [Lethargy](https:\/\/www.wikidoc.org\/index.php\/Lethargy \"Lethargy\") | Reduction of lactase enzyme activity or inability to produce persistent [lactase](https:\/\/www.wikidoc.org\/index.php\/Lactase \"Lactase\") Congenital [lactase deficiency](https:\/\/www.wikidoc.org\/index.php\/Lactase_deficiency \"Lactase deficiency\") Secondary lactose malabsorption | [Small bowel](https:\/\/www.wikidoc.org\/index.php\/Small_bowel \"Small bowel\") [biopsy](https:\/\/www.wikidoc.org\/index.php\/Biopsy \"Biopsy\") Lactose breath hydrogen test |   |\n| [Irritable bowel syndrome](https:\/\/www.wikidoc.org\/index.php\/Irritable_bowel_syndrome \"Irritable bowel syndrome\") | – | \\+ | ± | – | ± | – | ± | – | [Abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Abdominal_tenderness \"Abdominal tenderness\") [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distention \"Abdominal distention\") Normal [bowel sounds](https:\/\/www.wikidoc.org\/index.php\/Stomach_rumble \"Stomach rumble\") | – | – | – | Nl | – | Nl | Nl | Nl | Nl | [Anxiety](https:\/\/www.wikidoc.org\/index.php\/Anxiety \"Anxiety\") [Palpitation](https:\/\/www.wikidoc.org\/index.php\/Palpitation \"Palpitation\") | Unknown | Diagnosis of exclusion |   |\n| Cause | Duration | Diarrhea | Fever | Abdominal pain | Weight loss | GI signs | Stool exam | CBC | Other lab findings | Extra intestinal findings | Cause\/Pathogenesis | Gold standard diagnosis |   |   |   |   |   |   |   |   |   |   |\n| Acute | Chronic | Watery | Bloody | Fatty | WBC | RBC | Ova\/Parasite | Osmotic gap | Other | WBC | Hgb | Plt |   |   |   |   |   |   |   |   |   |   |\n| [Whipple's disease](https:\/\/www.wikidoc.org\/index.php\/Whipple%27s_disease \"Whipple's disease\") | – | \\+ | \\+ | – | \\+ | ± | \\+ | \\+ | [Hepatosplenomegaly](https:\/\/www.wikidoc.org\/index.php\/Hepatosplenomegaly \"Hepatosplenomegaly\") [Ascites](https:\/\/www.wikidoc.org\/index.php\/Ascites \"Ascites\") | – | – | – | Nl | Positive [fecal fat](https:\/\/www.wikidoc.org\/index.php\/Fecal_fat \"Fecal fat\") | ↓ | ↓ | ↓\/↑ | [Hypoalbuminemia](https:\/\/www.wikidoc.org\/index.php\/Hypoalbuminemia \"Hypoalbuminemia\") [Fat soluble vitamins](https:\/\/www.wikidoc.org\/index.php\/Fat_soluble_vitamins \"Fat soluble vitamins\") deficiency | [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") [Abnormal extraocular movement](https:\/\/www.wikidoc.org\/index.php\/Ocular_motility_disorders \"Ocular motility disorders\") [Lymphadenopathy](https:\/\/www.wikidoc.org\/index.php\/Lymphadenopathy \"Lymphadenopathy\") [Hyperpigmentation](https:\/\/www.wikidoc.org\/index.php\/Hyperpigmentation \"Hyperpigmentation\") [Uveitis](https:\/\/www.wikidoc.org\/index.php\/Uveitis \"Uveitis\") [Endocarditis](https:\/\/www.wikidoc.org\/index.php\/Endocarditis \"Endocarditis\") [Encephalitis](https:\/\/www.wikidoc.org\/index.php\/Encephalitis \"Encephalitis\") [Dementia](https:\/\/www.wikidoc.org\/index.php\/Dementia \"Dementia\") [Pleural effusion](https:\/\/www.wikidoc.org\/index.php\/Pleural_effusion \"Pleural effusion\") | [*Tropheryma whipplei*](https:\/\/www.wikidoc.org\/index.php\/Tropheryma_whipplei \"Tropheryma whipplei\") | [Small intestine](https:\/\/www.wikidoc.org\/index.php\/Small_intestine \"Small intestine\") [biopsy](https:\/\/www.wikidoc.org\/index.php\/Biopsy \"Biopsy\") for [Tropheryma whipplei](https:\/\/www.wikidoc.org\/index.php\/Tropheryma_whipplei \"Tropheryma whipplei\") testing [PCR](https:\/\/www.wikidoc.org\/index.php\/PCR \"PCR\") testing |   |\n| [Tropical sprue](https:\/\/www.wikidoc.org\/index.php\/Tropical_sprue \"Tropical sprue\") | \\+ | \\+ | \\+ | – | \\+ | \\+ | \\+ | \\+ | Angular [stomatitis](https:\/\/www.wikidoc.org\/index.php\/Stomatitis \"Stomatitis\") Oral mucosal lesion | \\+ | – | – | Nl | Positive [stool culture](https:\/\/www.wikidoc.org\/index.php\/Stool_culture \"Stool culture\") | Nl | ↓ | Nl | [Fat soluble vitamins](https:\/\/www.wikidoc.org\/index.php\/Fat_soluble_vitamins \"Fat soluble vitamins\") deficiency [Vitamin B12 deficiency](https:\/\/www.wikidoc.org\/index.php\/Vitamin_B12_deficiency \"Vitamin B12 deficiency\") [Folate deficiency](https:\/\/www.wikidoc.org\/index.php\/Folate_deficiency \"Folate deficiency\") [Hypokalemia](https:\/\/www.wikidoc.org\/index.php\/Hypokalemia \"Hypokalemia\") | [Myalgia](https:\/\/www.wikidoc.org\/index.php\/Myalgia \"Myalgia\") [Neuropathy](https:\/\/www.wikidoc.org\/index.php\/Neuropathy \"Neuropathy\") [Edema](https:\/\/www.wikidoc.org\/index.php\/Edema \"Edema\") | *[Escherichia coli](https:\/\/www.wikidoc.org\/index.php\/Escherichia_coli \"Escherichia coli\")* *[Klebsiella pneumoniae](https:\/\/www.wikidoc.org\/index.php\/Klebsiella_pneumoniae \"Klebsiella pneumoniae\")* *[Enterobacter cloacae](https:\/\/www.wikidoc.org\/index.php\/Enterobacter_cloacae \"Enterobacter cloacae\")* | Diagnosis of exclusion |   |\n| [Small bowel bacterial overgrowth](https:\/\/www.wikidoc.org\/index.php\/Small_bowel_bacterial_overgrowth_syndrome \"Small bowel bacterial overgrowth syndrome\") | – | \\+ | \\+ | – | \\+ | – | \\+ | \\+ | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distension \"Abdominal distension\") | \\+ | – | – | Nl | Positive [stool culture](https:\/\/www.wikidoc.org\/index.php\/Stool_culture \"Stool culture\") Positive [fecal fat](https:\/\/www.wikidoc.org\/index.php\/Fecal_fat \"Fecal fat\") | Nl | ↓ | Nl | [Hypoalbuminemia](https:\/\/www.wikidoc.org\/index.php\/Hypoalbuminemia \"Hypoalbuminemia\") Abnormal [hydrogen breath test](https:\/\/www.wikidoc.org\/index.php\/Hydrogen_Breath_Test \"Hydrogen Breath Test\") [Lactic acidosis](https:\/\/www.wikidoc.org\/index.php\/Lactic_acidosis \"Lactic acidosis\") | [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") [Rosacea](https:\/\/www.wikidoc.org\/index.php\/Rosacea \"Rosacea\") | Excess bacteria in the [small intestine](https:\/\/www.wikidoc.org\/index.php\/Small_intestine \"Small intestine\") Alterations in [intestinal](https:\/\/www.wikidoc.org\/index.php\/Intestine \"Intestine\") [anatomy](https:\/\/www.wikidoc.org\/index.php\/Anatomy \"Anatomy\") or GI motility | Diagnosis of exclusion |   |\n| Cause | Duration | Diarrhea | Fever | Abdominal pain | Weight loss | GI signs | Stool exam | CBC | Other lab findings | Extra intestinal findings | Cause\/Pathogenesis | Gold standard diagnosis |   |   |   |   |   |   |   |   |   |   |\n| Acute | Chronic | Watery | Bloody | Fatty | WBC | RBC | Ova\/Parasite | Osmotic gap | Other | WBC | Hgb | Plt |   |   |   |   |   |   |   |   |   |   |\n| [Salmonellosis](https:\/\/www.wikidoc.org\/index.php\/Salmonellosis \"Salmonellosis\") | \\+ | \\+ | \\+ | \\+ | – | \\+ | \\+ | – | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distention \"Abdominal distention\") Diffuse [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Abdominal_tenderness \"Abdominal tenderness\") [Hepatosplenomegaly](https:\/\/www.wikidoc.org\/index.php\/Hepatosplenomegaly \"Hepatosplenomegaly\") | \\+ | \\+ | – | Nl | Positive [stool culture](https:\/\/www.wikidoc.org\/index.php\/Stool_culture \"Stool culture\") Positive serologic testing | ↑ | Nl | ↑ | [Hypokalemia](https:\/\/www.wikidoc.org\/index.php\/Hypokalemia \"Hypokalemia\") [Hypernatremia](https:\/\/www.wikidoc.org\/index.php\/Hypernatremia \"Hypernatremia\") [Hyponatremia](https:\/\/www.wikidoc.org\/index.php\/Hyponatremia \"Hyponatremia\") [Hypercalciuria](https:\/\/www.wikidoc.org\/index.php\/Hypercalciuria \"Hypercalciuria\") [Hypocitraturia](https:\/\/www.wikidoc.org\/index.php\/Hypocitraturia \"Hypocitraturia\") | [Post–infectious arthritis](https:\/\/www.wikidoc.org\/index.php\/Post-infectious_arthritis \"Post-infectious arthritis\") [Obtundation](https:\/\/www.wikidoc.org\/index.php\/Obtundation \"Obtundation\") [Bacteremia](https:\/\/www.wikidoc.org\/index.php\/Bacteremia \"Bacteremia\") [Pericarditis](https:\/\/www.wikidoc.org\/index.php\/Pericarditis \"Pericarditis\") [Pyelonephritis](https:\/\/www.wikidoc.org\/index.php\/Pyelonephritis \"Pyelonephritis\") [Brain abscess](https:\/\/www.wikidoc.org\/index.php\/Brain_abscess \"Brain abscess\") | [*Salmonella*](https:\/\/www.wikidoc.org\/index.php\/Salmonella \"Salmonella\") | [Stool culture](https:\/\/www.wikidoc.org\/index.php\/Stool_culture \"Stool culture\") |   |\n| [Escherichia coli enteritis](https:\/\/www.wikidoc.org\/index.php\/Escherichia_coli_enteritis \"Escherichia coli enteritis\") | [**EPEC**](https:\/\/www.wikidoc.org\/index.php\/EPEC \"EPEC\") | \\+ | \\+ | \\+ | \\+ | – | \\+ | \\+ | \\+ | Diffuse [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Abdominal_tenderness \"Abdominal tenderness\") | \\+ | \\+ | – | Nl | Positive [stool culture](https:\/\/www.wikidoc.org\/index.php\/Stool_culture \"Stool culture\") | ↑ | Nl | Nl | – | – | *[Enteropathogenic E. coli](https:\/\/www.wikidoc.org\/index.php\/Enteropathogenic_E._coli \"Enteropathogenic E. coli\")* | [DNA probe](https:\/\/www.wikidoc.org\/index.php\/Hybridization_probe \"Hybridization probe\") or [polymerase chain reaction](https:\/\/www.wikidoc.org\/index.php\/Polymerase_chain_reaction \"Polymerase chain reaction\") ([PCR](https:\/\/www.wikidoc.org\/index.php\/Polymerase_chain_reaction \"Polymerase chain reaction\")) of the *EPEC* adherence factor [Stool culture](https:\/\/www.wikidoc.org\/index.php\/Stool_culture \"Stool culture\") |\n| [**EAEC**](https:\/\/www.wikidoc.org\/index.php\/EAEC \"EAEC\") | \\+ | \\+ | \\+ | \\+ | – | – | \\+ | – | Diffuse [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Abdominal_tenderness \"Abdominal tenderness\") | \\+ | \\+ | – | Nl | Positive [stool culture](https:\/\/www.wikidoc.org\/index.php\/Stool_culture \"Stool culture\") | ↑ | ↓ | ↓ | – | Chronic infection in [immunocompromised](https:\/\/www.wikidoc.org\/index.php\/Immunodeficiency \"Immunodeficiency\") patients | [*Enteroaggregative E. coli*](https:\/\/www.wikidoc.org\/index.php\/Escherichia_coli_enteritis \"Escherichia coli enteritis\") | [Stool culture](https:\/\/www.wikidoc.org\/index.php\/Stool_culture \"Stool culture\") |   |\n| [Aeromonas](https:\/\/www.wikidoc.org\/index.php\/Aeromonas \"Aeromonas\") | \\+ | \\+ | \\+ | \\+ | – | \\+ | \\+ | – | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distention \"Abdominal distention\") Hyperactive [bowel sounds](https:\/\/www.wikidoc.org\/index.php\/Stomach_rumble \"Stomach rumble\") Diffuse [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Abdominal_tenderness \"Abdominal tenderness\") | \\+ | \\+ | – | Nl | Positive [stool culture](https:\/\/www.wikidoc.org\/index.php\/Stool_culture \"Stool culture\") | ↑ | Nl | Nl | – | Wound [infection](https:\/\/www.wikidoc.org\/index.php\/Infection \"Infection\") [Bacteremia](https:\/\/www.wikidoc.org\/index.php\/Bacteremia \"Bacteremia\") [Hemolytic uremic syndrome](https:\/\/www.wikidoc.org\/index.php\/Hemolytic-uremic_syndrome \"Hemolytic-uremic syndrome\") [Meningitis](https:\/\/www.wikidoc.org\/index.php\/Meningitis \"Meningitis\") [Ocular](https:\/\/www.wikidoc.org\/index.php\/Ocular \"Ocular\") infection [Pneumonia](https:\/\/www.wikidoc.org\/index.php\/Pneumonia \"Pneumonia\") [Urinary tract infection](https:\/\/www.wikidoc.org\/index.php\/Urinary_tract_infection \"Urinary tract infection\") [Osteomyelitis](https:\/\/www.wikidoc.org\/index.php\/Osteomyelitis \"Osteomyelitis\") [Peritonitis](https:\/\/www.wikidoc.org\/index.php\/Peritonitis \"Peritonitis\") [Acute cholecystitis](https:\/\/www.wikidoc.org\/index.php\/Acute_cholecystitis \"Acute cholecystitis\") [Opportunistic infections](https:\/\/www.wikidoc.org\/index.php\/Opportunistic_infection \"Opportunistic infection\") in [immunocompromised](https:\/\/www.wikidoc.org\/index.php\/Immunodeficiency \"Immunodeficiency\") patients | *[Aeromonas](https:\/\/www.wikidoc.org\/index.php\/Aeromonas \"Aeromonas\")* virulence factors including [endotoxins](https:\/\/www.wikidoc.org\/index.php\/Endotoxin \"Endotoxin\"), [hemolysins](https:\/\/www.wikidoc.org\/index.php\/Hemolysin \"Hemolysin\"), [enterotoxins](https:\/\/www.wikidoc.org\/index.php\/Enterotoxin \"Enterotoxin\"), and adherence factors | [Blood culture](https:\/\/www.wikidoc.org\/index.php\/Blood_culture \"Blood culture\") Wound [culture](https:\/\/www.wikidoc.org\/index.php\/Culture_collection \"Culture collection\") |   |\n| Cause | Duration | Diarrhea | Fever | Abdominal pain | Weight loss | GI signs | Stool exam | CBC | Other lab findings | Extra intestinal findings | Cause\/Pathogenesis | Gold standard diagnosis |   |   |   |   |   |   |   |   |   |   |\n| Acute | Chronic | Watery | Bloody | Fatty | WBC | RBC | Ova\/Parasite | Osmotic gap | Other | WBC | Hgb | Plt |   |   |   |   |   |   |   |   |   |   |\n| [Mycobacterium avium complex](https:\/\/www.wikidoc.org\/index.php\/Mycobacterium_avium_complex \"Mycobacterium avium complex\") | \\+ | \\+ | \\+ | \\+ | – | \\+ | \\+ | – | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distension \"Abdominal distension\") [Hepatosplenomegaly](https:\/\/www.wikidoc.org\/index.php\/Hepatosplenomegaly \"Hepatosplenomegaly\") | \\+ | \\+ | – | Nl | – | ↓ | ↓ | Nl | Elevated [liver enzymes](https:\/\/www.wikidoc.org\/index.php\/Liver_function_tests \"Liver function tests\") | [Opportunistic infection](https:\/\/www.wikidoc.org\/index.php\/Opportunistic_infection \"Opportunistic infection\") in [immunocompromised](https:\/\/www.wikidoc.org\/index.php\/Immunodeficiency \"Immunodeficiency\") patients [Pulmonary](https:\/\/www.wikidoc.org\/index.php\/Pulmonary \"Pulmonary\") [infection](https:\/\/www.wikidoc.org\/index.php\/Infection \"Infection\") [Adenopathy](https:\/\/www.wikidoc.org\/index.php\/Lymphadenopathy \"Lymphadenopathy\") [Night sweats](https:\/\/www.wikidoc.org\/index.php\/Sleep_hyperhidrosis \"Sleep hyperhidrosis\") | [*Mycobacterium avium complex*](https:\/\/www.wikidoc.org\/index.php\/Mycobacterium_avium_complex \"Mycobacterium avium complex\") | [Blood culture](https:\/\/www.wikidoc.org\/index.php\/Blood_culture \"Blood culture\") |   |\n| [CMV colitis](https:\/\/www.wikidoc.org\/index.php\/CMV_colitis \"CMV colitis\") | \\+ | \\+ | – | \\+ | – | ± | \\+ | – | Diffuse [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") | \\+ | \\+ | – | Nl | Viral antigen assay | ↓ | Nl | Nl | Decreased [CD4](https:\/\/www.wikidoc.org\/index.php\/CD4 \"CD4\") level Abnormal [liver function test](https:\/\/www.wikidoc.org\/index.php\/Liver_function_tests \"Liver function tests\") | [Encephalitis](https:\/\/www.wikidoc.org\/index.php\/Encephalitis \"Encephalitis\") [Guillain–Barré syndrome](https:\/\/www.wikidoc.org\/index.php\/Guillain-Barr%C3%A9_syndrome \"Guillain-Barré syndrome\") [Pneumonia](https:\/\/www.wikidoc.org\/index.php\/Pneumonia \"Pneumonia\") [Retinitis](https:\/\/www.wikidoc.org\/index.php\/Retinitis \"Retinitis\") [Pericarditis](https:\/\/www.wikidoc.org\/index.php\/Pericarditis \"Pericarditis\") and [myocarditis](https:\/\/www.wikidoc.org\/index.php\/Myocarditis \"Myocarditis\") [Atherosclerosis](https:\/\/www.wikidoc.org\/index.php\/Atherosclerosis \"Atherosclerosis\") [Venous thrombosis](https:\/\/www.wikidoc.org\/index.php\/Venous_thromboembolism \"Venous thromboembolism\") | [*Cytomegalovirus*](https:\/\/www.wikidoc.org\/index.php\/Cytomegalovirus \"Cytomegalovirus\") | [Quantitative PCR](https:\/\/www.wikidoc.org\/index.php\/Quantitative_polymerase_chain_reaction \"Quantitative polymerase chain reaction\") tests |   |\n| [HIV](https:\/\/www.wikidoc.org\/index.php\/Human_Immunodeficiency_Virus_\\(HIV\\) \"Human Immunodeficiency Virus (HIV)\") | – | \\+ | \\+ | – | – | \\+ | \\+ | \\+ | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distension \"Abdominal distension\") Diffuse [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") | \\+ | – | – | Nl | – | ↓ | ↓ | Nl | Decreased [CD4](https:\/\/www.wikidoc.org\/index.php\/CD4 \"CD4\") level [Electrolyte imbalance](https:\/\/www.wikidoc.org\/index.php\/Electrolyte_disturbance \"Electrolyte disturbance\") | [Lymphadenopathy](https:\/\/www.wikidoc.org\/index.php\/Lymphadenopathy \"Lymphadenopathy\") Disseminated [infection](https:\/\/www.wikidoc.org\/index.php\/Infection \"Infection\") | [*HIV*](https:\/\/www.wikidoc.org\/index.php\/Human_Immunodeficiency_Virus_\\(HIV\\) \"Human Immunodeficiency Virus (HIV)\") | HIV virologic (viral load) test Immunoassay |   |\n| Cause | Duration | Diarrhea | Fever | Abdominal pain | Weight loss | GI signs | Stool exam | CBC | Other lab findings | Extra intestinal findings | Cause\/Pathogenesis | Gold standard diagnosis |   |   |   |   |   |   |   |   |   |   |\n| Acute | Chronic | Watery | Bloody | Fatty | WBC | RBC | Ova\/Parasite | Osmotic gap | Other | WBC | Hgb | Plt |   |   |   |   |   |   |   |   |   |   |\n| [Entamoeba histolytica](https:\/\/www.wikidoc.org\/index.php\/Entamoeba_histolytica \"Entamoeba histolytica\") | \\+ | \\+ | \\+ | \\+ | – | \\+ | \\+ | – | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distension \"Abdominal distension\") Diffuse [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") | \\+ | \\+ | \\+ | Nl | – | ↑ | Nl | Nl | – | [Liver abscess](https:\/\/www.wikidoc.org\/index.php\/Liver_abscess \"Liver abscess\") Pleuropulmonary infection [Cardiac](https:\/\/www.wikidoc.org\/index.php\/Cardiac \"Cardiac\") [infection](https:\/\/www.wikidoc.org\/index.php\/Infection \"Infection\") [Brain abscess](https:\/\/www.wikidoc.org\/index.php\/Brain_abscess \"Brain abscess\") [Cutaneous infection](https:\/\/www.wikidoc.org\/index.php\/Skin_and_soft-tissue_infections \"Skin and soft-tissue infections\") | [*Entamoeba histolytica*](https:\/\/www.wikidoc.org\/index.php\/Entamoeba_histolytica \"Entamoeba histolytica\") | Antigen testing Serology |   |\n| [Giardia](https:\/\/www.wikidoc.org\/index.php\/Giardia_lamblia \"Giardia lamblia\") | – | \\+ | \\+ | – | \\+ | – | \\+ | \\+ | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distension \"Abdominal distension\") Diffuse [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") | – | – | \\+ | Nl | – | Nl | Nl | Nl | – | [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") [Urticaria](https:\/\/www.wikidoc.org\/index.php\/Urticaria \"Urticaria\") [Depression](https:\/\/www.wikidoc.org\/index.php\/Depression \"Depression\") | *[Giardia lamblia](https:\/\/www.wikidoc.org\/index.php\/Giardia_lamblia \"Giardia lamblia\")* | Antigen detection assays |   |\n| [Cryptosporidium](https:\/\/www.wikidoc.org\/index.php\/Cryptosporidium \"Cryptosporidium\") | – | \\+ | \\+ | – | – | – | \\+ | \\+ | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distension \"Abdominal distension\") Diffuse [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") | – | – | \\+ | Nl | Positive stool microscopy | Nl | Nl | Nl | Elevated [alkaline phosphatase](https:\/\/www.wikidoc.org\/index.php\/Alkaline_phosphatase \"Alkaline phosphatase\") | Chronic, life–threatening illness in [immunocompromised](https:\/\/www.wikidoc.org\/index.php\/Immunodeficiency \"Immunodeficiency\") patients | [*Cryptosporidium*](https:\/\/www.wikidoc.org\/index.php\/Cryptosporidium \"Cryptosporidium\") | Polymerase chain reaction |   |\n| [Microsporidia](https:\/\/www.wikidoc.org\/index.php\/Microsporidia \"Microsporidia\") | \\+ | \\+ | \\+ | – | – | \\+ | \\+ | – | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distension \"Abdominal distension\") Diffuse [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") | – | – | \\+ | Nl | Positive stool microscopy | Nl | Nl | Nl | Decreased [CD4](https:\/\/www.wikidoc.org\/index.php\/CD4 \"CD4\") count | [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") [Keratitis](https:\/\/www.wikidoc.org\/index.php\/Keratitis \"Keratitis\") [Seizure](https:\/\/www.wikidoc.org\/index.php\/Seizure \"Seizure\") [Myositis](https:\/\/www.wikidoc.org\/index.php\/Myositis \"Myositis\") | [Microsporidia](https:\/\/www.wikidoc.org\/index.php\/Microsporidia \"Microsporidia\") | Antigen detection assays |   |\n| [Isospora](https:\/\/www.wikidoc.org\/index.php\/Isospora \"Isospora\") | \\+ | \\+ | \\+ | – | \\+ | \\+ | \\+ | \\+ | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distension \"Abdominal distension\") Diffuse [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") | \\+ | \\+ | \\+ | Nl | Positive stool microscopy Positive [fecal fat](https:\/\/www.wikidoc.org\/index.php\/Fecal_fat \"Fecal fat\") | ↑ | Nl | Nl | Elevated [eosinophils](https:\/\/www.wikidoc.org\/index.php\/Eosinophil_granulocyte \"Eosinophil granulocyte\") [Hypokalemia](https:\/\/www.wikidoc.org\/index.php\/Hypokalemia \"Hypokalemia\") Increased [creatinine](https:\/\/www.wikidoc.org\/index.php\/Creatinine \"Creatinine\") | Chronic illness in [immunocompromised](https:\/\/www.wikidoc.org\/index.php\/Immunodeficiency \"Immunodeficiency\") patients | [*Isospora*](https:\/\/www.wikidoc.org\/index.php\/Isospora \"Isospora\") | Detecting oocysts in the feces |   |\n| Cause | Duration | Diarrhea | Fever | Abdominal pain | Weight loss | GI signs | Stool exam | CBC | Other lab findings | Extra intestinal findings | Cause\/Pathogenesis | Gold standard diagnosis |   |   |   |   |   |   |   |   |   |   |\n| Acute | Chronic | Watery | Bloody | Fatty | WBC | RBC | Ova\/Parasite | Osmotic gap | Other | WBC | Hgb | Plt |   |   |   |   |   |   |   |   |   |   |\n| [Carcinoid tumor](https:\/\/www.wikidoc.org\/index.php\/Carcinoid_syndrome \"Carcinoid syndrome\") | – | \\+ | \\+ | \\+ | – | – | \\+ | \\+ | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distention \"Abdominal distention\") | – | \\+ | – | ↓ | – | Nl | Nl | Nl | Elevated urinary [5–hydroxyindoleacetic acid](https:\/\/www.wikidoc.org\/index.php\/5-Hydroxyindoleacetic_acid \"5-Hydroxyindoleacetic acid\") ([5–HIAA](https:\/\/www.wikidoc.org\/index.php\/5-Hydroxyindoleacetic_acid \"5-Hydroxyindoleacetic acid\")) level High [chromogranin A](https:\/\/www.wikidoc.org\/index.php\/Chromogranin_A \"Chromogranin A\") | [Facial flushing](https:\/\/www.wikidoc.org\/index.php\/Flushing \"Flushing\") [Jaundice](https:\/\/www.wikidoc.org\/index.php\/Jaundice \"Jaundice\") [Edema](https:\/\/www.wikidoc.org\/index.php\/Edema \"Edema\") [Valvular heart disease](https:\/\/www.wikidoc.org\/index.php\/Valvular_heart_disease \"Valvular heart disease\") [Right–sided heart failure](https:\/\/www.wikidoc.org\/index.php\/Congestive_heart_failure \"Congestive heart failure\") | Well–differentiated [neuroendocrine tumor](https:\/\/www.wikidoc.org\/index.php\/Neuroendocrine_tumors \"Neuroendocrine tumors\") | Blood [chromogranin A](https:\/\/www.wikidoc.org\/index.php\/Chromogranin_A \"Chromogranin A\") level |   |\n| [VIPoma](https:\/\/www.wikidoc.org\/index.php\/VIPoma \"VIPoma\") | \\+ | \\+ | \\+ | – | \\+ | – | \\+ | \\+ | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distention \"Abdominal distention\") Abdominal [RUQ](https:\/\/www.wikidoc.org\/index.php\/RUQ \"RUQ\") [tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness \"Tenderness\") [Nausea](https:\/\/www.wikidoc.org\/index.php\/Nausea \"Nausea\") [Vomiting](https:\/\/www.wikidoc.org\/index.php\/Vomiting \"Vomiting\") | – | – | – | ↓ | – | Nl | Nl | Nl | Elevated [VIP](https:\/\/www.wikidoc.org\/index.php\/VIP \"VIP\") level [Hypokalemia](https:\/\/www.wikidoc.org\/index.php\/Hypokalemia \"Hypokalemia\") [Hypochlorhydria](https:\/\/www.wikidoc.org\/index.php\/Hypochlorhydria \"Hypochlorhydria\") or [achlorhydria](https:\/\/www.wikidoc.org\/index.php\/Achlorhydria \"Achlorhydria\") Low osmotic gap (\\<50 mOsm\/kg) | [Rash](https:\/\/www.wikidoc.org\/index.php\/Rash \"Rash\") [Facial flushing](https:\/\/www.wikidoc.org\/index.php\/Facial_flushing \"Facial flushing\") [Dehydration](https:\/\/www.wikidoc.org\/index.php\/Dehydration \"Dehydration\") [Lethargy](https:\/\/www.wikidoc.org\/index.php\/Lethargy \"Lethargy\") [Muscle weakness](https:\/\/www.wikidoc.org\/index.php\/Muscle_weakness \"Muscle weakness\") | Primary secretory tumor | Blood [VIP](https:\/\/www.wikidoc.org\/index.php\/VIP \"VIP\") levels Followed by imaging |   |\n| [Zollinger–Ellison syndrome](https:\/\/www.wikidoc.org\/index.php\/Zollinger-Ellison_syndrome \"Zollinger-Ellison syndrome\") | – | \\+ | \\+ | \\+ | \\+ | – | \\+ | \\+ | [Epigastric tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness \"Tenderness\") | – | – | – | ↓ | – | Nl | ↓ | Nl | Positive [secretin](https:\/\/www.wikidoc.org\/index.php\/Secretin \"Secretin\") stimulation test Elevated serum [chromogranin A](https:\/\/www.wikidoc.org\/index.php\/Chromogranin_A \"Chromogranin A\") | [Jaundice](https:\/\/www.wikidoc.org\/index.php\/Jaundice \"Jaundice\") | [Gastrin](https:\/\/www.wikidoc.org\/index.php\/Gastrin \"Gastrin\") producing [tumor](https:\/\/www.wikidoc.org\/index.php\/Tumor \"Tumor\") mainly in [duodenum](https:\/\/www.wikidoc.org\/index.php\/Duodenum \"Duodenum\") | [Secretin](https:\/\/www.wikidoc.org\/index.php\/Secretin \"Secretin\") stimulation test |   |\n| [Somatostatinoma](https:\/\/www.wikidoc.org\/index.php\/Neuroendocrine_tumors \"Neuroendocrine tumors\") | – | \\+ | \\+ | – | – | – | \\+ | \\+ | [Epigastric tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness \"Tenderness\") | – | – | – | ↓ | – | Nl | Nl | Nl | Elevated fasting plasma [somatostatin](https:\/\/www.wikidoc.org\/index.php\/Somatostatin \"Somatostatin\") | [Diabetes mellitus](https:\/\/www.wikidoc.org\/index.php\/Diabetes_mellitus \"Diabetes mellitus\") [Cholelithiasis](https:\/\/www.wikidoc.org\/index.php\/Gallstone_disease \"Gallstone disease\") [Jaundice](https:\/\/www.wikidoc.org\/index.php\/Jaundice \"Jaundice\") | [Neuroendocrine tumors](https:\/\/www.wikidoc.org\/index.php\/Neuroendocrine_tumors \"Neuroendocrine tumors\") of D–cell origin | Plasma [somatostatin](https:\/\/www.wikidoc.org\/index.php\/Somatostatin \"Somatostatin\") level Followed by imaging |   |\n| Cause | Duration | Diarrhea | Fever | Abdominal pain | Weight loss | GI signs | Stool exam | CBC | Other lab findings | Extra intestinal findings | Cause\/Pathogenesis | Gold standard diagnosis |   |   |   |   |   |   |   |   |   |   |\n| Acute | Chronic | Watery | Bloody | Fatty | WBC | RBC | Ova\/Parasite | Osmotic gap | Other | WBC | Hgb | Plt |   |   |   |   |   |   |   |   |   |   |\n| [Lymphoma](https:\/\/www.wikidoc.org\/index.php\/Lymphoma \"Lymphoma\") | – | \\+ | \\+ | \\+ | – | \\+ | \\+ | \\+ | Diffuse [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") [Hepatosplenomegaly](https:\/\/www.wikidoc.org\/index.php\/Hepatosplenomegaly \"Hepatosplenomegaly\") | – | \\+ | – | Nl | – | Nl | ↓ | Nl | [Paraproteinemia](https:\/\/www.wikidoc.org\/index.php\/Paraproteinemia \"Paraproteinemia\") | [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") [Lactose intolerance](https:\/\/www.wikidoc.org\/index.php\/Lactose_intolerance \"Lactose intolerance\") [Ascites](https:\/\/www.wikidoc.org\/index.php\/Ascites \"Ascites\") | Primary [tumor](https:\/\/www.wikidoc.org\/index.php\/Tumor \"Tumor\") of GI tract | [Colonoscopy](https:\/\/www.wikidoc.org\/index.php\/Colonoscopy \"Colonoscopy\") with [biopsy](https:\/\/www.wikidoc.org\/index.php\/Biopsy \"Biopsy\") |   |\n| [Colorectal cancer](https:\/\/www.wikidoc.org\/index.php\/Colorectal_cancer \"Colorectal cancer\") | – | \\+ | \\+ | \\+ | \\+ | – | \\+ | \\+ | Diffuse [abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") | – | \\+ | – | Nl | – | Nl | ↓ | Nl | Positive [carcinoembryonic antigen](https:\/\/www.wikidoc.org\/index.php\/Carcinoembryonic_antigen \"Carcinoembryonic antigen\") | [Metastasis](https:\/\/www.wikidoc.org\/index.php\/Metastasis \"Metastasis\") | [FAP gene](https:\/\/www.wikidoc.org\/index.php\/FAP \"FAP\") [HNPCC gene](https:\/\/www.wikidoc.org\/index.php\/Hereditary_nonpolyposis_colorectal_cancer \"Hereditary nonpolyposis colorectal cancer\") | [Colonoscopy](https:\/\/www.wikidoc.org\/index.php\/Colonoscopy \"Colonoscopy\") and [biopsy](https:\/\/www.wikidoc.org\/index.php\/Biopsy \"Biopsy\") |   |\n| Medications [ACE inhibitors](https:\/\/www.wikidoc.org\/index.php\/ACE_inhibitor \"ACE inhibitor\") [Digoxin](https:\/\/www.wikidoc.org\/index.php\/Digoxin \"Digoxin\") [Cephalosporins](https:\/\/www.wikidoc.org\/index.php\/Cephalosporin \"Cephalosporin\") [Statins](https:\/\/www.wikidoc.org\/index.php\/Statins \"Statins\") [Thiazide diuretics](https:\/\/www.wikidoc.org\/index.php\/Thiazide \"Thiazide\") [Triptans](https:\/\/www.wikidoc.org\/index.php\/Triptans \"Triptans\") [Lactulose](https:\/\/www.wikidoc.org\/index.php\/Lactulose \"Lactulose\") [Anti retroviral agents](https:\/\/www.wikidoc.org\/index.php\/HIV_AIDS_medical_therapy \"HIV AIDS medical therapy\") [Chemotherapeutic agents](https:\/\/www.wikidoc.org\/index.php\/Chemotherapy \"Chemotherapy\") [Antifungals](https:\/\/www.wikidoc.org\/index.php\/Antifungal_drug \"Antifungal drug\") [Magnesium](https:\/\/www.wikidoc.org\/index.php\/Magnesium \"Magnesium\") | \\+ | \\+ | \\+ | – | ± | ± | \\+ | \\+ | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distention \"Abdominal distention\") [Dehydration](https:\/\/www.wikidoc.org\/index.php\/Dehydration \"Dehydration\") | – | – | – | ↑\/↓ | – | ↑ | Nl | Nl | Elevated plasma level of drug | – | [Inflammation](https:\/\/www.wikidoc.org\/index.php\/Inflammation \"Inflammation\") [Pseudomembranous colitis](https:\/\/www.wikidoc.org\/index.php\/Pseudomembranous_enterocolitis \"Pseudomembranous enterocolitis\") | Clinical evaluation after discontinuation of the drugs |   |\n| Factitious diarrhea | \\+ | \\+ | \\+ | – | – | – | \\+ | \\+ | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distention \"Abdominal distention\") | – | – | – | ↑\/↓ | – | Nl | Nl | Nl | [Hypokalemia](https:\/\/www.wikidoc.org\/index.php\/Hypokalemia \"Hypokalemia\") [Metabolic alkalosis](https:\/\/www.wikidoc.org\/index.php\/Metabolic_alkalosis \"Metabolic alkalosis\") [Hypermagnesemia](https:\/\/www.wikidoc.org\/index.php\/Hypermagnesemia \"Hypermagnesemia\") | [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") [Lethargy](https:\/\/www.wikidoc.org\/index.php\/Lethargy \"Lethargy\") [Generalized weakness](https:\/\/www.wikidoc.org\/index.php\/Generalized_weakness \"Generalized weakness\") [Acute renal failure](https:\/\/www.wikidoc.org\/index.php\/Acute_kidney_injury \"Acute kidney injury\") | [Medications](https:\/\/www.wikidoc.org\/index.php\/Medication \"Medication\") | Clinical evaluation after discontinuation of the drugs |   |\n| Cause | Duration | Diarrhea | Fever | Abdominal pain | Weight loss | GI signs | Stool exam | CBC | Other lab findings | Extra intestinal findings | Cause\/Pathogenesis | Gold standard diagnosis |   |   |   |   |   |   |   |   |   |   |\n| Acute | Chronic | Watery | Bloody | Fatty | WBC | RBC | Ova\/Parasite | Osmotic gap | Other | WBC | Hgb | Plt |   |   |   |   |   |   |   |   |   |   |\n| [Heavy metal ingestion](https:\/\/www.wikidoc.org\/index.php\/Heavy_metal_ingestion \"Heavy metal ingestion\") | – | \\+ | \\+ | – | – | – | \\+ | \\+ | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distention \"Abdominal distention\") | – | – | – | Nl | – | Nl | Nl | Nl | Elevated plasma heavy metal level | [Headache](https:\/\/www.wikidoc.org\/index.php\/Headache \"Headache\") [Numbness](https:\/\/www.wikidoc.org\/index.php\/Paresthesia \"Paresthesia\") [Alopecia](https:\/\/www.wikidoc.org\/index.php\/Alopecia \"Alopecia\") [Vertigo](https:\/\/www.wikidoc.org\/index.php\/Vertigo \"Vertigo\") | [Heavy metal ingestion](https:\/\/www.wikidoc.org\/index.php\/Heavy_metal_ingestion \"Heavy metal ingestion\") | Plasma level of heavy metal |   |\n| [Organophosphate poisoning](https:\/\/www.wikidoc.org\/index.php\/Organophosphate_poisoning \"Organophosphate poisoning\") | \\+ | \\+ | \\+ | – | – | – | \\+ | – | [Salivation](https:\/\/www.wikidoc.org\/index.php\/Saliva \"Saliva\") [Vomiting](https:\/\/www.wikidoc.org\/index.php\/Nausea_and_vomiting \"Nausea and vomiting\") | – | – | – | Nl | – | Nl | Nl | Nl | Reduced RBC acetylcholinesterase Plasma [cholinesterase](https:\/\/www.wikidoc.org\/index.php\/Cholinesterase \"Cholinesterase\") activity | [Autonomic dysfunction](https:\/\/www.wikidoc.org\/index.php\/Dysautonomia \"Dysautonomia\") Motor deficit Sensory deficit [Bronchospasm](https:\/\/www.wikidoc.org\/index.php\/Bronchospasm \"Bronchospasm\") [Urination](https:\/\/www.wikidoc.org\/index.php\/Urination \"Urination\") [Miosis](https:\/\/www.wikidoc.org\/index.php\/Miosis \"Miosis\") [Bradycardia](https:\/\/www.wikidoc.org\/index.php\/Bradycardia \"Bradycardia\") [Lacrimation](https:\/\/www.wikidoc.org\/index.php\/Lacrimation \"Lacrimation\") [Sweating](https:\/\/www.wikidoc.org\/index.php\/Sweating \"Sweating\") [Cardiac arrhythmias](https:\/\/www.wikidoc.org\/index.php\/Cardiac_arrhythmia \"Cardiac arrhythmia\") [Acute renal injury](https:\/\/www.wikidoc.org\/index.php\/Acute_kidney_injury \"Acute kidney injury\") | [Neurotoxins](https:\/\/www.wikidoc.org\/index.php\/Neurotoxin \"Neurotoxin\") bind to [acetylcholinesterase](https:\/\/www.wikidoc.org\/index.php\/ACHE \"ACHE\") (AChE) | Clinical diagnosis |   |\n| [Opium withdrawal](https:\/\/www.wikidoc.org\/index.php\/Opium_withdrawal \"Opium withdrawal\") | \\+ | \\+ | \\+ | – | – | – | \\+ | – | Hyperactive [bowel sounds](https:\/\/www.wikidoc.org\/index.php\/Stomach_rumble \"Stomach rumble\") | – | – | – | Nl | – | Nl | Nl | Nl | [Azotemia](https:\/\/www.wikidoc.org\/index.php\/Azotemia \"Azotemia\") [Hypokalemia](https:\/\/www.wikidoc.org\/index.php\/Hypokalemia \"Hypokalemia\") [Metabolic alkalosis](https:\/\/www.wikidoc.org\/index.php\/Metabolic_alkalosis \"Metabolic alkalosis\") | [Dysphoria](https:\/\/www.wikidoc.org\/index.php\/Dysphoria \"Dysphoria\") [Restlessness](https:\/\/www.wikidoc.org\/index.php\/Agitation_\\(emotion\\) \"Agitation (emotion)\") [Sweating](https:\/\/www.wikidoc.org\/index.php\/Perspiration \"Perspiration\") [Rhinorrhea](https:\/\/www.wikidoc.org\/index.php\/Rhinorrhea \"Rhinorrhea\") [Lacrimation](https:\/\/www.wikidoc.org\/index.php\/Tears \"Tears\") [Myalgia](https:\/\/www.wikidoc.org\/index.php\/Myalgia \"Myalgia\") [Arthralgia](https:\/\/www.wikidoc.org\/index.php\/Arthralgia \"Arthralgia\") | [Opium withdrawal](https:\/\/www.wikidoc.org\/index.php\/Opium \"Opium\") | Clinical diagnosis following [opium withdrawal](https:\/\/www.wikidoc.org\/index.php\/Opium_withdrawal \"Opium withdrawal\") |   |\n| Cause | Duration | Diarrhea | Fever | Abdominal pain | Weight loss | GI signs | Stool exam | CBC | Other lab findings | Extra intestinal findings | Cause\/Pathogenesis | Gold standard diagnosis |   |   |   |   |   |   |   |   |   |   |\n| Acute | Chronic | Watery | Bloody | Fatty | WBC | RBC | Ova\/Parasite | Osmotic gap | Other | WBC | Hgb | Plt |   |   |   |   |   |   |   |   |   |   |\n| [Short bowel syndrome](https:\/\/www.wikidoc.org\/index.php\/Short_bowel_syndrome \"Short bowel syndrome\") | \\+ | \\+ | \\+ | – | \\+ | – | – | \\+ | [Abdominal distention](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distension \"Abdominal distension\") [Abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") | – | – | – | Nl | Positive [fecal fat](https:\/\/www.wikidoc.org\/index.php\/Fecal_fat \"Fecal fat\") | Nl | ↓ | ↑ | [Hypoalbuminemia](https:\/\/www.wikidoc.org\/index.php\/Hypoalbuminemia \"Hypoalbuminemia\") High level of [acute phase reactant](https:\/\/www.wikidoc.org\/index.php\/Acute_phase_protein \"Acute phase protein\") Abnormal [liver function tests](https:\/\/www.wikidoc.org\/index.php\/Liver_function_tests \"Liver function tests\") | Prior [intestinal](https:\/\/www.wikidoc.org\/index.php\/Intestine \"Intestine\") surgery [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") [Crohn's disease](https:\/\/www.wikidoc.org\/index.php\/Crohn%27s_disease \"Crohn's disease\") [Malignancy](https:\/\/www.wikidoc.org\/index.php\/Cancer \"Cancer\") Peripheral [edema](https:\/\/www.wikidoc.org\/index.php\/Edema \"Edema\") [Muscle atrophy](https:\/\/www.wikidoc.org\/index.php\/Muscle_atrophy \"Muscle atrophy\") | Surgical [bowel resection](https:\/\/www.wikidoc.org\/index.php\/Bowel_resection \"Bowel resection\") | Clinical diagnosis following [bowel resection](https:\/\/www.wikidoc.org\/index.php\/Bowel_resection \"Bowel resection\") |   |\n| [Radiation enteritis](https:\/\/www.wikidoc.org\/index.php\/Radiation_enteropathy \"Radiation enteropathy\") | \\+ | \\+ | \\+ | \\+ | \\+ | – | \\+ | \\+ | [Abdominal tenderness](https:\/\/www.wikidoc.org\/index.php\/Tenderness_\\(medicine\\) \"Tenderness (medicine)\") | \\+ | \\+ | – | Nl | Positive [fecal fat](https:\/\/www.wikidoc.org\/index.php\/Fecal_fat \"Fecal fat\") | Nl | ↓ | Nl | Vitamin B12 deficiency [Hypoalbuminemia](https:\/\/www.wikidoc.org\/index.php\/Hypoalbuminemia \"Hypoalbuminemia\") | Prior history of [malignancy](https:\/\/www.wikidoc.org\/index.php\/Cancer \"Cancer\") and [radiation therapy](https:\/\/www.wikidoc.org\/index.php\/Radiation_therapy \"Radiation therapy\") [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") [Telangiectasias](https:\/\/www.wikidoc.org\/index.php\/Telangiectasia \"Telangiectasia\") | [Radiation](https:\/\/www.wikidoc.org\/index.php\/Radiation_therapy \"Radiation therapy\") | Segmental bowel [inflammation](https:\/\/www.wikidoc.org\/index.php\/Inflammation \"Inflammation\") on [endoscopy](https:\/\/www.wikidoc.org\/index.php\/Endoscopy \"Endoscopy\") or [colonoscopy](https:\/\/www.wikidoc.org\/index.php\/Colonoscopy \"Colonoscopy\") |   |\n| [Dumping syndrome](https:\/\/www.wikidoc.org\/index.php\/Gastric_dumping_syndrome \"Gastric dumping syndrome\") | – | \\+ | \\+ | – | \\+ | – | – | \\+ | Hyperactive [bowel sound](https:\/\/www.wikidoc.org\/index.php\/Bowel_sound \"Bowel sound\") | – | – | – | Nl | – | Nl | Nl | Nl | [Hypoglycemia](https:\/\/www.wikidoc.org\/index.php\/Hypoglycemia \"Hypoglycemia\") [Hydrogen breath test](https:\/\/www.wikidoc.org\/index.php\/Hydrogen_Breath_Test \"Hydrogen Breath Test\") | [Malnutrition](https:\/\/www.wikidoc.org\/index.php\/Malnutrition \"Malnutrition\") [Fat soluble vitamin](https:\/\/www.wikidoc.org\/index.php\/Fat_soluble_vitamins \"Fat soluble vitamins\") deficiency | [Postgastrectomy](https:\/\/www.wikidoc.org\/index.php\/Post_operative_complications \"Post operative complications\") | Clinical diagnosis following [gastrectomy](https:\/\/www.wikidoc.org\/index.php\/Gastrectomy \"Gastrectomy\") |   |\n| Cause | Duration | Diarrhea | Fever | Abdominal pain | Weight loss | GI signs | Stool exam | CBC | Other lab findings | Extra intestinal findings | Cause\/Pathogenesis | Gold standard diagnosis |   |   |   |   |   |   |   |   |   |   |\n| Acute | Chronic | Watery | Bloody | Fatty | WBC | RBC | Ova\/Parasite | Osmotic gap | Other | WBC | Hgb | Plt |   |   |   |   |   |   |   |   |   |   |\n| [Abetalipoproteinemia](https:\/\/www.wikidoc.org\/index.php\/Abetalipoproteinemia \"Abetalipoproteinemia\") | – | \\+ | \\+ | – | \\+ | – | \\+ | \\+ | [Abdominal distension](https:\/\/www.wikidoc.org\/index.php\/Abdominal_distension \"Abdominal distension\") | – | – | – | Nl | – | Nl | Nl | Nl | Low [triglyceride](https:\/\/www.wikidoc.org\/index.php\/Triglyceride \"Triglyceride\") Low total [cholesterol](https:\/\/www.wikidoc.org\/index.php\/Cholesterol \"Cholesterol\") levels [Acanthocytes](https:\/\/www.wikidoc.org\/index.php\/Acanthocytes \"Acanthocytes\") Low [vitamin E](https:\/\/www.wikidoc.org\/index.php\/Vitamin_E \"Vitamin E\") levels | [Ataxia](https:\/\/www.wikidoc.org\/index.php\/Ataxia \"Ataxia\") [Visual field defect](https:\/\/www.wikidoc.org\/index.php\/Visual_field_defect \"Visual field defect\") [Dysarthria](https:\/\/www.wikidoc.org\/index.php\/Dysarthria \"Dysarthria\") | [Autosomal recessive](https:\/\/www.wikidoc.org\/index.php\/Autosomal_recessive \"Autosomal recessive\") disorder caused by mutations encoding the [microsomal triglyceride transfer protein](https:\/\/www.wikidoc.org\/index.php\/Microsomal_triglyceride_transfer_protein \"Microsomal triglyceride transfer protein\") (MTP) | Clinical findings and low [triglyceride](https:\/\/www.wikidoc.org\/index.php\/Triglyceride \"Triglyceride\") and [cholesterol](https:\/\/www.wikidoc.org\/index.php\/Cholesterol \"Cholesterol\") level |   |\n| [Hyperthyroidism](https:\/\/www.wikidoc.org\/index.php\/Hyperthyroidism \"Hyperthyroidism\") | – | \\+ | \\+ | – | – | ± | \\+ | \\+ | – | – | – | – | Nl | Positive [fecal fat](https:\/\/www.wikidoc.org\/index.php\/Fecal_fat \"Fecal fat\") | Nl | Nl | Nl | Elevated [T4](https:\/\/www.wikidoc.org\/index.php\/T4 \"T4\") Elevated [T3](https:\/\/www.wikidoc.org\/index.php\/T3 \"T3\") Decreased [TSH](https:\/\/www.wikidoc.org\/index.php\/TSH \"TSH\") High serum [alkaline phosphatase](https:\/\/www.wikidoc.org\/index.php\/Alkaline_phosphatase \"Alkaline phosphatase\") | Lump in the neck Lid lag [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") [Sweating](https:\/\/www.wikidoc.org\/index.php\/Sweating \"Sweating\") [Hyperpigmentation](https:\/\/www.wikidoc.org\/index.php\/Hyperpigmentation \"Hyperpigmentation\") [Proptosis](https:\/\/www.wikidoc.org\/index.php\/Proptosis \"Proptosis\") [Tremor](https:\/\/www.wikidoc.org\/index.php\/Tremor \"Tremor\") Increased [DTR](https:\/\/www.wikidoc.org\/index.php\/Deep_tendon_reflex \"Deep tendon reflex\") | [Graves' disease](https:\/\/www.wikidoc.org\/index.php\/Graves%27_disease \"Graves' disease\") [Hashimoto's thyroiditis](https:\/\/www.wikidoc.org\/index.php\/Hashimoto%27s_thyroiditis \"Hashimoto's thyroiditis\") [Toxic adenoma](https:\/\/www.wikidoc.org\/index.php\/Toxic_adenoma \"Toxic adenoma\") | [TSH](https:\/\/www.wikidoc.org\/index.php\/TSH \"TSH\") |   |\n| [Diabetic neuropathy](https:\/\/www.wikidoc.org\/index.php\/Diabetic_neuropathy \"Diabetic neuropathy\") | – | \\+ | \\+ | – | \\+ | – | \\+ | \\+ | [Fecal incontinence](https:\/\/www.wikidoc.org\/index.php\/Fecal_incontinence \"Fecal incontinence\") | – | – | – | Nl | Positive [fecal fat](https:\/\/www.wikidoc.org\/index.php\/Fecal_fat \"Fecal fat\") | Nl | ↓ | Nl | [Hyperglycemia](https:\/\/www.wikidoc.org\/index.php\/Hyperglycemia \"Hyperglycemia\") [Azotemia](https:\/\/www.wikidoc.org\/index.php\/Azotemia \"Azotemia\") [Hypokalemia](https:\/\/www.wikidoc.org\/index.php\/Hypokalemia \"Hypokalemia\") | [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") | Unclear Disordered [motility](https:\/\/www.wikidoc.org\/index.php\/Motility \"Motility\") Increased [intestinal](https:\/\/www.wikidoc.org\/index.php\/Intestine \"Intestine\") secretion [Small intestinal bacterial overgrowth](https:\/\/www.wikidoc.org\/index.php\/Small_intestinal_bacterial_overgrowth \"Small intestinal bacterial overgrowth\") | Clinical diagnosis in a patient with long lasting [diabetes mellitus](https:\/\/www.wikidoc.org\/index.php\/Diabetes_mellitus \"Diabetes mellitus\") |   |\n| [Systemic sclerosis](https:\/\/www.wikidoc.org\/index.php\/Scleroderma \"Scleroderma\") | – | \\+ | \\+ | ± | \\+ | – | \\+ | \\+ | [Epigastric tenderness](https:\/\/www.wikidoc.org\/index.php\/Abdominal_pain \"Abdominal pain\") [Fecal incontinence](https:\/\/www.wikidoc.org\/index.php\/Fecal_incontinence \"Fecal incontinence\") | – | \\+ | – | Nl | Positive [fecal fat](https:\/\/www.wikidoc.org\/index.php\/Fecal_fat \"Fecal fat\") | Nl | ↓ | Nl | Anti–[topoisomerase I](https:\/\/www.wikidoc.org\/index.php\/Type_I_topoisomerase \"Type I topoisomerase\") (Scl‑70) antibodies [Antinuclear antibodies](https:\/\/www.wikidoc.org\/index.php\/Antinuclear_antibodies \"Antinuclear antibodies\") ([ANA](https:\/\/www.wikidoc.org\/index.php\/Antinuclear_antibodies \"Antinuclear antibodies\")) [Anti–centromere antibodies](https:\/\/www.wikidoc.org\/index.php\/Anti-centromere_antibodies \"Anti-centromere antibodies\") Anti–[RNA polymerase III](https:\/\/www.wikidoc.org\/index.php\/RNA_polymerase_III \"RNA polymerase III\") antibody | [Malabsorption](https:\/\/www.wikidoc.org\/index.php\/Malabsorption \"Malabsorption\") [Skin changes](https:\/\/www.wikidoc.org\/index.php\/Skin_changes \"Skin changes\") [Raynaud phenomenon](https:\/\/www.wikidoc.org\/index.php\/Raynaud%27s_phenomenon \"Raynaud's phenomenon\") [Pulmonary hypertension](https:\/\/www.wikidoc.org\/index.php\/Pulmonary_hypertension \"Pulmonary hypertension\") [Arthritis](https:\/\/www.wikidoc.org\/index.php\/Arthritis \"Arthritis\") [Telangiectasia](https:\/\/www.wikidoc.org\/index.php\/Telangiectasia \"Telangiectasia\") [Chronic renal failure](https:\/\/www.wikidoc.org\/index.php\/Chronic_renal_failure \"Chronic renal failure\") | [Autoimmune reaction](https:\/\/www.wikidoc.org\/index.php\/Autoimmunity \"Autoimmunity\") | Clinical diagnosis Followed by serologic tests |   |\n\nReferences\n\n1. [↑](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_ref-Casburn-JonesFarthing2004_1-0)\n   Casburn-Jones, Anna C; Farthing, Michael Jg (2004). \"Traveler's diarrhea\". *Journal of Gastroenterology and Hepatology*. **19** (6): 610–618. [doi](https:\/\/www.wikidoc.org\/index.php\/Digital_object_identifier \"Digital object identifier\"):[10\\.1111\/j.1440-1746.2003.03287.x](https:\/\/doi.org\/10.1111%2Fj.1440-1746.2003.03287.x). [ISSN](https:\/\/www.wikidoc.org\/index.php\/International_Standard_Serial_Number \"International Standard Serial Number\") [0815-9319](https:\/\/www.worldcat.org\/issn\/0815-9319).\n2. [↑](https:\/\/www.wikidoc.org\/index.php\/Chronic_diarrhea_differential_diagnosis#cite_ref-KamatMathur2006_2-0)\n   Kamat, Deepak; Mathur, Ambika (2006). \"Prevention and Management of Travelers' Diarrhea\". *Disease-a-Month*. **52** (7): 289–302. 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Boilerpipe Text	To review the differential diagnosis of diarrhea, click here . Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D. [2] , Seyedmahdi Pahlavani, M.D. [3] Overview The differential diagnosis for chronic diarrhea is enormous, with a large number of diagnostic tests available that can be used to evaluate these patients. Classifying a patient's chronic diarrhea into a subcategory such as watery , fatty and inflammatory helps to direct the diagnostic work-up. Some watery causes of chronic diarrhea which should be differentiated from one another include crohn's disease , hyperthyroidism , VIPoma , lactose intolerance , celiac disease and irritable bowel syndrome (IBS). The causes of fatty diarrhea that should be differentiated from one another include celiac sprue , pancreatic insufficiency , bacterial overgrowth and maldigestion problems which results from pancreatic exocrine insufficiency . Finally, the inflammatory causes of chronic diarrhea such as ulcerative colitis and entamoeba histolytica must also be differentiated. Differential Diagnosis of Chronic Diarrhea from other diseases The following table outlines the major differential diagnoses of chronic diarrhea. [ 1 ] [ 2 ] [ 3 ] [ 4 ] [ 5 ] [ 6 ] [ 7 ] [ 8 ] [ 9 ] [ 10 ] [ 11 ] [ 12 ] [ 13 ] [ 14 ] [ 15 ] [ 16 ] [ 17 ] [ 18 ] [ 19 ] [ 20 ] [ 21 ] [ 22 ] [ 23 ] [ 24 ] [ 25 ] [ 26 ] [ 27 ] [ 28 ] [ 29 ] [ 30 ] Abbreviations: GI: Gastrointestinal , CBC : Complete blood count , WBC: White blood cell , RBC : Red blood cell , Plt: Platelet , Hgb: Hemoglobin , ESR : Erythrocyte sedimentation rate , CRP : C–reactive protein , IgE: Immunoglobulin E , IgA: Immunoglobulin A , ETEC: Escherichia coli enteritis , EPEC : Enteropathogenic Escherichia coli , EIEC : Enteroinvasive Escherichia coli , EHEC : Enterohemorrhagic Escherichia coli , EAEC : Enteroaggregative Escherichia coli , Nl : Normal, ASCA : Anti saccharomyces cerevisiae antibodies , ANCA : Anti–neutrophil cytoplasmic antibody , DNA : Deoxyribonucleic acid , CFTR : Cystic fibrosis transmembrane conductance regulator , SLC10A2 : Solute carrier family 10 member 2 , SeHCAT : Selenium homocholic acid taurine or tauroselcholic acid , IEL : Intraepithelial lymphocytes , MRCP : Magnetic resonance cholangiopancreatography , ANA : Antinuclear antibodies , AMA : Anti-mitochondrial antibody , LDH : Lactate dehydrogenase , CPK : Creatine phosphokinase , PCR : Polymerase chain reaction , ELISA : Enzyme–linked immunosorbent assay , LT : Heat–labile enterotoxin , ST: Heat–stable enterotoxin , RT-PCR : Reverse–transcriptase polymerase chain reaction , CD4: Cluster of differentiation 4 , HIV : Human immunodeficiency virus , RUQ : Right-upper quadrant , VIP : Vasoactive intestinal peptide , GI: Gastrointestinal , FAP : Familial adenomatous polyposis , HNPCC : Hereditary nonpolyposis colorectal cancer , MTP : Microsomal triglyceride transfer protein , Scl‑70 : Anti– topoisomerase I , TSH : Thyroid-stimulating hormone , T4 : Thyroxine , T3 : Triiodothyronine , DTR : Deep tendon reflex , RNA : Ribonucleic acid Cause Clinical manifestation Lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis Symptoms GI signs Duration Diarrhea Fever Abdominal pain Weight loss Stool exam CBC Other lab findings Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt Crohn's disease – + + + + ± + + Abdominal tenderness Oral mucosal lesions + + – Nl – ↑ ↓ ↑ Anti saccharomyces cerevisiae antibodies (ASCA) Vitamin B12 deficiency Elevated ESR Elevated CRP Uveitis Arthritis Erythema nodosum Pyoderma gangrenosum Amyloidosis Venous and arterial thromboembolism Renal stones Bronchiectasis Abnormal immune response to self antigens Colonoscopy with biopsy Ulcerative colitis – + + + + ± + + Abdominal tenderness Blood on rectal examination + + – Nl – ↑ ↓ ↑ Anti–neutrophil cytoplasmic antibody ( P–ANCA ) Hypoalbuminemia Hypokalemia Hypomagnesemia Elevated ESR Elevated CRP Skin rash Iritis Uveitis Seronegative arthritis Clubbing Erythema nodosum Abnormal immune response to self antigens Colonoscopy with biopsy Celiac disease – + ± – ± – + + Abdominal distention Increased bowel sounds Oral mucosal lesions Hepatosplenomegaly Ascites – – – Nl Fat droplets on sudan stain Nl ↓ Nl IgA endomysial antibody Anti–tissue transglutaminase antibody Anti–gliadin antibody Fat soluble vitamins deficiency Malabsorption Dementia Dermatitis herpetiformis HLA–DQ2 HLA–DQ8 Innate responses to wheat proteins IgA endomysial antibody Anti–tissue transglutaminase antibody Cause Duration Diarrhea Fever Abdominal pain Weight loss GI signs Stool exam CBC Other lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt Cystic fibrosis – + – – + ± + + Abdominal distention Hepatosplenomegaly Rectal prolapse – – – Nl Fat droplets on sudan stain Nl ↓ Nl Positive DNA analysis for cystic fibrosis transmembrane conductance regulator (CFTR) Nasal transepithelial potential difference Fat soluble vitamins deficiency Malabsorption Recurrent respiratory tract infection Bronchiectasis Diabetes mellitus Scoliosis Infertility Mutations in the cystic fibrosis transmembrane conductance regulator ( CFTR ) protein Positive genetic testing Elevated sweat chloride ≥60 mmol/L Chronic pancreatitis – + + – + – + + Abdominal tenderness – – – Nl Fat droplets on sudan stain Positive fecal elastase measurement Nl Nl Nl Slightly elevated amylase and lipase Abnormal pancreatic function test Secretin stimulation test Malabsorption Diabetes mellitus Pancreatic pseudocyst Toxins Recurrent acute pancreatitis Genetic predesposition Autoimmune Magnetic resonance cholangiopancreatography ( MRCP ) Bile acid malabsorption – + + – + – – + – – – Nl Fat droplets on sudan stain Nl Nl Nl Reduced cholesterol level Malabsorption Hypotension Tachycardia Genetic defects in SLC10A2 SeHCAT test Microscopic colitis – + + – – – + + Abdominal tenderness Fecal incontinence – – – Nl – Nl ↓ Nl Hypokalemia Elevated CRP Positive autoantibodies include: RF ANA AMA ANCA Arthritis Uveitis Idiopathic thrombocytopenic purpura Pleuro pericarditis Hypothyroidism Psoriasis Mucosal immune responses to luminal factors in a genetically predisposed individual Drug–induced Colonoscopy with mucosal biopsy with mononuclear infiltrates: Collagenous colitis is characterized by a colonic subepithelial collagen band >10 micrometers in diameter Lymphocytic colitis is characterized by ≥20 intraepithelial lymphocytes (IEL) per 100 surface epithelial cells Cause Duration Diarrhea Fever Abdominal pain Weight loss GI signs Stool exam CBC Other lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt Infective colitis – + + + – + + + Rebound abdominal tenderness + + + Nl Positive stool culture Positive fecal calprotectin Positive fecal lactoferrin ↑ ↓ ↑ Elevated CRP Elevated ESR Arthritis Uveitis Salmonella Shigella Campylobacter E. coli 0157:H7 Clostridium difficile Entamoeba histolytica Adenovirus Cytomegalovirus Herpes simplex virus Stool culture Blood culture Ischemic colitis + + + + – + + + Hyperactive then absent bowel sounds Abdominal tenderness + + – Nl – ↑ ↓ ↑ Elevated CRP Elevated ESR Elevated serum lactate Elevated lactate dehydrogenase ( LDH ) Elevated creatine phosphokinase ( CPK ) Elevated amylase Hypoalbuminemia IgA vasculitis Hypercoagulability Nonocclusive colonic ischemia Embolic and thrombotic arterial occlusion Mesenteric vein thrombosis Abdominal CT scan Lactose intolerance + + + – – – + – Abdominal tenderness Abdominal distention – – – ↑ – Nl Nl Nl Lactose tolerance test Genetic testing Headache Vertigo Memory impairment Lethargy Reduction of lactase enzyme activity or inability to produce persistent lactase Congenital lactase deficiency Secondary lactose malabsorption Small bowel biopsy Lactose breath hydrogen test Irritable bowel syndrome – + ± – ± – ± – Abdominal tenderness Abdominal distention Normal bowel sounds – – – Nl – Nl Nl Nl Nl Anxiety Palpitation Unknown Diagnosis of exclusion Cause Duration Diarrhea Fever Abdominal pain Weight loss GI signs Stool exam CBC Other lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt Whipple's disease – + + – + ± + + Hepatosplenomegaly Ascites – – – Nl Positive fecal fat ↓ ↓ ↓/↑ Hypoalbuminemia Fat soluble vitamins deficiency Malabsorption Abnormal extraocular movement Lymphadenopathy Hyperpigmentation Uveitis Endocarditis Encephalitis Dementia Pleural effusion Tropheryma whipplei Small intestine biopsy for Tropheryma whipplei testing PCR testing Tropical sprue + + + – + + + + Angular stomatitis Oral mucosal lesion + – – Nl Positive stool culture Nl ↓ Nl Fat soluble vitamins deficiency Vitamin B12 deficiency Folate deficiency Hypokalemia Myalgia Neuropathy Edema Escherichia coli Klebsiella pneumoniae Enterobacter cloacae Diagnosis of exclusion Small bowel bacterial overgrowth – + + – + – + + Abdominal distention + – – Nl Positive stool culture Positive fecal fat Nl ↓ Nl Hypoalbuminemia Abnormal hydrogen breath test Lactic acidosis Malabsorption Rosacea Excess bacteria in the small intestine Alterations in intestinal anatomy or GI motility Diagnosis of exclusion Cause Duration Diarrhea Fever Abdominal pain Weight loss GI signs Stool exam CBC Other lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt Salmonellosis + + + + – + + – Abdominal distention Diffuse abdominal tenderness Hepatosplenomegaly + + – Nl Positive stool culture Positive serologic testing ↑ Nl ↑ Hypokalemia Hypernatremia Hyponatremia Hypercalciuria Hypocitraturia Post–infectious arthritis Obtundation Bacteremia Pericarditis Pyelonephritis Brain abscess Salmonella Stool culture Escherichia coli enteritis EPEC + + + + – + + + Diffuse abdominal tenderness + + – Nl Positive stool culture ↑ Nl Nl – – Enteropathogenic E. coli DNA probe or polymerase chain reaction ( PCR ) of the EPEC adherence factor Stool culture EAEC + + + + – – + – Diffuse abdominal tenderness + + – Nl Positive stool culture ↑ ↓ ↓ – Chronic infection in immunocompromised patients Enteroaggregative E. coli Stool culture Aeromonas + + + + – + + – Abdominal distention Hyperactive bowel sounds Diffuse abdominal tenderness + + – Nl Positive stool culture ↑ Nl Nl – Wound infection Bacteremia Hemolytic uremic syndrome Meningitis Ocular infection Pneumonia Urinary tract infection Osteomyelitis Peritonitis Acute cholecystitis Opportunistic infections in immunocompromised patients Aeromonas virulence factors including endotoxins , hemolysins , enterotoxins , and adherence factors Blood culture Wound culture Cause Duration Diarrhea Fever Abdominal pain Weight loss GI signs Stool exam CBC Other lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt Mycobacterium avium complex + + + + – + + – Abdominal distention Hepatosplenomegaly + + – Nl – ↓ ↓ Nl Elevated liver enzymes Opportunistic infection in immunocompromised patients Pulmonary infection Adenopathy Night sweats Mycobacterium avium complex Blood culture CMV colitis + + – + – ± + – Diffuse abdominal tenderness + + – Nl Viral antigen assay ↓ Nl Nl Decreased CD4 level Abnormal liver function test Encephalitis Guillain–Barré syndrome Pneumonia Retinitis Pericarditis and myocarditis Atherosclerosis Venous thrombosis Cytomegalovirus Quantitative PCR tests HIV – + + – – + + + Abdominal distention Diffuse abdominal tenderness + – – Nl – ↓ ↓ Nl Decreased CD4 level Electrolyte imbalance Lymphadenopathy Disseminated infection HIV HIV virologic (viral load) test Immunoassay Cause Duration Diarrhea Fever Abdominal pain Weight loss GI signs Stool exam CBC Other lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt Entamoeba histolytica + + + + – + + – Abdominal distention Diffuse abdominal tenderness + + + Nl – ↑ Nl Nl – Liver abscess Pleuropulmonary infection Cardiac infection Brain abscess Cutaneous infection Entamoeba histolytica Antigen testing Serology Giardia – + + – + – + + Abdominal distention Diffuse abdominal tenderness – – + Nl – Nl Nl Nl – Malabsorption Urticaria Depression Giardia lamblia Antigen detection assays Cryptosporidium – + + – – – + + Abdominal distention Diffuse abdominal tenderness – – + Nl Positive stool microscopy Nl Nl Nl Elevated alkaline phosphatase Chronic, life–threatening illness in immunocompromised patients Cryptosporidium Polymerase chain reaction Microsporidia + + + – – + + – Abdominal distention Diffuse abdominal tenderness – – + Nl Positive stool microscopy Nl Nl Nl Decreased CD4 count Malabsorption Keratitis Seizure Myositis Microsporidia Antigen detection assays Isospora + + + – + + + + Abdominal distention Diffuse abdominal tenderness + + + Nl Positive stool microscopy Positive fecal fat ↑ Nl Nl Elevated eosinophils Hypokalemia Increased creatinine Chronic illness in immunocompromised patients Isospora Detecting oocysts in the feces Cause Duration Diarrhea Fever Abdominal pain Weight loss GI signs Stool exam CBC Other lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt Carcinoid tumor – + + + – – + + Abdominal distention – + – ↓ – Nl Nl Nl Elevated urinary 5–hydroxyindoleacetic acid ( 5–HIAA ) level High chromogranin A Facial flushing Jaundice Edema Valvular heart disease Right–sided heart failure Well–differentiated neuroendocrine tumor Blood chromogranin A level VIPoma + + + – + – + + Abdominal distention Abdominal RUQ tenderness Nausea Vomiting – – – ↓ – Nl Nl Nl Elevated VIP level Hypokalemia Hypochlorhydria or achlorhydria Low osmotic gap (<50 mOsm/kg) Rash Facial flushing Dehydration Lethargy Muscle weakness Primary secretory tumor Blood VIP levels Followed by imaging Zollinger–Ellison syndrome – + + + + – + + Epigastric tenderness – – – ↓ – Nl ↓ Nl Positive secretin stimulation test Elevated serum chromogranin A Jaundice Gastrin producing tumor mainly in duodenum Secretin stimulation test Somatostatinoma – + + – – – + + Epigastric tenderness – – – ↓ – Nl Nl Nl Elevated fasting plasma somatostatin Diabetes mellitus Cholelithiasis Jaundice Neuroendocrine tumors of D–cell origin Plasma somatostatin level Followed by imaging Cause Duration Diarrhea Fever Abdominal pain Weight loss GI signs Stool exam CBC Other lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt Lymphoma – + + + – + + + Diffuse abdominal tenderness Hepatosplenomegaly – + – Nl – Nl ↓ Nl Paraproteinemia Malabsorption Lactose intolerance Ascites Primary tumor of GI tract Colonoscopy with biopsy Colorectal cancer – + + + + – + + Diffuse abdominal tenderness – + – Nl – Nl ↓ Nl Positive carcinoembryonic antigen Metastasis FAP gene HNPCC gene Colonoscopy and biopsy Medications ACE inhibitors Digoxin Cephalosporins Statins Thiazide diuretics Triptans Lactulose Anti retroviral agents Chemotherapeutic agents Antifungals Magnesium + + + – ± ± + + Abdominal distention Dehydration – – – ↑/↓ – ↑ Nl Nl Elevated plasma level of drug – Inflammation Pseudomembranous colitis Clinical evaluation after discontinuation of the drugs Factitious diarrhea + + + – – – + + Abdominal distention – – – ↑/↓ – Nl Nl Nl Hypokalemia Metabolic alkalosis Hypermagnesemia Malabsorption Lethargy Generalized weakness Acute renal failure Medications Clinical evaluation after discontinuation of the drugs Cause Duration Diarrhea Fever Abdominal pain Weight loss GI signs Stool exam CBC Other lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt Heavy metal ingestion – + + – – – + + Abdominal distention – – – Nl – Nl Nl Nl Elevated plasma heavy metal level Headache Numbness Alopecia Vertigo Heavy metal ingestion Plasma level of heavy metal Organophosphate poisoning + + + – – – + – Salivation Vomiting – – – Nl – Nl Nl Nl Reduced RBC acetylcholinesterase Plasma cholinesterase activity Autonomic dysfunction Motor deficit Sensory deficit Bronchospasm Urination Miosis Bradycardia Lacrimation Sweating Cardiac arrhythmias Acute renal injury Neurotoxins bind to acetylcholinesterase (AChE) Clinical diagnosis Opium withdrawal + + + – – – + – Hyperactive bowel sounds – – – Nl – Nl Nl Nl Azotemia Hypokalemia Metabolic alkalosis Dysphoria Restlessness Sweating Rhinorrhea Lacrimation Myalgia Arthralgia Opium withdrawal Clinical diagnosis following opium withdrawal Cause Duration Diarrhea Fever Abdominal pain Weight loss GI signs Stool exam CBC Other lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt Short bowel syndrome + + + – + – – + Abdominal distention Abdominal tenderness – – – Nl Positive fecal fat Nl ↓ ↑ Hypoalbuminemia High level of acute phase reactant Abnormal liver function tests Prior intestinal surgery Malabsorption Crohn's disease Malignancy Peripheral edema Muscle atrophy Surgical bowel resection Clinical diagnosis following bowel resection Radiation enteritis + + + + + – + + Abdominal tenderness + + – Nl Positive fecal fat Nl ↓ Nl Vitamin B12 deficiency Hypoalbuminemia Prior history of malignancy and radiation therapy Malabsorption Telangiectasias Radiation Segmental bowel inflammation on endoscopy or colonoscopy Dumping syndrome – + + – + – – + Hyperactive bowel sound – – – Nl – Nl Nl Nl Hypoglycemia Hydrogen breath test Malnutrition Fat soluble vitamin deficiency Postgastrectomy Clinical diagnosis following gastrectomy Cause Duration Diarrhea Fever Abdominal pain Weight loss GI signs Stool exam CBC Other lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt Abetalipoproteinemia – + + – + – + + Abdominal distension – – – Nl – Nl Nl Nl Low triglyceride Low total cholesterol levels Acanthocytes Low vitamin E levels Ataxia Visual field defect Dysarthria Autosomal recessive disorder caused by mutations encoding the microsomal triglyceride transfer protein (MTP) Clinical findings and low triglyceride and cholesterol level Hyperthyroidism – + + – – ± + + – – – – Nl Positive fecal fat Nl Nl Nl Elevated T4 Elevated T3 Decreased TSH High serum alkaline phosphatase Lump in the neck Lid lag Malabsorption Sweating Hyperpigmentation Proptosis Tremor Increased DTR Graves' disease Hashimoto's thyroiditis Toxic adenoma TSH Diabetic neuropathy – + + – + – + + Fecal incontinence – – – Nl Positive fecal fat Nl ↓ Nl Hyperglycemia Azotemia Hypokalemia Malabsorption Unclear Disordered motility Increased intestinal secretion Small intestinal bacterial overgrowth Clinical diagnosis in a patient with long lasting diabetes mellitus Systemic sclerosis – + + ± + – + + Epigastric tenderness Fecal incontinence – + – Nl Positive fecal fat Nl ↓ Nl Anti– topoisomerase I (Scl‑70) antibodies Antinuclear antibodies ( ANA ) Anti–centromere antibodies Anti– RNA polymerase III antibody Malabsorption Skin changes Raynaud phenomenon Pulmonary hypertension Arthritis Telangiectasia Chronic renal failure Autoimmune reaction Clinical diagnosis Followed by serologic tests References ↑ Casburn-Jones, Anna C; Farthing, Michael Jg (2004). "Traveler's diarrhea". Journal of Gastroenterology and Hepatology . 19 (6): 610–618. doi : 10.1111/j.1440-1746.2003.03287.x . ISSN 0815-9319 . ↑ Kamat, Deepak; Mathur, Ambika (2006). "Prevention and Management of Travelers' Diarrhea". Disease-a-Month . 52 (7): 289–302. doi : 10.1016/j.disamonth.2006.08.003 . ISSN 0011-5029 . ↑ Pfeiffer, Margaret L.; DuPont, Herbert L.; Ochoa, Theresa J. (2012). "The patient presenting with acute dysentery – A systematic review". Journal of Infection . 64 (4): 374–386. doi : 10.1016/j.jinf.2012.01.006 . ISSN 0163-4453 . ↑ Barr W, Smith A (2014). "Acute diarrhea". Am Fam Physician . 89 (3): 180–9. PMID 24506120 . ↑ Amil Dias J (2017). "Celiac Disease: What Do We Know in 2017?". GE Port J Gastroenterol . 24 (6): 275–278. doi : 10.1159/000479881 . PMID 29255768 . ↑ Kotloff KL, Riddle MS, Platts-Mills JA, Pavlinac P, Zaidi A (2017). "Shigellosis". Lancet . doi : 10.1016/S0140-6736(17)33296-8 . PMID 29254859 . ↑ Yamamoto-Furusho, J.K.; Bosques-Padilla, F.; de-Paula, J.; Galiano, M.T.; Ibañez, P.; Juliao, F.; Kotze, P.G.; Rocha, J.L.; Steinwurz, F.; Veitia, G.; Zaltman, C. (2017). "Diagnóstico y tratamiento de la enfermedad inflamatoria intestinal: Primer Consenso Latinoamericano de la Pan American Crohn's and Colitis Organisation". Revista de Gastroenterología de México . 82 (1): 46–84. doi : 10.1016/j.rgmx.2016.07.003 . ISSN 0375-0906 . ↑ Borbély, Yves M; Osterwalder, Alice; Kröll, Dino; Nett, Philipp C; Inglin, Roman A (2017). "Diarrhea after bariatric procedures: Diagnosis and therapy". World Journal of Gastroenterology . 23 (26): 4689. doi : 10.3748/wjg.v23.i26.4689 . ISSN 1007-9327 . ↑ Crawford, Sue E.; Ramani, Sasirekha; Tate, Jacqueline E.; Parashar, Umesh D.; Svensson, Lennart; Hagbom, Marie; Franco, Manuel A.; Greenberg, Harry B.; O'Ryan, Miguel; Kang, Gagandeep; Desselberger, Ulrich; Estes, Mary K. (2017). "Rotavirus infection". Nature Reviews Disease Primers . 3 : 17083. doi : 10.1038/nrdp.2017.83 . ISSN 2056-676X . ↑ Kist M (2000). "[Chronic diarrhea: value of microbiology in diagnosis]". Praxis (Bern 1994) (in German). 89 (39): 1559–65. PMID 11068510 . ↑ Guerrant RL, Shields DS, Thorson SM, Schorling JB, Gröschel DH (1985). "Evaluation and diagnosis of acute infectious diarrhea". Am. J. Med . 78 (6B): 91–8. PMID 4014291 . ↑ López-Vélez R, Turrientes MC, Garrón C, Montilla P, Navajas R, Fenoy S, del Aguila C (1999). "Microsporidiosis in travelers with diarrhea from the tropics". J Travel Med . 6 (4): 223–7. PMID 10575169 . ↑ Wahnschaffe, Ulrich; Ignatius, Ralf; Loddenkemper, Christoph; Liesenfeld, Oliver; Muehlen, Marion; Jelinek, Thomas; Burchard, Gerd Dieter; Weinke, Thomas; Harms, Gundel; Stein, Harald; Zeitz, Martin; Ullrich, Reiner; Schneider, Thomas (2009). "Diagnostic value of endoscopy for the diagnosis of giardiasis and other intestinal diseases in patients with persistent diarrhea from tropical or subtropical areas". Scandinavian Journal of Gastroenterology . 42 (3): 391–396. doi : 10.1080/00365520600881193 . ISSN 0036-5521 . ↑ Mena Bares LM, Carmona Asenjo E, García Sánchez MV, Moreno Ortega E, Maza Muret FR, Guiote Moreno MV, Santos Bueno AM, Iglesias Flores E, Benítez Cantero JM, Vallejo Casas JA (2017). "75SeHCAT scan in bile acid malabsorption in chronic diarrhoea". Rev Esp Med Nucl Imagen Mol . 36 (1): 37–47. doi : 10.1016/j.remn.2016.08.005 . PMID 27765536 . ↑ Gibson RJ, Stringer AM (2009). "Chemotherapy-induced diarrhoea". Curr Opin Support Palliat Care . 3 (1): 31–5. doi : 10.1097/SPC.0b013e32832531bb . PMID 19365159 . ↑ Abraham BP, Sellin JH (2012). "Drug-induced, factitious, & idiopathic diarrhoea". Best Pract Res Clin Gastroenterol . 26 (5): 633–48. doi : 10.1016/j.bpg.2012.11.007 . PMID 23384808 . ↑ Reintam Blaser A, Deane AM, Fruhwald S (2015). "Diarrhoea in the critically ill". Curr Opin Crit Care . 21 (2): 142–53. doi : 10.1097/MCC.0000000000000188 . PMID 25692805 . ↑ McMahan ZH, DuPont HL (2007). "Review article: the history of acute infectious diarrhoea management--from poorly focused empiricism to fluid therapy and modern pharmacotherapy". Aliment. Pharmacol. Ther . 25 (7): 759–69. doi : 10.1111/j.1365-2036.2007.03261.x . PMID 17373914 . ↑ Schiller LR (2012). "Definitions, pathophysiology, and evaluation of chronic diarrhoea". Best Pract Res Clin Gastroenterol . 26 (5): 551–62. doi : 10.1016/j.bpg.2012.11.011 . PMID 23384801 . ↑ Giannella RA (1986). "Chronic diarrhea in travelers: diagnostic and therapeutic considerations". Rev. Infect. Dis . 8 Suppl 2: S223–6. PMID 3523719 . ↑ Silverberg MS, Satsangi J, Ahmad T, Arnott ID, Bernstein CN, Brant SR; et al. (2005). "Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a Working Party of the 2005 Montreal World Congress of Gastroenterology" . Can J Gastroenterol . 19 Suppl A: 5A–36A. PMID 16151544 . ↑ Sauter GH, Moussavian AC, Meyer G, Steitz HO, Parhofer KG, Jüngst D (2002). "Bowel habits and bile acid malabsorption in the months after cholecystectomy" . Am J Gastroenterol . 97 (7): 1732–5. doi : 10.1111/j.1572-0241.2002.05779.x . PMID 12135027 . ↑ Maiuri L, Raia V, Potter J, Swallow D, Ho MW, Fiocca R; et al. (1991). "Mosaic pattern of lactase expression by villous enterocytes in human adult-type hypolactasia" . Gastroenterology . 100 (2): 359–69. PMID 1702075 . ↑ RUBIN CE, BRANDBORG LL, PHELPS PC, TAYLOR HC (1960). "Studies of celiac disease. I. The apparent identical and specific nature of the duodenal and proximal jejunal lesion in celiac disease and idiopathic sprue" . Gastroenterology . 38 : 28–49. PMID 14439871 . ↑ Konvolinka CW (1994). "Acute diverticulitis under age forty" . Am J Surg . 167 (6): 562–5. PMID 8209928 . ↑ Satsangi J, Silverberg MS, Vermeire S, Colombel JF (2006). "The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications" . Gut . 55 (6): 749–53. doi : 10.1136/gut.2005.082909 . PMC 1856208 . PMID 16698746 . ↑ Haque R, Huston CD, Hughes M, Houpt E, Petri WA (2003). "Amebiasis" . N Engl J Med . 348 (16): 1565–73. doi : 10.1056/NEJMra022710 . PMID 12700377 . ↑ Hertzler SR, Savaiano DA (1996). "Colonic adaptation to daily lactose feeding in lactose maldigesters reduces lactose intolerance" . Am J Clin Nutr . 64 (2): 232–6. PMID 8694025 . ↑ Briet F, Pochart P, Marteau P, Flourie B, Arrigoni E, Rambaud JC (1997). "Improved clinical tolerance to chronic lactose ingestion in subjects with lactose intolerance: a placebo effect?" . Gut . 41 (5): 632–5. PMC 1891556 . PMID 9414969 . ↑ BLACK-SCHAFFER B (1949). 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Markdown	# Chronic diarrhea differential diagnosis [Jump to navigation](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#mw-head) [Jump to search](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#searchInput) [![](https://www.wikidoc.org/images/1/16/Home_logo1.png)](https://www.wikidoc.org/index.php/Chronic_diarrhea) *To review the differential diagnosis of diarrhea, click [here](https://www.wikidoc.org/index.php/Diarrhea#Differential_Diagnosis_of_Diarrhea_of_other_diseases "Diarrhea").* Editor-In-Chief: [C. Michael Gibson, M.S., M.D.](https://www.wikidoc.org/index.php/User:C_Michael_Gibson "User:C Michael Gibson") [\[1\]](mailto:charlesmichaelgibson@gmail.com); Associate Editor(s)-in-Chief: [Sadaf Sharfaei M.D.](https://www.wikidoc.org/index.php/User:Ssharfaei "User:Ssharfaei")[\[2\]](Mailto:sadaf.sharfaei@gmail.com), [Seyedmahdi Pahlavani, M.D.](https://www.wikidoc.org/index.php/User:Mehdi_Pahlavani "User:Mehdi Pahlavani") [\[3\]](mailto:spahlava@bidmc.harvard.edu) ## Overview The [differential diagnosis](https://www.wikidoc.org/index.php/Differential_diagnosis "Differential diagnosis") for [chronic diarrhea](https://www.wikidoc.org/index.php/Chronic_diarrhea "Chronic diarrhea") is enormous, with a large number of diagnostic tests available that can be used to evaluate these patients. Classifying a patient's [chronic diarrhea](https://www.wikidoc.org/index.php/Chronic_diarrhea "Chronic diarrhea") into a subcategory such as [watery](https://www.wikidoc.org/index.php/Watery_diarrhea "Watery diarrhea"), fatty and [inflammatory](https://www.wikidoc.org/index.php/Inflammatory "Inflammatory") helps to direct the [diagnostic](https://www.wikidoc.org/index.php/Diagnostic "Diagnostic") work-up. Some [watery](https://www.wikidoc.org/index.php/Watery_diarrhea "Watery diarrhea") causes of chronic diarrhea which should be differentiated from one another include [crohn's disease](https://www.wikidoc.org/index.php/Crohn%27s_disease "Crohn's disease"), [hyperthyroidism](https://www.wikidoc.org/index.php/Hyperthyroidism "Hyperthyroidism"), [VIPoma](https://www.wikidoc.org/index.php/VIPoma "VIPoma"), [lactose intolerance](https://www.wikidoc.org/index.php/Lactose_intolerance "Lactose intolerance"), [celiac disease](https://www.wikidoc.org/index.php/Celiac_disease "Celiac disease") and [irritable bowel syndrome](https://www.wikidoc.org/index.php/Irritable_bowel_syndrome "Irritable bowel syndrome") (IBS). The causes of fatty diarrhea that should be differentiated from one another include [celiac sprue](https://www.wikidoc.org/index.php/Celiac_sprue "Celiac sprue"), [pancreatic insufficiency](https://www.wikidoc.org/index.php/Pancreatic_insufficiency "Pancreatic insufficiency"), [bacterial overgrowth](https://www.wikidoc.org/index.php/Bacterial_overgrowth "Bacterial overgrowth") and [maldigestion](https://www.wikidoc.org/index.php/Maldigestion "Maldigestion") problems which results from [pancreatic exocrine insufficiency](https://www.wikidoc.org/index.php/Pancreatic_insufficiency "Pancreatic insufficiency"). Finally, the [inflammatory](https://www.wikidoc.org/index.php/Inflammatory "Inflammatory") causes of chronic diarrhea such as [ulcerative colitis](https://www.wikidoc.org/index.php/Ulcerative_colitis "Ulcerative colitis") and [entamoeba histolytica](https://www.wikidoc.org/index.php/Entamoeba_histolytica "Entamoeba histolytica") must also be differentiated. ## Differential Diagnosis of Chronic Diarrhea from other diseases The following table outlines the major differential diagnoses of chronic diarrhea.[\[1\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-Casburn-JonesFarthing2004-1)[\[2\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-KamatMathur2006-2)[\[3\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-PfeifferDuPont2012-3)[\[4\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid24506120-4)[\[5\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid29255768-5)[\[6\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid29254859-6)[\[7\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-Yamamoto-FurushoBosques-Padilla2017-7)[\[8\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-Borb%C3%A9lyOsterwalder2017-8)[\[9\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-CrawfordRamani2017-9)[\[10\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid11068510-10)[\[11\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid4014291-11)[\[12\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid10575169-12)[\[13\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-WahnschaffeIgnatius2009-13)[\[14\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid27765536-14)[\[15\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid19365159-15)[\[16\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid23384808-16)[\[17\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid25692805-17)[\[18\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid17373914-18)[\[19\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid23384801-19)[\[20\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid3523719-20)[\[21\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid16151544-21)[\[22\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid12135027-22)[\[23\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid1702075-23)[\[24\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid14439871-24)[\[25\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid8209928-25)[\[26\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid16698746-26)[\[27\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid12700377-27)[\[28\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid8694025-28)[\[29\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid9414969-29)[\[30\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid15391722-30) Abbreviations: GI: [Gastrointestinal](https://www.wikidoc.org/index.php/Gastrointestinal_tract "Gastrointestinal tract"), CBC: [Complete blood count](https://www.wikidoc.org/index.php/Complete_blood_count "Complete blood count"), WBC: [White blood cell](https://www.wikidoc.org/index.php/White_blood_cells "White blood cells"), RBC: [Red blood cell](https://www.wikidoc.org/index.php/Red_blood_cell "Red blood cell"), Plt: [Platelet](https://www.wikidoc.org/index.php/Platelet "Platelet"), Hgb: [Hemoglobin](https://www.wikidoc.org/index.php/Hemoglobin "Hemoglobin"), ESR: [Erythrocyte sedimentation rate](https://www.wikidoc.org/index.php/Erythrocyte_sedimentation_rate "Erythrocyte sedimentation rate"), CRP: [C–reactive protein](https://www.wikidoc.org/index.php/C-reactive_protein "C-reactive protein"), IgE: [Immunoglobulin E](https://www.wikidoc.org/index.php/Immunoglobulin_E "Immunoglobulin E"), IgA: [Immunoglobulin A](https://www.wikidoc.org/index.php/Immunoglobulin_A "Immunoglobulin A"), ETEC: [Escherichia coli enteritis](https://www.wikidoc.org/index.php/Escherichia_coli_enteritis "Escherichia coli enteritis"), EPEC: [Enteropathogenic Escherichia coli](https://www.wikidoc.org/index.php/Escherichia_coli "Escherichia coli"), EIEC: [Enteroinvasive Escherichia coli](https://www.wikidoc.org/index.php/Escherichia_coli_enteritis "Escherichia coli enteritis"), EHEC: [Enterohemorrhagic Escherichia coli](https://www.wikidoc.org/index.php/Escherichia_coli "Escherichia coli"), EAEC: [Enteroaggregative Escherichia coli](https://www.wikidoc.org/index.php/Escherichia_coli_enteritis "Escherichia coli enteritis"), Nl: Normal, ASCA: [Anti saccharomyces cerevisiae antibodies](https://www.wikidoc.org/index.php/Anti_saccharomyces_cerevisiae_antibodies "Anti saccharomyces cerevisiae antibodies"), ANCA: [Anti–neutrophil cytoplasmic antibody](https://www.wikidoc.org/index.php/Anti-neutrophil_cytoplasmic_antibody "Anti-neutrophil cytoplasmic antibody"), DNA: [Deoxyribonucleic acid](https://www.wikidoc.org/index.php/DNA "DNA"), CFTR: [Cystic fibrosis transmembrane conductance regulator](https://www.wikidoc.org/index.php/Cystic_fibrosis_transmembrane_conductance_regulator "Cystic fibrosis transmembrane conductance regulator"), SLC10A2: [Solute carrier family 10 member 2](https://www.wikidoc.org/index.php/SLC10A2 "SLC10A2"), SeHCAT: [Selenium homocholic acid taurine or tauroselcholic acid](https://www.wikidoc.org/index.php/SeHCAT "SeHCAT"), IEL: Intraepithelial [lymphocytes](https://www.wikidoc.org/index.php/Lymphocyte "Lymphocyte"), MRCP: [Magnetic resonance cholangiopancreatography](https://www.wikidoc.org/index.php/Magnetic_resonance_cholangiopancreatography "Magnetic resonance cholangiopancreatography"), ANA: [Antinuclear antibodies](https://www.wikidoc.org/index.php/Antinuclear_antibodies "Antinuclear antibodies"), AMA: [Anti-mitochondrial antibody](https://www.wikidoc.org/index.php/Anti-mitochondrial_antibody "Anti-mitochondrial antibody"), LDH: [Lactate dehydrogenase](https://www.wikidoc.org/index.php/Lactate_dehydrogenase "Lactate dehydrogenase"), CPK: [Creatine phosphokinase](https://www.wikidoc.org/index.php/Creatine_phosphokinase "Creatine phosphokinase"), PCR: [Polymerase chain reaction](https://www.wikidoc.org/index.php/Polymerase_chain_reaction "Polymerase chain reaction"), ELISA: [Enzyme–linked immunosorbent assay](https://www.wikidoc.org/index.php/Enzyme_linked_immunosorbent_assay_\(ELISA\) "Enzyme linked immunosorbent assay (ELISA)"), LT: Heat–labile [enterotoxin](https://www.wikidoc.org/index.php/Enterotoxin "Enterotoxin"), ST: Heat–stable [enterotoxin](https://www.wikidoc.org/index.php/Enterotoxin "Enterotoxin"), RT-PCR: Reverse–transcriptase [polymerase chain reaction](https://www.wikidoc.org/index.php/Polymerase_chain_reaction "Polymerase chain reaction"), CD4: [Cluster of differentiation 4](https://www.wikidoc.org/index.php/CD4 "CD4"), HIV: [Human immunodeficiency virus](https://www.wikidoc.org/index.php/Human_Immunodeficiency_Virus_\(HIV\) "Human Immunodeficiency Virus (HIV)"), RUQ: [Right-upper quadrant](https://www.wikidoc.org/index.php/RUQ "RUQ"), VIP: [Vasoactive intestinal peptide](https://www.wikidoc.org/index.php/Vasoactive_intestinal_peptide "Vasoactive intestinal peptide"), GI: [Gastrointestinal](https://www.wikidoc.org/index.php/Gastrointestinal_tract "Gastrointestinal tract"), FAP: [Familial adenomatous polyposis](https://www.wikidoc.org/index.php/Familial_adenomatous_polyposis "Familial adenomatous polyposis"), HNPCC: [Hereditary nonpolyposis colorectal cancer](https://www.wikidoc.org/index.php/Hereditary_nonpolyposis_colorectal_cancer "Hereditary nonpolyposis colorectal cancer"), MTP: [Microsomal triglyceride transfer protein](https://www.wikidoc.org/index.php/Microsomal_triglyceride_transfer_protein "Microsomal triglyceride transfer protein"), Scl‑70: Anti–[topoisomerase I](https://www.wikidoc.org/index.php/Type_I_topoisomerase "Type I topoisomerase"), TSH: [Thyroid-stimulating hormone](https://www.wikidoc.org/index.php/Thyroid-stimulating_hormone "Thyroid-stimulating hormone"), T4: [Thyroxine](https://www.wikidoc.org/index.php/Thyroxine "Thyroxine"), T3: [Triiodothyronine](https://www.wikidoc.org/index.php/Triiodothyronine "Triiodothyronine"), DTR: [Deep tendon reflex](https://www.wikidoc.org/index.php/Deep_tendon_reflex "Deep tendon reflex"), RNA: [Ribonucleic acid](https://www.wikidoc.org/index.php/RNA "RNA") \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\| \| Cause \| Clinical manifestation \| Lab findings \| Extra intestinal findings \| Cause/Pathogenesis \| Gold standard diagnosis \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| Symptoms \| GI signs \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| Duration \| Diarrhea \| Fever \| Abdominal pain \| Weight loss \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| Stool exam \| CBC \| Other lab findings \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| Acute \| Chronic \| Watery \| Bloody \| Fatty \| WBC \| RBC \| Ova/Parasite \| Osmotic gap \| Other \| WBC \| Hgb \| Plt \| \| \| \| \| \| \| \| \| \| \| \| [Crohn's disease](https://www.wikidoc.org/index.php/Crohns_disease "Crohns disease") \| – \| \+ \| \+ \| \+ \| \+ \| ± \| \+ \| \+ \| [Abdominal tenderness](https://www.wikidoc.org/index.php/Abdominal_tenderness "Abdominal tenderness") Oral [mucosal](https://www.wikidoc.org/index.php/Mucosal "Mucosal") lesions \| \+ \| \+ \| – \| Nl \| – \| ↑ \| ↓ \| ↑ \| [Anti saccharomyces cerevisiae antibodies](https://www.wikidoc.org/index.php/Anti_saccharomyces_cerevisiae_antibodies "Anti saccharomyces cerevisiae antibodies") (ASCA) [Vitamin B12](https://www.wikidoc.org/index.php/Vitamin_B12 "Vitamin B12") deficiency Elevated [ESR](https://www.wikidoc.org/index.php/Erythrocyte_sedimentation_rate "Erythrocyte sedimentation rate") Elevated [CRP](https://www.wikidoc.org/index.php/C-reactive_protein "C-reactive protein") \| [Uveitis](https://www.wikidoc.org/index.php/Uveitis "Uveitis") [Arthritis](https://www.wikidoc.org/index.php/Arthritis "Arthritis") [Erythema nodosum](https://www.wikidoc.org/index.php/Erythema_nodosum "Erythema nodosum") [Pyoderma gangrenosum](https://www.wikidoc.org/index.php/Pyoderma_gangrenosum "Pyoderma gangrenosum") [Amyloidosis](https://www.wikidoc.org/index.php/Amyloidosis "Amyloidosis") Venous and arterial [thromboembolism](https://www.wikidoc.org/index.php/Thromboembolism "Thromboembolism") [Renal stones](https://www.wikidoc.org/index.php/Kidney_stone "Kidney stone") [Bronchiectasis](https://www.wikidoc.org/index.php/Bronchiectasis "Bronchiectasis") \| Abnormal immune response to self [antigens](https://www.wikidoc.org/index.php/Antigens "Antigens") \| [Colonoscopy](https://www.wikidoc.org/index.php/Colonoscopy "Colonoscopy") with [biopsy](https://www.wikidoc.org/index.php/Biopsy "Biopsy") \| \| \| [Ulcerative colitis](https://www.wikidoc.org/index.php/Ulcerative_colitis "Ulcerative colitis") \| – \| \+ \| \+ \| \+ \| \+ \| ± \| \+ \| \+ \| [Abdominal tenderness](https://www.wikidoc.org/index.php/Abdominal_tenderness "Abdominal tenderness") [Blood](https://www.wikidoc.org/index.php/Blood "Blood") on [rectal examination](https://www.wikidoc.org/index.php/Rectal_examination "Rectal examination") \| \+ \| \+ \| – \| Nl \| – \| ↑ \| ↓ \| ↑ \| [Anti–neutrophil cytoplasmic antibody](https://www.wikidoc.org/index.php/Anti-neutrophil_cytoplasmic_antibody "Anti-neutrophil cytoplasmic antibody") ([P–ANCA](https://www.wikidoc.org/index.php/P-ANCA "P-ANCA")) [Hypoalbuminemia](https://www.wikidoc.org/index.php/Hypoalbuminemia "Hypoalbuminemia") [Hypokalemia](https://www.wikidoc.org/index.php/Hypokalemia "Hypokalemia") [Hypomagnesemia](https://www.wikidoc.org/index.php/Hypomagnesemia "Hypomagnesemia") Elevated [ESR](https://www.wikidoc.org/index.php/Erythrocyte_sedimentation_rate "Erythrocyte sedimentation rate") Elevated [CRP](https://www.wikidoc.org/index.php/C-reactive_protein "C-reactive protein") \| [Skin rash](https://www.wikidoc.org/index.php/Skin_rash "Skin rash") [Iritis](https://www.wikidoc.org/index.php/Iritis "Iritis") [Uveitis](https://www.wikidoc.org/index.php/Uveitis "Uveitis") Seronegative [arthritis](https://www.wikidoc.org/index.php/Arthritis "Arthritis") [Clubbing](https://www.wikidoc.org/index.php/Clubbing "Clubbing") [Erythema nodosum](https://www.wikidoc.org/index.php/Erythema_nodosum "Erythema nodosum") \| Abnormal immune response to self [antigens](https://www.wikidoc.org/index.php/Antigens "Antigens") \| [Colonoscopy](https://www.wikidoc.org/index.php/Colonoscopy "Colonoscopy") with [biopsy](https://www.wikidoc.org/index.php/Biopsy "Biopsy") \| \| \| [Celiac disease](https://www.wikidoc.org/index.php/Celiac_disease "Celiac disease") \| – \| \+ \| ± \| – \| ± \| – \| \+ \| \+ \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distention "Abdominal distention") Increased [bowel](https://www.wikidoc.org/index.php/Bowel "Bowel") sounds Oral [mucosal](https://www.wikidoc.org/index.php/Mucous_membrane "Mucous membrane") lesions [Hepatosplenomegaly](https://www.wikidoc.org/index.php/Hepatosplenomegaly "Hepatosplenomegaly") [Ascites](https://www.wikidoc.org/index.php/Ascites "Ascites") \| – \| – \| – \| Nl \| Fat droplets on [sudan stain](https://www.wikidoc.org/index.php/Sudan_stain "Sudan stain") \| Nl \| ↓ \| Nl \| [IgA](https://www.wikidoc.org/index.php/IgA "IgA") endomysial [antibody](https://www.wikidoc.org/index.php/Antibody "Antibody") Anti–tissue [transglutaminase](https://www.wikidoc.org/index.php/Transglutaminase "Transglutaminase") [antibody](https://www.wikidoc.org/index.php/Antibody "Antibody") [Anti–gliadin antibody](https://www.wikidoc.org/index.php/Anti-gliadin_antibodies "Anti-gliadin antibodies") [Fat soluble vitamins](https://www.wikidoc.org/index.php/Fat_soluble_vitamins "Fat soluble vitamins") deficiency \| [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") [Dementia](https://www.wikidoc.org/index.php/Dementia "Dementia") [Dermatitis herpetiformis](https://www.wikidoc.org/index.php/Dermatitis_herpetiformis "Dermatitis herpetiformis") \| [HLA–DQ2](https://www.wikidoc.org/index.php/HLA-DQ2 "HLA-DQ2") [HLA–DQ8](https://www.wikidoc.org/index.php/HLA-DQ8 "HLA-DQ8") Innate responses to wheat [proteins](https://www.wikidoc.org/index.php/Protein "Protein") \| [IgA](https://www.wikidoc.org/index.php/IgA "IgA") endomysial [antibody](https://www.wikidoc.org/index.php/Antibody "Antibody") Anti–tissue [transglutaminase](https://www.wikidoc.org/index.php/Transglutaminase "Transglutaminase") [antibody](https://www.wikidoc.org/index.php/Antibody "Antibody") \| \| \| Cause \| Duration \| Diarrhea \| Fever \| Abdominal pain \| Weight loss \| GI signs \| Stool exam \| CBC \| Other lab findings \| Extra intestinal findings \| Cause/Pathogenesis \| Gold standard diagnosis \| \| \| \| \| \| \| \| \| \| \| \| Acute \| Chronic \| Watery \| Bloody \| Fatty \| WBC \| RBC \| Ova/Parasite \| Osmotic gap \| Other \| WBC \| Hgb \| Plt \| \| \| \| \| \| \| \| \| \| \| \| [Cystic fibrosis](https://www.wikidoc.org/index.php/Cystic_fibrosis "Cystic fibrosis") \| – \| \+ \| – \| – \| \+ \| ± \| \+ \| \+ \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distension "Abdominal distension") [Hepatosplenomegaly](https://www.wikidoc.org/index.php/Hepatosplenomegaly "Hepatosplenomegaly") [Rectal prolapse](https://www.wikidoc.org/index.php/Rectal_prolapse "Rectal prolapse") \| – \| – \| – \| Nl \| Fat droplets on [sudan stain](https://www.wikidoc.org/index.php/Sudan_stain "Sudan stain") \| Nl \| ↓ \| Nl \| Positive [DNA](https://www.wikidoc.org/index.php/DNA "DNA") analysis for [cystic fibrosis transmembrane conductance regulator](https://www.wikidoc.org/index.php/CFTR "CFTR") [(CFTR)](https://www.wikidoc.org/index.php/CFTR "CFTR") Nasal transepithelial potential difference [Fat soluble vitamins](https://www.wikidoc.org/index.php/Fat_soluble_vitamins "Fat soluble vitamins") deficiency \| [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") Recurrent [respiratory tract infection](https://www.wikidoc.org/index.php/Respiratory_tract_infection "Respiratory tract infection") [Bronchiectasis](https://www.wikidoc.org/index.php/Bronchiectasis "Bronchiectasis") [Diabetes mellitus](https://www.wikidoc.org/index.php/Diabetes_mellitus "Diabetes mellitus") [Scoliosis](https://www.wikidoc.org/index.php/Scoliosis "Scoliosis") [Infertility](https://www.wikidoc.org/index.php/Infertility "Infertility") \| Mutations in the [cystic fibrosis transmembrane conductance regulator](https://www.wikidoc.org/index.php/Cystic_fibrosis_transmembrane_conductance_regulator "Cystic fibrosis transmembrane conductance regulator") ([CFTR](https://www.wikidoc.org/index.php/CFTR "CFTR")) protein \| Positive [genetic testing](https://www.wikidoc.org/index.php/Genetic_testing "Genetic testing") Elevated [sweat chloride](https://www.wikidoc.org/index.php/Sweat_chloride_test "Sweat chloride test") ≥60 mmol/L \| \| \| [Chronic pancreatitis](https://www.wikidoc.org/index.php/Chronic_pancreatitis "Chronic pancreatitis") \| – \| \+ \| \+ \| – \| \+ \| – \| \+ \| \+ \| [Abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") \| – \| – \| – \| Nl \| Fat droplets on [sudan stain](https://www.wikidoc.org/index.php/Sudan_stain "Sudan stain") Positive [fecal elastase](https://www.wikidoc.org/index.php/Fecal_elastase "Fecal elastase") measurement \| Nl \| Nl \| Nl \| Slightly elevated [amylase](https://www.wikidoc.org/index.php/Amylase "Amylase") and [lipase](https://www.wikidoc.org/index.php/Lipase "Lipase") Abnormal pancreatic function test [Secretin](https://www.wikidoc.org/index.php/Secretin "Secretin") stimulation test \| [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") [Diabetes mellitus](https://www.wikidoc.org/index.php/Diabetes_mellitus "Diabetes mellitus") [Pancreatic pseudocyst](https://www.wikidoc.org/index.php/Pancreatic_pseudocyst "Pancreatic pseudocyst") \| [Toxins](https://www.wikidoc.org/index.php/Toxin "Toxin") Recurrent [acute pancreatitis](https://www.wikidoc.org/index.php/Acute_pancreatitis "Acute pancreatitis") [Genetic](https://www.wikidoc.org/index.php/Genetics "Genetics") predesposition [Autoimmune](https://www.wikidoc.org/index.php/Autoimmunity "Autoimmunity") \| [Magnetic resonance cholangiopancreatography](https://www.wikidoc.org/index.php/Magnetic_resonance_cholangiopancreatography "Magnetic resonance cholangiopancreatography") ([MRCP](https://www.wikidoc.org/index.php/Magnetic_resonance_cholangiopancreatography "Magnetic resonance cholangiopancreatography")) \| \| \| [Bile acid malabsorption](https://www.wikidoc.org/index.php/Bile_acid_malabsorption "Bile acid malabsorption") \| – \| \+ \| \+ \| – \| \+ \| – \| – \| \+ \| \| – \| – \| – \| Nl \| Fat droplets on [sudan stain](https://www.wikidoc.org/index.php/Sudan_stain "Sudan stain") \| Nl \| Nl \| Nl \| Reduced [cholesterol](https://www.wikidoc.org/index.php/Cholesterol "Cholesterol") level \| [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") [Hypotension](https://www.wikidoc.org/index.php/Hypotension "Hypotension") [Tachycardia](https://www.wikidoc.org/index.php/Tachycardia "Tachycardia") \| Genetic defects in [SLC10A2](https://www.wikidoc.org/index.php/SLC10A2 "SLC10A2") \| [SeHCAT](https://www.wikidoc.org/index.php/SeHCAT "SeHCAT") test \| \| \| [Microscopic colitis](https://www.wikidoc.org/index.php/Microscopic_colitis "Microscopic colitis") \| – \| \+ \| \+ \| – \| – \| – \| \+ \| \+ \| [Abdominal tenderness](https://www.wikidoc.org/index.php/Abdominal_tenderness "Abdominal tenderness") Fecal [incontinence](https://www.wikidoc.org/index.php/Incontinence "Incontinence") \| – \| – \| – \| Nl \| – \| Nl \| ↓ \| Nl \| [Hypokalemia](https://www.wikidoc.org/index.php/Hypokalemia "Hypokalemia") Elevated [CRP](https://www.wikidoc.org/index.php/C-reactive_protein "C-reactive protein") Positive [autoantibodies](https://www.wikidoc.org/index.php/Autoantibodies "Autoantibodies") include: RF [ANA](https://www.wikidoc.org/index.php/ANA "ANA") [AMA](https://www.wikidoc.org/index.php/Anti-mitochondrial_antibody "Anti-mitochondrial antibody") [ANCA](https://www.wikidoc.org/index.php/ANCA "ANCA") \| [Arthritis](https://www.wikidoc.org/index.php/Arthritis "Arthritis") [Uveitis](https://www.wikidoc.org/index.php/Uveitis "Uveitis") [Idiopathic thrombocytopenic purpura](https://www.wikidoc.org/index.php/Idiopathic_thrombocytopenic_purpura "Idiopathic thrombocytopenic purpura") Pleuro [pericarditis](https://www.wikidoc.org/index.php/Pericarditis "Pericarditis") [Hypothyroidism](https://www.wikidoc.org/index.php/Hypothyroidism "Hypothyroidism") [Psoriasis](https://www.wikidoc.org/index.php/Psoriasis "Psoriasis") \| [Mucosal](https://www.wikidoc.org/index.php/Mucosal "Mucosal") [immune responses](https://www.wikidoc.org/index.php/Immune_responses "Immune responses") to luminal factors in a genetically predisposed individual Drug–induced \| [Colonoscopy](https://www.wikidoc.org/index.php/Colonoscopy "Colonoscopy") with [mucosal](https://www.wikidoc.org/index.php/Mucosal "Mucosal") [biopsy](https://www.wikidoc.org/index.php/Biopsy "Biopsy") with [mononuclear](https://www.wikidoc.org/index.php/Mononuclear "Mononuclear") infiltrates: [Collagenous colitis](https://www.wikidoc.org/index.php/Collagenous_colitis "Collagenous colitis") is characterized by a colonic subepithelial [collagen](https://www.wikidoc.org/index.php/Collagen "Collagen") band \>10 micrometers in diameter [Lymphocytic](https://www.wikidoc.org/index.php/Lymphocytic "Lymphocytic") [colitis](https://www.wikidoc.org/index.php/Colitis "Colitis") is characterized by ≥20 intraepithelial [lymphocytes](https://www.wikidoc.org/index.php/Lymphocytes "Lymphocytes") (IEL) per 100 surface epithelial cells \| \| \| Cause \| Duration \| Diarrhea \| Fever \| Abdominal pain \| Weight loss \| GI signs \| Stool exam \| CBC \| Other lab findings \| Extra intestinal findings \| Cause/Pathogenesis \| Gold standard diagnosis \| \| \| \| \| \| \| \| \| \| \| \| Acute \| Chronic \| Watery \| Bloody \| Fatty \| WBC \| RBC \| Ova/Parasite \| Osmotic gap \| Other \| WBC \| Hgb \| Plt \| \| \| \| \| \| \| \| \| \| \| \| [Infective colitis](https://www.wikidoc.org/index.php/Infective_colitis "Infective colitis") \| – \| \+ \| \+ \| \+ \| – \| \+ \| \+ \| \+ \| Rebound [abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") \| \+ \| \+ \| \+ \| Nl \| Positive [stool culture](https://www.wikidoc.org/index.php/Stool_culture "Stool culture") Positive fecal calprotectin Positive fecal [lactoferrin](https://www.wikidoc.org/index.php/Lactoferrin "Lactoferrin") \| ↑ \| ↓ \| ↑ \| Elevated [CRP](https://www.wikidoc.org/index.php/C-reactive_protein "C-reactive protein") Elevated [ESR](https://www.wikidoc.org/index.php/Erythrocyte_sedimentation_rate "Erythrocyte sedimentation rate") \| [Arthritis](https://www.wikidoc.org/index.php/Arthritis "Arthritis") [Uveitis](https://www.wikidoc.org/index.php/Uveitis "Uveitis") \| [Salmonella](https://www.wikidoc.org/index.php/Salmonella "Salmonella") [Shigella](https://www.wikidoc.org/index.php/Shigella "Shigella") [Campylobacter](https://www.wikidoc.org/index.php/Campylobacter "Campylobacter") [E. coli 0157:H7](https://www.wikidoc.org/index.php/Escherichia_coli "Escherichia coli") [Clostridium difficile](https://www.wikidoc.org/index.php/Clostridium_difficile "Clostridium difficile") [Entamoeba histolytica](https://www.wikidoc.org/index.php/Entamoeba_histolytica "Entamoeba histolytica") [Adenovirus](https://www.wikidoc.org/index.php/Adenoviridae "Adenoviridae") [Cytomegalovirus](https://www.wikidoc.org/index.php/Cytomegalovirus "Cytomegalovirus") [Herpes simplex virus](https://www.wikidoc.org/index.php/Herpes_simplex_virus "Herpes simplex virus") \| [Stool culture](https://www.wikidoc.org/index.php/Stool_culture "Stool culture") [Blood culture](https://www.wikidoc.org/index.php/Blood_culture "Blood culture") \| \| \| [Ischemic colitis](https://www.wikidoc.org/index.php/Ischemic_colitis "Ischemic colitis") \| \+ \| \+ \| \+ \| \+ \| – \| \+ \| \+ \| \+ \| Hyperactive then absent [bowel sounds](https://www.wikidoc.org/index.php/Stomach_rumble "Stomach rumble") [Abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") \| \+ \| \+ \| – \| Nl \| – \| ↑ \| ↓ \| ↑ \| Elevated [CRP](https://www.wikidoc.org/index.php/C-reactive_protein "C-reactive protein") Elevated [ESR](https://www.wikidoc.org/index.php/Erythrocyte_sedimentation_rate "Erythrocyte sedimentation rate") Elevated serum [lactate](https://www.wikidoc.org/index.php/Lactic_acid "Lactic acid") Elevated [lactate dehydrogenase](https://www.wikidoc.org/index.php/Lactate_dehydrogenase "Lactate dehydrogenase") ([LDH](https://www.wikidoc.org/index.php/Lactate_dehydrogenase "Lactate dehydrogenase")) Elevated [creatine phosphokinase](https://www.wikidoc.org/index.php/Creatine_kinase "Creatine kinase") ([CPK](https://www.wikidoc.org/index.php/Creatine_kinase "Creatine kinase")) Elevated [amylase](https://www.wikidoc.org/index.php/Amylase "Amylase") [Hypoalbuminemia](https://www.wikidoc.org/index.php/Hypoalbuminemia "Hypoalbuminemia") \| [IgA vasculitis](https://www.wikidoc.org/index.php/Henoch-Sch%C3%B6nlein_purpura "Henoch-Schönlein purpura") \| [Hypercoagulability](https://www.wikidoc.org/index.php/Thrombophilia "Thrombophilia") Nonocclusive [colonic ischemia](https://www.wikidoc.org/index.php/Ischemic_colitis "Ischemic colitis") [Embolic](https://www.wikidoc.org/index.php/Embolism "Embolism") and [thrombotic](https://www.wikidoc.org/index.php/Thrombosis "Thrombosis") arterial occlusion [Mesenteric vein thrombosis](https://www.wikidoc.org/index.php/Mesenteric_vein_thrombosis "Mesenteric vein thrombosis") \| Abdominal [CT scan](https://www.wikidoc.org/index.php/Computed_tomography "Computed tomography") \| \| \| [Lactose intolerance](https://www.wikidoc.org/index.php/Lactose_intolerance "Lactose intolerance") \| \+ \| \+ \| \+ \| – \| – \| – \| \+ \| – \| [Abdominal tenderness](https://www.wikidoc.org/index.php/Abdominal_tenderness "Abdominal tenderness") [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distention "Abdominal distention") \| – \| – \| – \| ↑ \| – \| Nl \| Nl \| Nl \| Lactose tolerance test Genetic testing \| [Headache](https://www.wikidoc.org/index.php/Headache "Headache") [Vertigo](https://www.wikidoc.org/index.php/Vertigo "Vertigo") [Memory impairment](https://www.wikidoc.org/index.php/Memory_impairment "Memory impairment") [Lethargy](https://www.wikidoc.org/index.php/Lethargy "Lethargy") \| Reduction of lactase enzyme activity or inability to produce persistent [lactase](https://www.wikidoc.org/index.php/Lactase "Lactase") Congenital [lactase deficiency](https://www.wikidoc.org/index.php/Lactase_deficiency "Lactase deficiency") Secondary lactose malabsorption \| [Small bowel](https://www.wikidoc.org/index.php/Small_bowel "Small bowel") [biopsy](https://www.wikidoc.org/index.php/Biopsy "Biopsy") Lactose breath hydrogen test \| \| \| [Irritable bowel syndrome](https://www.wikidoc.org/index.php/Irritable_bowel_syndrome "Irritable bowel syndrome") \| – \| \+ \| ± \| – \| ± \| – \| ± \| – \| [Abdominal tenderness](https://www.wikidoc.org/index.php/Abdominal_tenderness "Abdominal tenderness") [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distention "Abdominal distention") Normal [bowel sounds](https://www.wikidoc.org/index.php/Stomach_rumble "Stomach rumble") \| – \| – \| – \| Nl \| – \| Nl \| Nl \| Nl \| Nl \| [Anxiety](https://www.wikidoc.org/index.php/Anxiety "Anxiety") [Palpitation](https://www.wikidoc.org/index.php/Palpitation "Palpitation") \| Unknown \| Diagnosis of exclusion \| \| \| Cause \| Duration \| Diarrhea \| Fever \| Abdominal pain \| Weight loss \| GI signs \| Stool exam \| CBC \| Other lab findings \| Extra intestinal findings \| Cause/Pathogenesis \| Gold standard diagnosis \| \| \| \| \| \| \| \| \| \| \| \| Acute \| Chronic \| Watery \| Bloody \| Fatty \| WBC \| RBC \| Ova/Parasite \| Osmotic gap \| Other \| WBC \| Hgb \| Plt \| \| \| \| \| \| \| \| \| \| \| \| [Whipple's disease](https://www.wikidoc.org/index.php/Whipple%27s_disease "Whipple's disease") \| – \| \+ \| \+ \| – \| \+ \| ± \| \+ \| \+ \| [Hepatosplenomegaly](https://www.wikidoc.org/index.php/Hepatosplenomegaly "Hepatosplenomegaly") [Ascites](https://www.wikidoc.org/index.php/Ascites "Ascites") \| – \| – \| – \| Nl \| Positive [fecal fat](https://www.wikidoc.org/index.php/Fecal_fat "Fecal fat") \| ↓ \| ↓ \| ↓/↑ \| [Hypoalbuminemia](https://www.wikidoc.org/index.php/Hypoalbuminemia "Hypoalbuminemia") [Fat soluble vitamins](https://www.wikidoc.org/index.php/Fat_soluble_vitamins "Fat soluble vitamins") deficiency \| [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") [Abnormal extraocular movement](https://www.wikidoc.org/index.php/Ocular_motility_disorders "Ocular motility disorders") [Lymphadenopathy](https://www.wikidoc.org/index.php/Lymphadenopathy "Lymphadenopathy") [Hyperpigmentation](https://www.wikidoc.org/index.php/Hyperpigmentation "Hyperpigmentation") [Uveitis](https://www.wikidoc.org/index.php/Uveitis "Uveitis") [Endocarditis](https://www.wikidoc.org/index.php/Endocarditis "Endocarditis") [Encephalitis](https://www.wikidoc.org/index.php/Encephalitis "Encephalitis") [Dementia](https://www.wikidoc.org/index.php/Dementia "Dementia") [Pleural effusion](https://www.wikidoc.org/index.php/Pleural_effusion "Pleural effusion") \| [Tropheryma whipplei](https://www.wikidoc.org/index.php/Tropheryma_whipplei "Tropheryma whipplei") \| [Small intestine](https://www.wikidoc.org/index.php/Small_intestine "Small intestine") [biopsy](https://www.wikidoc.org/index.php/Biopsy "Biopsy") for [Tropheryma whipplei](https://www.wikidoc.org/index.php/Tropheryma_whipplei "Tropheryma whipplei") testing [PCR](https://www.wikidoc.org/index.php/PCR "PCR") testing \| \| \| [Tropical sprue](https://www.wikidoc.org/index.php/Tropical_sprue "Tropical sprue") \| \+ \| \+ \| \+ \| – \| \+ \| \+ \| \+ \| \+ \| Angular [stomatitis](https://www.wikidoc.org/index.php/Stomatitis "Stomatitis") Oral mucosal lesion \| \+ \| – \| – \| Nl \| Positive [stool culture](https://www.wikidoc.org/index.php/Stool_culture "Stool culture") \| Nl \| ↓ \| Nl \| [Fat soluble vitamins](https://www.wikidoc.org/index.php/Fat_soluble_vitamins "Fat soluble vitamins") deficiency [Vitamin B12 deficiency](https://www.wikidoc.org/index.php/Vitamin_B12_deficiency "Vitamin B12 deficiency") [Folate deficiency](https://www.wikidoc.org/index.php/Folate_deficiency "Folate deficiency") [Hypokalemia](https://www.wikidoc.org/index.php/Hypokalemia "Hypokalemia") \| [Myalgia](https://www.wikidoc.org/index.php/Myalgia "Myalgia") [Neuropathy](https://www.wikidoc.org/index.php/Neuropathy "Neuropathy") [Edema](https://www.wikidoc.org/index.php/Edema "Edema") \| [Escherichia coli](https://www.wikidoc.org/index.php/Escherichia_coli "Escherichia coli") [Klebsiella pneumoniae](https://www.wikidoc.org/index.php/Klebsiella_pneumoniae "Klebsiella pneumoniae") [Enterobacter cloacae](https://www.wikidoc.org/index.php/Enterobacter_cloacae "Enterobacter cloacae") \| Diagnosis of exclusion \| \| \| [Small bowel bacterial overgrowth](https://www.wikidoc.org/index.php/Small_bowel_bacterial_overgrowth_syndrome "Small bowel bacterial overgrowth syndrome") \| – \| \+ \| \+ \| – \| \+ \| – \| \+ \| \+ \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distension "Abdominal distension") \| \+ \| – \| – \| Nl \| Positive [stool culture](https://www.wikidoc.org/index.php/Stool_culture "Stool culture") Positive [fecal fat](https://www.wikidoc.org/index.php/Fecal_fat "Fecal fat") \| Nl \| ↓ \| Nl \| [Hypoalbuminemia](https://www.wikidoc.org/index.php/Hypoalbuminemia "Hypoalbuminemia") Abnormal [hydrogen breath test](https://www.wikidoc.org/index.php/Hydrogen_Breath_Test "Hydrogen Breath Test") [Lactic acidosis](https://www.wikidoc.org/index.php/Lactic_acidosis "Lactic acidosis") \| [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") [Rosacea](https://www.wikidoc.org/index.php/Rosacea "Rosacea") \| Excess bacteria in the [small intestine](https://www.wikidoc.org/index.php/Small_intestine "Small intestine") Alterations in [intestinal](https://www.wikidoc.org/index.php/Intestine "Intestine") [anatomy](https://www.wikidoc.org/index.php/Anatomy "Anatomy") or GI motility \| Diagnosis of exclusion \| \| \| Cause \| Duration \| Diarrhea \| Fever \| Abdominal pain \| Weight loss \| GI signs \| Stool exam \| CBC \| Other lab findings \| Extra intestinal findings \| Cause/Pathogenesis \| Gold standard diagnosis \| \| \| \| \| \| \| \| \| \| \| \| Acute \| Chronic \| Watery \| Bloody \| Fatty \| WBC \| RBC \| Ova/Parasite \| Osmotic gap \| Other \| WBC \| Hgb \| Plt \| \| \| \| \| \| \| \| \| \| \| \| [Salmonellosis](https://www.wikidoc.org/index.php/Salmonellosis "Salmonellosis") \| \+ \| \+ \| \+ \| \+ \| – \| \+ \| \+ \| – \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distention "Abdominal distention") Diffuse [abdominal tenderness](https://www.wikidoc.org/index.php/Abdominal_tenderness "Abdominal tenderness") [Hepatosplenomegaly](https://www.wikidoc.org/index.php/Hepatosplenomegaly "Hepatosplenomegaly") \| \+ \| \+ \| – \| Nl \| Positive [stool culture](https://www.wikidoc.org/index.php/Stool_culture "Stool culture") Positive serologic testing \| ↑ \| Nl \| ↑ \| [Hypokalemia](https://www.wikidoc.org/index.php/Hypokalemia "Hypokalemia") [Hypernatremia](https://www.wikidoc.org/index.php/Hypernatremia "Hypernatremia") [Hyponatremia](https://www.wikidoc.org/index.php/Hyponatremia "Hyponatremia") [Hypercalciuria](https://www.wikidoc.org/index.php/Hypercalciuria "Hypercalciuria") [Hypocitraturia](https://www.wikidoc.org/index.php/Hypocitraturia "Hypocitraturia") \| [Post–infectious arthritis](https://www.wikidoc.org/index.php/Post-infectious_arthritis "Post-infectious arthritis") [Obtundation](https://www.wikidoc.org/index.php/Obtundation "Obtundation") [Bacteremia](https://www.wikidoc.org/index.php/Bacteremia "Bacteremia") [Pericarditis](https://www.wikidoc.org/index.php/Pericarditis "Pericarditis") [Pyelonephritis](https://www.wikidoc.org/index.php/Pyelonephritis "Pyelonephritis") [Brain abscess](https://www.wikidoc.org/index.php/Brain_abscess "Brain abscess") \| [Salmonella](https://www.wikidoc.org/index.php/Salmonella "Salmonella") \| [Stool culture](https://www.wikidoc.org/index.php/Stool_culture "Stool culture") \| \| \| [Escherichia coli enteritis](https://www.wikidoc.org/index.php/Escherichia_coli_enteritis "Escherichia coli enteritis") \| [EPEC](https://www.wikidoc.org/index.php/EPEC "EPEC") \| \+ \| \+ \| \+ \| \+ \| – \| \+ \| \+ \| \+ \| Diffuse [abdominal tenderness](https://www.wikidoc.org/index.php/Abdominal_tenderness "Abdominal tenderness") \| \+ \| \+ \| – \| Nl \| Positive [stool culture](https://www.wikidoc.org/index.php/Stool_culture "Stool culture") \| ↑ \| Nl \| Nl \| – \| – \| [Enteropathogenic E. coli](https://www.wikidoc.org/index.php/Enteropathogenic_E._coli "Enteropathogenic E. coli") \| [DNA probe](https://www.wikidoc.org/index.php/Hybridization_probe "Hybridization probe") or [polymerase chain reaction](https://www.wikidoc.org/index.php/Polymerase_chain_reaction "Polymerase chain reaction") ([PCR](https://www.wikidoc.org/index.php/Polymerase_chain_reaction "Polymerase chain reaction")) of the EPEC adherence factor [Stool culture](https://www.wikidoc.org/index.php/Stool_culture "Stool culture") \| \| [EAEC](https://www.wikidoc.org/index.php/EAEC "EAEC") \| \+ \| \+ \| \+ \| \+ \| – \| – \| \+ \| – \| Diffuse [abdominal tenderness](https://www.wikidoc.org/index.php/Abdominal_tenderness "Abdominal tenderness") \| \+ \| \+ \| – \| Nl \| Positive [stool culture](https://www.wikidoc.org/index.php/Stool_culture "Stool culture") \| ↑ \| ↓ \| ↓ \| – \| Chronic infection in [immunocompromised](https://www.wikidoc.org/index.php/Immunodeficiency "Immunodeficiency") patients \| [Enteroaggregative E. coli](https://www.wikidoc.org/index.php/Escherichia_coli_enteritis "Escherichia coli enteritis") \| [Stool culture](https://www.wikidoc.org/index.php/Stool_culture "Stool culture") \| \| \| [Aeromonas](https://www.wikidoc.org/index.php/Aeromonas "Aeromonas") \| \+ \| \+ \| \+ \| \+ \| – \| \+ \| \+ \| – \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distention "Abdominal distention") Hyperactive [bowel sounds](https://www.wikidoc.org/index.php/Stomach_rumble "Stomach rumble") Diffuse [abdominal tenderness](https://www.wikidoc.org/index.php/Abdominal_tenderness "Abdominal tenderness") \| \+ \| \+ \| – \| Nl \| Positive [stool culture](https://www.wikidoc.org/index.php/Stool_culture "Stool culture") \| ↑ \| Nl \| Nl \| – \| Wound [infection](https://www.wikidoc.org/index.php/Infection "Infection") [Bacteremia](https://www.wikidoc.org/index.php/Bacteremia "Bacteremia") [Hemolytic uremic syndrome](https://www.wikidoc.org/index.php/Hemolytic-uremic_syndrome "Hemolytic-uremic syndrome") [Meningitis](https://www.wikidoc.org/index.php/Meningitis "Meningitis") [Ocular](https://www.wikidoc.org/index.php/Ocular "Ocular") infection [Pneumonia](https://www.wikidoc.org/index.php/Pneumonia "Pneumonia") [Urinary tract infection](https://www.wikidoc.org/index.php/Urinary_tract_infection "Urinary tract infection") [Osteomyelitis](https://www.wikidoc.org/index.php/Osteomyelitis "Osteomyelitis") [Peritonitis](https://www.wikidoc.org/index.php/Peritonitis "Peritonitis") [Acute cholecystitis](https://www.wikidoc.org/index.php/Acute_cholecystitis "Acute cholecystitis") [Opportunistic infections](https://www.wikidoc.org/index.php/Opportunistic_infection "Opportunistic infection") in [immunocompromised](https://www.wikidoc.org/index.php/Immunodeficiency "Immunodeficiency") patients \| [Aeromonas](https://www.wikidoc.org/index.php/Aeromonas "Aeromonas") virulence factors including [endotoxins](https://www.wikidoc.org/index.php/Endotoxin "Endotoxin"), [hemolysins](https://www.wikidoc.org/index.php/Hemolysin "Hemolysin"), [enterotoxins](https://www.wikidoc.org/index.php/Enterotoxin "Enterotoxin"), and adherence factors \| [Blood culture](https://www.wikidoc.org/index.php/Blood_culture "Blood culture") Wound [culture](https://www.wikidoc.org/index.php/Culture_collection "Culture collection") \| \| \| Cause \| Duration \| Diarrhea \| Fever \| Abdominal pain \| Weight loss \| GI signs \| Stool exam \| CBC \| Other lab findings \| Extra intestinal findings \| Cause/Pathogenesis \| Gold standard diagnosis \| \| \| \| \| \| \| \| \| \| \| \| Acute \| Chronic \| Watery \| Bloody \| Fatty \| WBC \| RBC \| Ova/Parasite \| Osmotic gap \| Other \| WBC \| Hgb \| Plt \| \| \| \| \| \| \| \| \| \| \| \| [Mycobacterium avium complex](https://www.wikidoc.org/index.php/Mycobacterium_avium_complex "Mycobacterium avium complex") \| \+ \| \+ \| \+ \| \+ \| – \| \+ \| \+ \| – \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distension "Abdominal distension") [Hepatosplenomegaly](https://www.wikidoc.org/index.php/Hepatosplenomegaly "Hepatosplenomegaly") \| \+ \| \+ \| – \| Nl \| – \| ↓ \| ↓ \| Nl \| Elevated [liver enzymes](https://www.wikidoc.org/index.php/Liver_function_tests "Liver function tests") \| [Opportunistic infection](https://www.wikidoc.org/index.php/Opportunistic_infection "Opportunistic infection") in [immunocompromised](https://www.wikidoc.org/index.php/Immunodeficiency "Immunodeficiency") patients [Pulmonary](https://www.wikidoc.org/index.php/Pulmonary "Pulmonary") [infection](https://www.wikidoc.org/index.php/Infection "Infection") [Adenopathy](https://www.wikidoc.org/index.php/Lymphadenopathy "Lymphadenopathy") [Night sweats](https://www.wikidoc.org/index.php/Sleep_hyperhidrosis "Sleep hyperhidrosis") \| [Mycobacterium avium complex](https://www.wikidoc.org/index.php/Mycobacterium_avium_complex "Mycobacterium avium complex") \| [Blood culture](https://www.wikidoc.org/index.php/Blood_culture "Blood culture") \| \| \| [CMV colitis](https://www.wikidoc.org/index.php/CMV_colitis "CMV colitis") \| \+ \| \+ \| – \| \+ \| – \| ± \| \+ \| – \| Diffuse [abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") \| \+ \| \+ \| – \| Nl \| Viral antigen assay \| ↓ \| Nl \| Nl \| Decreased [CD4](https://www.wikidoc.org/index.php/CD4 "CD4") level Abnormal [liver function test](https://www.wikidoc.org/index.php/Liver_function_tests "Liver function tests") \| [Encephalitis](https://www.wikidoc.org/index.php/Encephalitis "Encephalitis") [Guillain–Barré syndrome](https://www.wikidoc.org/index.php/Guillain-Barr%C3%A9_syndrome "Guillain-Barré syndrome") [Pneumonia](https://www.wikidoc.org/index.php/Pneumonia "Pneumonia") [Retinitis](https://www.wikidoc.org/index.php/Retinitis "Retinitis") [Pericarditis](https://www.wikidoc.org/index.php/Pericarditis "Pericarditis") and [myocarditis](https://www.wikidoc.org/index.php/Myocarditis "Myocarditis") [Atherosclerosis](https://www.wikidoc.org/index.php/Atherosclerosis "Atherosclerosis") [Venous thrombosis](https://www.wikidoc.org/index.php/Venous_thromboembolism "Venous thromboembolism") \| [Cytomegalovirus](https://www.wikidoc.org/index.php/Cytomegalovirus "Cytomegalovirus") \| [Quantitative PCR](https://www.wikidoc.org/index.php/Quantitative_polymerase_chain_reaction "Quantitative polymerase chain reaction") tests \| \| \| [HIV](https://www.wikidoc.org/index.php/Human_Immunodeficiency_Virus_\(HIV\) "Human Immunodeficiency Virus (HIV)") \| – \| \+ \| \+ \| – \| – \| \+ \| \+ \| \+ \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distension "Abdominal distension") Diffuse [abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") \| \+ \| – \| – \| Nl \| – \| ↓ \| ↓ \| Nl \| Decreased [CD4](https://www.wikidoc.org/index.php/CD4 "CD4") level [Electrolyte imbalance](https://www.wikidoc.org/index.php/Electrolyte_disturbance "Electrolyte disturbance") \| [Lymphadenopathy](https://www.wikidoc.org/index.php/Lymphadenopathy "Lymphadenopathy") Disseminated [infection](https://www.wikidoc.org/index.php/Infection "Infection") \| [HIV](https://www.wikidoc.org/index.php/Human_Immunodeficiency_Virus_\(HIV\) "Human Immunodeficiency Virus (HIV)") \| HIV virologic (viral load) test Immunoassay \| \| \| Cause \| Duration \| Diarrhea \| Fever \| Abdominal pain \| Weight loss \| GI signs \| Stool exam \| CBC \| Other lab findings \| Extra intestinal findings \| Cause/Pathogenesis \| Gold standard diagnosis \| \| \| \| \| \| \| \| \| \| \| \| Acute \| Chronic \| Watery \| Bloody \| Fatty \| WBC \| RBC \| Ova/Parasite \| Osmotic gap \| Other \| WBC \| Hgb \| Plt \| \| \| \| \| \| \| \| \| \| \| \| [Entamoeba histolytica](https://www.wikidoc.org/index.php/Entamoeba_histolytica "Entamoeba histolytica") \| \+ \| \+ \| \+ \| \+ \| – \| \+ \| \+ \| – \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distension "Abdominal distension") Diffuse [abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") \| \+ \| \+ \| \+ \| Nl \| – \| ↑ \| Nl \| Nl \| – \| [Liver abscess](https://www.wikidoc.org/index.php/Liver_abscess "Liver abscess") Pleuropulmonary infection [Cardiac](https://www.wikidoc.org/index.php/Cardiac "Cardiac") [infection](https://www.wikidoc.org/index.php/Infection "Infection") [Brain abscess](https://www.wikidoc.org/index.php/Brain_abscess "Brain abscess") [Cutaneous infection](https://www.wikidoc.org/index.php/Skin_and_soft-tissue_infections "Skin and soft-tissue infections") \| [Entamoeba histolytica](https://www.wikidoc.org/index.php/Entamoeba_histolytica "Entamoeba histolytica") \| Antigen testing Serology \| \| \| [Giardia](https://www.wikidoc.org/index.php/Giardia_lamblia "Giardia lamblia") \| – \| \+ \| \+ \| – \| \+ \| – \| \+ \| \+ \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distension "Abdominal distension") Diffuse [abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") \| – \| – \| \+ \| Nl \| – \| Nl \| Nl \| Nl \| – \| [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") [Urticaria](https://www.wikidoc.org/index.php/Urticaria "Urticaria") [Depression](https://www.wikidoc.org/index.php/Depression "Depression") \| [Giardia lamblia](https://www.wikidoc.org/index.php/Giardia_lamblia "Giardia lamblia") \| Antigen detection assays \| \| \| [Cryptosporidium](https://www.wikidoc.org/index.php/Cryptosporidium "Cryptosporidium") \| – \| \+ \| \+ \| – \| – \| – \| \+ \| \+ \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distension "Abdominal distension") Diffuse [abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") \| – \| – \| \+ \| Nl \| Positive stool microscopy \| Nl \| Nl \| Nl \| Elevated [alkaline phosphatase](https://www.wikidoc.org/index.php/Alkaline_phosphatase "Alkaline phosphatase") \| Chronic, life–threatening illness in [immunocompromised](https://www.wikidoc.org/index.php/Immunodeficiency "Immunodeficiency") patients \| [Cryptosporidium](https://www.wikidoc.org/index.php/Cryptosporidium "Cryptosporidium") \| Polymerase chain reaction \| \| \| [Microsporidia](https://www.wikidoc.org/index.php/Microsporidia "Microsporidia") \| \+ \| \+ \| \+ \| – \| – \| \+ \| \+ \| – \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distension "Abdominal distension") Diffuse [abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") \| – \| – \| \+ \| Nl \| Positive stool microscopy \| Nl \| Nl \| Nl \| Decreased [CD4](https://www.wikidoc.org/index.php/CD4 "CD4") count \| [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") [Keratitis](https://www.wikidoc.org/index.php/Keratitis "Keratitis") [Seizure](https://www.wikidoc.org/index.php/Seizure "Seizure") [Myositis](https://www.wikidoc.org/index.php/Myositis "Myositis") \| [Microsporidia](https://www.wikidoc.org/index.php/Microsporidia "Microsporidia") \| Antigen detection assays \| \| \| [Isospora](https://www.wikidoc.org/index.php/Isospora "Isospora") \| \+ \| \+ \| \+ \| – \| \+ \| \+ \| \+ \| \+ \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distension "Abdominal distension") Diffuse [abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") \| \+ \| \+ \| \+ \| Nl \| Positive stool microscopy Positive [fecal fat](https://www.wikidoc.org/index.php/Fecal_fat "Fecal fat") \| ↑ \| Nl \| Nl \| Elevated [eosinophils](https://www.wikidoc.org/index.php/Eosinophil_granulocyte "Eosinophil granulocyte") [Hypokalemia](https://www.wikidoc.org/index.php/Hypokalemia "Hypokalemia") Increased [creatinine](https://www.wikidoc.org/index.php/Creatinine "Creatinine") \| Chronic illness in [immunocompromised](https://www.wikidoc.org/index.php/Immunodeficiency "Immunodeficiency") patients \| [Isospora](https://www.wikidoc.org/index.php/Isospora "Isospora") \| Detecting oocysts in the feces \| \| \| Cause \| Duration \| Diarrhea \| Fever \| Abdominal pain \| Weight loss \| GI signs \| Stool exam \| CBC \| Other lab findings \| Extra intestinal findings \| Cause/Pathogenesis \| Gold standard diagnosis \| \| \| \| \| \| \| \| \| \| \| \| Acute \| Chronic \| Watery \| Bloody \| Fatty \| WBC \| RBC \| Ova/Parasite \| Osmotic gap \| Other \| WBC \| Hgb \| Plt \| \| \| \| \| \| \| \| \| \| \| \| [Carcinoid tumor](https://www.wikidoc.org/index.php/Carcinoid_syndrome "Carcinoid syndrome") \| – \| \+ \| \+ \| \+ \| – \| – \| \+ \| \+ \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distention "Abdominal distention") \| – \| \+ \| – \| ↓ \| – \| Nl \| Nl \| Nl \| Elevated urinary [5–hydroxyindoleacetic acid](https://www.wikidoc.org/index.php/5-Hydroxyindoleacetic_acid "5-Hydroxyindoleacetic acid") ([5–HIAA](https://www.wikidoc.org/index.php/5-Hydroxyindoleacetic_acid "5-Hydroxyindoleacetic acid")) level High [chromogranin A](https://www.wikidoc.org/index.php/Chromogranin_A "Chromogranin A") \| [Facial flushing](https://www.wikidoc.org/index.php/Flushing "Flushing") [Jaundice](https://www.wikidoc.org/index.php/Jaundice "Jaundice") [Edema](https://www.wikidoc.org/index.php/Edema "Edema") [Valvular heart disease](https://www.wikidoc.org/index.php/Valvular_heart_disease "Valvular heart disease") [Right–sided heart failure](https://www.wikidoc.org/index.php/Congestive_heart_failure "Congestive heart failure") \| Well–differentiated [neuroendocrine tumor](https://www.wikidoc.org/index.php/Neuroendocrine_tumors "Neuroendocrine tumors") \| Blood [chromogranin A](https://www.wikidoc.org/index.php/Chromogranin_A "Chromogranin A") level \| \| \| [VIPoma](https://www.wikidoc.org/index.php/VIPoma "VIPoma") \| \+ \| \+ \| \+ \| – \| \+ \| – \| \+ \| \+ \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distention "Abdominal distention") Abdominal [RUQ](https://www.wikidoc.org/index.php/RUQ "RUQ") [tenderness](https://www.wikidoc.org/index.php/Tenderness "Tenderness") [Nausea](https://www.wikidoc.org/index.php/Nausea "Nausea") [Vomiting](https://www.wikidoc.org/index.php/Vomiting "Vomiting") \| – \| – \| – \| ↓ \| – \| Nl \| Nl \| Nl \| Elevated [VIP](https://www.wikidoc.org/index.php/VIP "VIP") level [Hypokalemia](https://www.wikidoc.org/index.php/Hypokalemia "Hypokalemia") [Hypochlorhydria](https://www.wikidoc.org/index.php/Hypochlorhydria "Hypochlorhydria") or [achlorhydria](https://www.wikidoc.org/index.php/Achlorhydria "Achlorhydria") Low osmotic gap (\<50 mOsm/kg) \| [Rash](https://www.wikidoc.org/index.php/Rash "Rash") [Facial flushing](https://www.wikidoc.org/index.php/Facial_flushing "Facial flushing") [Dehydration](https://www.wikidoc.org/index.php/Dehydration "Dehydration") [Lethargy](https://www.wikidoc.org/index.php/Lethargy "Lethargy") [Muscle weakness](https://www.wikidoc.org/index.php/Muscle_weakness "Muscle weakness") \| Primary secretory tumor \| Blood [VIP](https://www.wikidoc.org/index.php/VIP "VIP") levels Followed by imaging \| \| \| [Zollinger–Ellison syndrome](https://www.wikidoc.org/index.php/Zollinger-Ellison_syndrome "Zollinger-Ellison syndrome") \| – \| \+ \| \+ \| \+ \| \+ \| – \| \+ \| \+ \| [Epigastric tenderness](https://www.wikidoc.org/index.php/Tenderness "Tenderness") \| – \| – \| – \| ↓ \| – \| Nl \| ↓ \| Nl \| Positive [secretin](https://www.wikidoc.org/index.php/Secretin "Secretin") stimulation test Elevated serum [chromogranin A](https://www.wikidoc.org/index.php/Chromogranin_A "Chromogranin A") \| [Jaundice](https://www.wikidoc.org/index.php/Jaundice "Jaundice") \| [Gastrin](https://www.wikidoc.org/index.php/Gastrin "Gastrin") producing [tumor](https://www.wikidoc.org/index.php/Tumor "Tumor") mainly in [duodenum](https://www.wikidoc.org/index.php/Duodenum "Duodenum") \| [Secretin](https://www.wikidoc.org/index.php/Secretin "Secretin") stimulation test \| \| \| [Somatostatinoma](https://www.wikidoc.org/index.php/Neuroendocrine_tumors "Neuroendocrine tumors") \| – \| \+ \| \+ \| – \| – \| – \| \+ \| \+ \| [Epigastric tenderness](https://www.wikidoc.org/index.php/Tenderness "Tenderness") \| – \| – \| – \| ↓ \| – \| Nl \| Nl \| Nl \| Elevated fasting plasma [somatostatin](https://www.wikidoc.org/index.php/Somatostatin "Somatostatin") \| [Diabetes mellitus](https://www.wikidoc.org/index.php/Diabetes_mellitus "Diabetes mellitus") [Cholelithiasis](https://www.wikidoc.org/index.php/Gallstone_disease "Gallstone disease") [Jaundice](https://www.wikidoc.org/index.php/Jaundice "Jaundice") \| [Neuroendocrine tumors](https://www.wikidoc.org/index.php/Neuroendocrine_tumors "Neuroendocrine tumors") of D–cell origin \| Plasma [somatostatin](https://www.wikidoc.org/index.php/Somatostatin "Somatostatin") level Followed by imaging \| \| \| Cause \| Duration \| Diarrhea \| Fever \| Abdominal pain \| Weight loss \| GI signs \| Stool exam \| CBC \| Other lab findings \| Extra intestinal findings \| Cause/Pathogenesis \| Gold standard diagnosis \| \| \| \| \| \| \| \| \| \| \| \| Acute \| Chronic \| Watery \| Bloody \| Fatty \| WBC \| RBC \| Ova/Parasite \| Osmotic gap \| Other \| WBC \| Hgb \| Plt \| \| \| \| \| \| \| \| \| \| \| \| [Lymphoma](https://www.wikidoc.org/index.php/Lymphoma "Lymphoma") \| – \| \+ \| \+ \| \+ \| – \| \+ \| \+ \| \+ \| Diffuse [abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") [Hepatosplenomegaly](https://www.wikidoc.org/index.php/Hepatosplenomegaly "Hepatosplenomegaly") \| – \| \+ \| – \| Nl \| – \| Nl \| ↓ \| Nl \| [Paraproteinemia](https://www.wikidoc.org/index.php/Paraproteinemia "Paraproteinemia") \| [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") [Lactose intolerance](https://www.wikidoc.org/index.php/Lactose_intolerance "Lactose intolerance") [Ascites](https://www.wikidoc.org/index.php/Ascites "Ascites") \| Primary [tumor](https://www.wikidoc.org/index.php/Tumor "Tumor") of GI tract \| [Colonoscopy](https://www.wikidoc.org/index.php/Colonoscopy "Colonoscopy") with [biopsy](https://www.wikidoc.org/index.php/Biopsy "Biopsy") \| \| \| [Colorectal cancer](https://www.wikidoc.org/index.php/Colorectal_cancer "Colorectal cancer") \| – \| \+ \| \+ \| \+ \| \+ \| – \| \+ \| \+ \| Diffuse [abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") \| – \| \+ \| – \| Nl \| – \| Nl \| ↓ \| Nl \| Positive [carcinoembryonic antigen](https://www.wikidoc.org/index.php/Carcinoembryonic_antigen "Carcinoembryonic antigen") \| [Metastasis](https://www.wikidoc.org/index.php/Metastasis "Metastasis") \| [FAP gene](https://www.wikidoc.org/index.php/FAP "FAP") [HNPCC gene](https://www.wikidoc.org/index.php/Hereditary_nonpolyposis_colorectal_cancer "Hereditary nonpolyposis colorectal cancer") \| [Colonoscopy](https://www.wikidoc.org/index.php/Colonoscopy "Colonoscopy") and [biopsy](https://www.wikidoc.org/index.php/Biopsy "Biopsy") \| \| \| Medications [ACE inhibitors](https://www.wikidoc.org/index.php/ACE_inhibitor "ACE inhibitor") [Digoxin](https://www.wikidoc.org/index.php/Digoxin "Digoxin") [Cephalosporins](https://www.wikidoc.org/index.php/Cephalosporin "Cephalosporin") [Statins](https://www.wikidoc.org/index.php/Statins "Statins") [Thiazide diuretics](https://www.wikidoc.org/index.php/Thiazide "Thiazide") [Triptans](https://www.wikidoc.org/index.php/Triptans "Triptans") [Lactulose](https://www.wikidoc.org/index.php/Lactulose "Lactulose") [Anti retroviral agents](https://www.wikidoc.org/index.php/HIV_AIDS_medical_therapy "HIV AIDS medical therapy") [Chemotherapeutic agents](https://www.wikidoc.org/index.php/Chemotherapy "Chemotherapy") [Antifungals](https://www.wikidoc.org/index.php/Antifungal_drug "Antifungal drug") [Magnesium](https://www.wikidoc.org/index.php/Magnesium "Magnesium") \| \+ \| \+ \| \+ \| – \| ± \| ± \| \+ \| \+ \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distention "Abdominal distention") [Dehydration](https://www.wikidoc.org/index.php/Dehydration "Dehydration") \| – \| – \| – \| ↑/↓ \| – \| ↑ \| Nl \| Nl \| Elevated plasma level of drug \| – \| [Inflammation](https://www.wikidoc.org/index.php/Inflammation "Inflammation") [Pseudomembranous colitis](https://www.wikidoc.org/index.php/Pseudomembranous_enterocolitis "Pseudomembranous enterocolitis") \| Clinical evaluation after discontinuation of the drugs \| \| \| Factitious diarrhea \| \+ \| \+ \| \+ \| – \| – \| – \| \+ \| \+ \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distention "Abdominal distention") \| – \| – \| – \| ↑/↓ \| – \| Nl \| Nl \| Nl \| [Hypokalemia](https://www.wikidoc.org/index.php/Hypokalemia "Hypokalemia") [Metabolic alkalosis](https://www.wikidoc.org/index.php/Metabolic_alkalosis "Metabolic alkalosis") [Hypermagnesemia](https://www.wikidoc.org/index.php/Hypermagnesemia "Hypermagnesemia") \| [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") [Lethargy](https://www.wikidoc.org/index.php/Lethargy "Lethargy") [Generalized weakness](https://www.wikidoc.org/index.php/Generalized_weakness "Generalized weakness") [Acute renal failure](https://www.wikidoc.org/index.php/Acute_kidney_injury "Acute kidney injury") \| [Medications](https://www.wikidoc.org/index.php/Medication "Medication") \| Clinical evaluation after discontinuation of the drugs \| \| \| Cause \| Duration \| Diarrhea \| Fever \| Abdominal pain \| Weight loss \| GI signs \| Stool exam \| CBC \| Other lab findings \| Extra intestinal findings \| Cause/Pathogenesis \| Gold standard diagnosis \| \| \| \| \| \| \| \| \| \| \| \| Acute \| Chronic \| Watery \| Bloody \| Fatty \| WBC \| RBC \| Ova/Parasite \| Osmotic gap \| Other \| WBC \| Hgb \| Plt \| \| \| \| \| \| \| \| \| \| \| \| [Heavy metal ingestion](https://www.wikidoc.org/index.php/Heavy_metal_ingestion "Heavy metal ingestion") \| – \| \+ \| \+ \| – \| – \| – \| \+ \| \+ \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distention "Abdominal distention") \| – \| – \| – \| Nl \| – \| Nl \| Nl \| Nl \| Elevated plasma heavy metal level \| [Headache](https://www.wikidoc.org/index.php/Headache "Headache") [Numbness](https://www.wikidoc.org/index.php/Paresthesia "Paresthesia") [Alopecia](https://www.wikidoc.org/index.php/Alopecia "Alopecia") [Vertigo](https://www.wikidoc.org/index.php/Vertigo "Vertigo") \| [Heavy metal ingestion](https://www.wikidoc.org/index.php/Heavy_metal_ingestion "Heavy metal ingestion") \| Plasma level of heavy metal \| \| \| [Organophosphate poisoning](https://www.wikidoc.org/index.php/Organophosphate_poisoning "Organophosphate poisoning") \| \+ \| \+ \| \+ \| – \| – \| – \| \+ \| – \| [Salivation](https://www.wikidoc.org/index.php/Saliva "Saliva") [Vomiting](https://www.wikidoc.org/index.php/Nausea_and_vomiting "Nausea and vomiting") \| – \| – \| – \| Nl \| – \| Nl \| Nl \| Nl \| Reduced RBC acetylcholinesterase Plasma [cholinesterase](https://www.wikidoc.org/index.php/Cholinesterase "Cholinesterase") activity \| [Autonomic dysfunction](https://www.wikidoc.org/index.php/Dysautonomia "Dysautonomia") Motor deficit Sensory deficit [Bronchospasm](https://www.wikidoc.org/index.php/Bronchospasm "Bronchospasm") [Urination](https://www.wikidoc.org/index.php/Urination "Urination") [Miosis](https://www.wikidoc.org/index.php/Miosis "Miosis") [Bradycardia](https://www.wikidoc.org/index.php/Bradycardia "Bradycardia") [Lacrimation](https://www.wikidoc.org/index.php/Lacrimation "Lacrimation") [Sweating](https://www.wikidoc.org/index.php/Sweating "Sweating") [Cardiac arrhythmias](https://www.wikidoc.org/index.php/Cardiac_arrhythmia "Cardiac arrhythmia") [Acute renal injury](https://www.wikidoc.org/index.php/Acute_kidney_injury "Acute kidney injury") \| [Neurotoxins](https://www.wikidoc.org/index.php/Neurotoxin "Neurotoxin") bind to [acetylcholinesterase](https://www.wikidoc.org/index.php/ACHE "ACHE") (AChE) \| Clinical diagnosis \| \| \| [Opium withdrawal](https://www.wikidoc.org/index.php/Opium_withdrawal "Opium withdrawal") \| \+ \| \+ \| \+ \| – \| – \| – \| \+ \| – \| Hyperactive [bowel sounds](https://www.wikidoc.org/index.php/Stomach_rumble "Stomach rumble") \| – \| – \| – \| Nl \| – \| Nl \| Nl \| Nl \| [Azotemia](https://www.wikidoc.org/index.php/Azotemia "Azotemia") [Hypokalemia](https://www.wikidoc.org/index.php/Hypokalemia "Hypokalemia") [Metabolic alkalosis](https://www.wikidoc.org/index.php/Metabolic_alkalosis "Metabolic alkalosis") \| [Dysphoria](https://www.wikidoc.org/index.php/Dysphoria "Dysphoria") [Restlessness](https://www.wikidoc.org/index.php/Agitation_\(emotion\) "Agitation (emotion)") [Sweating](https://www.wikidoc.org/index.php/Perspiration "Perspiration") [Rhinorrhea](https://www.wikidoc.org/index.php/Rhinorrhea "Rhinorrhea") [Lacrimation](https://www.wikidoc.org/index.php/Tears "Tears") [Myalgia](https://www.wikidoc.org/index.php/Myalgia "Myalgia") [Arthralgia](https://www.wikidoc.org/index.php/Arthralgia "Arthralgia") \| [Opium withdrawal](https://www.wikidoc.org/index.php/Opium "Opium") \| Clinical diagnosis following [opium withdrawal](https://www.wikidoc.org/index.php/Opium_withdrawal "Opium withdrawal") \| \| \| Cause \| Duration \| Diarrhea \| Fever \| Abdominal pain \| Weight loss \| GI signs \| Stool exam \| CBC \| Other lab findings \| Extra intestinal findings \| Cause/Pathogenesis \| Gold standard diagnosis \| \| \| \| \| \| \| \| \| \| \| \| Acute \| Chronic \| Watery \| Bloody \| Fatty \| WBC \| RBC \| Ova/Parasite \| Osmotic gap \| Other \| WBC \| Hgb \| Plt \| \| \| \| \| \| \| \| \| \| \| \| [Short bowel syndrome](https://www.wikidoc.org/index.php/Short_bowel_syndrome "Short bowel syndrome") \| \+ \| \+ \| \+ \| – \| \+ \| – \| – \| \+ \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distension "Abdominal distension") [Abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") \| – \| – \| – \| Nl \| Positive [fecal fat](https://www.wikidoc.org/index.php/Fecal_fat "Fecal fat") \| Nl \| ↓ \| ↑ \| [Hypoalbuminemia](https://www.wikidoc.org/index.php/Hypoalbuminemia "Hypoalbuminemia") High level of [acute phase reactant](https://www.wikidoc.org/index.php/Acute_phase_protein "Acute phase protein") Abnormal [liver function tests](https://www.wikidoc.org/index.php/Liver_function_tests "Liver function tests") \| Prior [intestinal](https://www.wikidoc.org/index.php/Intestine "Intestine") surgery [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") [Crohn's disease](https://www.wikidoc.org/index.php/Crohn%27s_disease "Crohn's disease") [Malignancy](https://www.wikidoc.org/index.php/Cancer "Cancer") Peripheral [edema](https://www.wikidoc.org/index.php/Edema "Edema") [Muscle atrophy](https://www.wikidoc.org/index.php/Muscle_atrophy "Muscle atrophy") \| Surgical [bowel resection](https://www.wikidoc.org/index.php/Bowel_resection "Bowel resection") \| Clinical diagnosis following [bowel resection](https://www.wikidoc.org/index.php/Bowel_resection "Bowel resection") \| \| \| [Radiation enteritis](https://www.wikidoc.org/index.php/Radiation_enteropathy "Radiation enteropathy") \| \+ \| \+ \| \+ \| \+ \| \+ \| – \| \+ \| \+ \| [Abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") \| \+ \| \+ \| – \| Nl \| Positive [fecal fat](https://www.wikidoc.org/index.php/Fecal_fat "Fecal fat") \| Nl \| ↓ \| Nl \| Vitamin B12 deficiency [Hypoalbuminemia](https://www.wikidoc.org/index.php/Hypoalbuminemia "Hypoalbuminemia") \| Prior history of [malignancy](https://www.wikidoc.org/index.php/Cancer "Cancer") and [radiation therapy](https://www.wikidoc.org/index.php/Radiation_therapy "Radiation therapy") [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") [Telangiectasias](https://www.wikidoc.org/index.php/Telangiectasia "Telangiectasia") \| [Radiation](https://www.wikidoc.org/index.php/Radiation_therapy "Radiation therapy") \| Segmental bowel [inflammation](https://www.wikidoc.org/index.php/Inflammation "Inflammation") on [endoscopy](https://www.wikidoc.org/index.php/Endoscopy "Endoscopy") or [colonoscopy](https://www.wikidoc.org/index.php/Colonoscopy "Colonoscopy") \| \| \| [Dumping syndrome](https://www.wikidoc.org/index.php/Gastric_dumping_syndrome "Gastric dumping syndrome") \| – \| \+ \| \+ \| – \| \+ \| – \| – \| \+ \| Hyperactive [bowel sound](https://www.wikidoc.org/index.php/Bowel_sound "Bowel sound") \| – \| – \| – \| Nl \| – \| Nl \| Nl \| Nl \| [Hypoglycemia](https://www.wikidoc.org/index.php/Hypoglycemia "Hypoglycemia") [Hydrogen breath test](https://www.wikidoc.org/index.php/Hydrogen_Breath_Test "Hydrogen Breath Test") \| [Malnutrition](https://www.wikidoc.org/index.php/Malnutrition "Malnutrition") [Fat soluble vitamin](https://www.wikidoc.org/index.php/Fat_soluble_vitamins "Fat soluble vitamins") deficiency \| [Postgastrectomy](https://www.wikidoc.org/index.php/Post_operative_complications "Post operative complications") \| Clinical diagnosis following [gastrectomy](https://www.wikidoc.org/index.php/Gastrectomy "Gastrectomy") \| \| \| Cause \| Duration \| Diarrhea \| Fever \| Abdominal pain \| Weight loss \| GI signs \| Stool exam \| CBC \| Other lab findings \| Extra intestinal findings \| Cause/Pathogenesis \| Gold standard diagnosis \| \| \| \| \| \| \| \| \| \| \| \| Acute \| Chronic \| Watery \| Bloody \| Fatty \| WBC \| RBC \| Ova/Parasite \| Osmotic gap \| Other \| WBC \| Hgb \| Plt \| \| \| \| \| \| \| \| \| \| \| \| [Abetalipoproteinemia](https://www.wikidoc.org/index.php/Abetalipoproteinemia "Abetalipoproteinemia") \| – \| \+ \| \+ \| – \| \+ \| – \| \+ \| \+ \| [Abdominal distension](https://www.wikidoc.org/index.php/Abdominal_distension "Abdominal distension") \| – \| – \| – \| Nl \| – \| Nl \| Nl \| Nl \| Low [triglyceride](https://www.wikidoc.org/index.php/Triglyceride "Triglyceride") Low total [cholesterol](https://www.wikidoc.org/index.php/Cholesterol "Cholesterol") levels [Acanthocytes](https://www.wikidoc.org/index.php/Acanthocytes "Acanthocytes") Low [vitamin E](https://www.wikidoc.org/index.php/Vitamin_E "Vitamin E") levels \| [Ataxia](https://www.wikidoc.org/index.php/Ataxia "Ataxia") [Visual field defect](https://www.wikidoc.org/index.php/Visual_field_defect "Visual field defect") [Dysarthria](https://www.wikidoc.org/index.php/Dysarthria "Dysarthria") \| [Autosomal recessive](https://www.wikidoc.org/index.php/Autosomal_recessive "Autosomal recessive") disorder caused by mutations encoding the [microsomal triglyceride transfer protein](https://www.wikidoc.org/index.php/Microsomal_triglyceride_transfer_protein "Microsomal triglyceride transfer protein") (MTP) \| Clinical findings and low [triglyceride](https://www.wikidoc.org/index.php/Triglyceride "Triglyceride") and [cholesterol](https://www.wikidoc.org/index.php/Cholesterol "Cholesterol") level \| \| \| [Hyperthyroidism](https://www.wikidoc.org/index.php/Hyperthyroidism "Hyperthyroidism") \| – \| \+ \| \+ \| – \| – \| ± \| \+ \| \+ \| – \| – \| – \| – \| Nl \| Positive [fecal fat](https://www.wikidoc.org/index.php/Fecal_fat "Fecal fat") \| Nl \| Nl \| Nl \| Elevated [T4](https://www.wikidoc.org/index.php/T4 "T4") Elevated [T3](https://www.wikidoc.org/index.php/T3 "T3") Decreased [TSH](https://www.wikidoc.org/index.php/TSH "TSH") High serum [alkaline phosphatase](https://www.wikidoc.org/index.php/Alkaline_phosphatase "Alkaline phosphatase") \| Lump in the neck Lid lag [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") [Sweating](https://www.wikidoc.org/index.php/Sweating "Sweating") [Hyperpigmentation](https://www.wikidoc.org/index.php/Hyperpigmentation "Hyperpigmentation") [Proptosis](https://www.wikidoc.org/index.php/Proptosis "Proptosis") [Tremor](https://www.wikidoc.org/index.php/Tremor "Tremor") Increased [DTR](https://www.wikidoc.org/index.php/Deep_tendon_reflex "Deep tendon reflex") \| [Graves' disease](https://www.wikidoc.org/index.php/Graves%27_disease "Graves' disease") [Hashimoto's thyroiditis](https://www.wikidoc.org/index.php/Hashimoto%27s_thyroiditis "Hashimoto's thyroiditis") [Toxic adenoma](https://www.wikidoc.org/index.php/Toxic_adenoma "Toxic adenoma") \| [TSH](https://www.wikidoc.org/index.php/TSH "TSH") \| \| \| [Diabetic neuropathy](https://www.wikidoc.org/index.php/Diabetic_neuropathy "Diabetic neuropathy") \| – \| \+ \| \+ \| – \| \+ \| – \| \+ \| \+ \| [Fecal incontinence](https://www.wikidoc.org/index.php/Fecal_incontinence "Fecal incontinence") \| – \| – \| – \| Nl \| Positive [fecal fat](https://www.wikidoc.org/index.php/Fecal_fat "Fecal fat") \| Nl \| ↓ \| Nl \| [Hyperglycemia](https://www.wikidoc.org/index.php/Hyperglycemia "Hyperglycemia") [Azotemia](https://www.wikidoc.org/index.php/Azotemia "Azotemia") [Hypokalemia](https://www.wikidoc.org/index.php/Hypokalemia "Hypokalemia") \| [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") \| Unclear Disordered [motility](https://www.wikidoc.org/index.php/Motility "Motility") Increased [intestinal](https://www.wikidoc.org/index.php/Intestine "Intestine") secretion [Small intestinal bacterial overgrowth](https://www.wikidoc.org/index.php/Small_intestinal_bacterial_overgrowth "Small intestinal bacterial overgrowth") \| Clinical diagnosis in a patient with long lasting [diabetes mellitus](https://www.wikidoc.org/index.php/Diabetes_mellitus "Diabetes mellitus") \| \| \| [Systemic sclerosis](https://www.wikidoc.org/index.php/Scleroderma "Scleroderma") \| – \| \+ \| \+ \| ± \| \+ \| – \| \+ \| \+ \| [Epigastric tenderness](https://www.wikidoc.org/index.php/Abdominal_pain "Abdominal pain") [Fecal incontinence](https://www.wikidoc.org/index.php/Fecal_incontinence "Fecal incontinence") \| – \| \+ \| – \| Nl \| Positive [fecal fat](https://www.wikidoc.org/index.php/Fecal_fat "Fecal fat") \| Nl \| ↓ \| Nl \| Anti–[topoisomerase I](https://www.wikidoc.org/index.php/Type_I_topoisomerase "Type I topoisomerase") (Scl‑70) antibodies [Antinuclear antibodies](https://www.wikidoc.org/index.php/Antinuclear_antibodies "Antinuclear antibodies") ([ANA](https://www.wikidoc.org/index.php/Antinuclear_antibodies "Antinuclear antibodies")) [Anti–centromere antibodies](https://www.wikidoc.org/index.php/Anti-centromere_antibodies "Anti-centromere antibodies") Anti–[RNA polymerase III](https://www.wikidoc.org/index.php/RNA_polymerase_III "RNA polymerase III") antibody \| [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") [Skin changes](https://www.wikidoc.org/index.php/Skin_changes "Skin changes") [Raynaud phenomenon](https://www.wikidoc.org/index.php/Raynaud%27s_phenomenon "Raynaud's phenomenon") [Pulmonary hypertension](https://www.wikidoc.org/index.php/Pulmonary_hypertension "Pulmonary hypertension") [Arthritis](https://www.wikidoc.org/index.php/Arthritis "Arthritis") [Telangiectasia](https://www.wikidoc.org/index.php/Telangiectasia "Telangiectasia") [Chronic renal failure](https://www.wikidoc.org/index.php/Chronic_renal_failure "Chronic renal failure") \| [Autoimmune reaction](https://www.wikidoc.org/index.php/Autoimmunity "Autoimmunity") \| Clinical diagnosis Followed by serologic tests \| \| ## References 1. 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CS1 maint: Multiple names: authors list ([link](https://www.wikidoc.org/index.php/Category:CS1_maint:_Multiple_names:_authors_list "Category:CS1 maint: Multiple names: authors list")) 25. [↑](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_ref-pmid8209928_25-0) Konvolinka CW (1994). ["Acute diverticulitis under age forty"](https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8209928). Am J Surg. 167 (6): 562–5. [PMID](https://www.wikidoc.org/index.php?title=PubMed_Identifier&action=edit&redlink=1 "PubMed Identifier (page does not exist)") [8209928](https://www.ncbi.nlm.nih.gov/pubmed/8209928). 26. [↑](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_ref-pmid16698746_26-0) Satsangi J, Silverberg MS, Vermeire S, Colombel JF (2006). ["The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications"](https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16698746). Gut. 55 (6): 749–53. [doi](https://www.wikidoc.org/index.php/Digital_object_identifier "Digital object identifier"):[10\.1136/gut.2005.082909](https://doi.org/10.1136%2Fgut.2005.082909). [PMC](https://www.wikidoc.org/index.php/PubMed_Central "PubMed Central") [1856208](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1856208). [PMID](https://www.wikidoc.org/index.php?title=PubMed_Identifier&action=edit&redlink=1 "PubMed Identifier (page does not exist)") [16698746](https://www.ncbi.nlm.nih.gov/pubmed/16698746). CS1 maint: Multiple names: authors list ([link](https://www.wikidoc.org/index.php/Category:CS1_maint:_Multiple_names:_authors_list "Category:CS1 maint: Multiple names: authors list")) 27. [↑](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_ref-pmid12700377_27-0) Haque R, Huston CD, Hughes M, Houpt E, Petri WA (2003). ["Amebiasis"](https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12700377). N Engl J Med. 348 (16): 1565–73. [doi](https://www.wikidoc.org/index.php/Digital_object_identifier "Digital object identifier"):[10\.1056/NEJMra022710](https://doi.org/10.1056%2FNEJMra022710). [PMID](https://www.wikidoc.org/index.php?title=PubMed_Identifier&action=edit&redlink=1 "PubMed Identifier (page does not exist)") [12700377](https://www.ncbi.nlm.nih.gov/pubmed/12700377). CS1 maint: Multiple names: authors list ([link](https://www.wikidoc.org/index.php/Category:CS1_maint:_Multiple_names:_authors_list "Category:CS1 maint: Multiple names: authors list")) 28. [↑](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_ref-pmid8694025_28-0) Hertzler SR, Savaiano DA (1996). ["Colonic adaptation to daily lactose feeding in lactose maldigesters reduces lactose intolerance"](https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8694025). Am J Clin Nutr. 64 (2): 232–6. [PMID](https://www.wikidoc.org/index.php?title=PubMed_Identifier&action=edit&redlink=1 "PubMed Identifier (page does not exist)") [8694025](https://www.ncbi.nlm.nih.gov/pubmed/8694025). 29. [↑](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_ref-pmid9414969_29-0) Briet F, Pochart P, Marteau P, Flourie B, Arrigoni E, Rambaud JC (1997). 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["The tinctoral demonstration of a glycoprotein in Whipple's disease"](https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15391722). Proc Soc Exp Biol Med. 72 (1): 225–7. [PMID](https://www.wikidoc.org/index.php?title=PubMed_Identifier&action=edit&redlink=1 "PubMed Identifier (page does not exist)") [15391722](https://www.ncbi.nlm.nih.gov/pubmed/15391722). 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Readable Markdown	[![](https://www.wikidoc.org/images/1/16/Home_logo1.png)](https://www.wikidoc.org/index.php/Chronic_diarrhea) *To review the differential diagnosis of diarrhea, click [here](https://www.wikidoc.org/index.php/Diarrhea#Differential_Diagnosis_of_Diarrhea_of_other_diseases "Diarrhea").* Editor-In-Chief: [C. Michael Gibson, M.S., M.D.](https://www.wikidoc.org/index.php/User:C_Michael_Gibson "User:C Michael Gibson") [\[1\]](mailto:charlesmichaelgibson@gmail.com); Associate Editor(s)-in-Chief: [Sadaf Sharfaei M.D.](https://www.wikidoc.org/index.php/User:Ssharfaei "User:Ssharfaei")[\[2\]](Mailto:sadaf.sharfaei@gmail.com), [Seyedmahdi Pahlavani, M.D.](https://www.wikidoc.org/index.php/User:Mehdi_Pahlavani "User:Mehdi Pahlavani") [\[3\]](mailto:spahlava@bidmc.harvard.edu) Overview The [differential diagnosis](https://www.wikidoc.org/index.php/Differential_diagnosis "Differential diagnosis") for [chronic diarrhea](https://www.wikidoc.org/index.php/Chronic_diarrhea "Chronic diarrhea") is enormous, with a large number of diagnostic tests available that can be used to evaluate these patients. Classifying a patient's [chronic diarrhea](https://www.wikidoc.org/index.php/Chronic_diarrhea "Chronic diarrhea") into a subcategory such as [watery](https://www.wikidoc.org/index.php/Watery_diarrhea "Watery diarrhea"), fatty and [inflammatory](https://www.wikidoc.org/index.php/Inflammatory "Inflammatory") helps to direct the [diagnostic](https://www.wikidoc.org/index.php/Diagnostic "Diagnostic") work-up. Some [watery](https://www.wikidoc.org/index.php/Watery_diarrhea "Watery diarrhea") causes of chronic diarrhea which should be differentiated from one another include [crohn's disease](https://www.wikidoc.org/index.php/Crohn%27s_disease "Crohn's disease"), [hyperthyroidism](https://www.wikidoc.org/index.php/Hyperthyroidism "Hyperthyroidism"), [VIPoma](https://www.wikidoc.org/index.php/VIPoma "VIPoma"), [lactose intolerance](https://www.wikidoc.org/index.php/Lactose_intolerance "Lactose intolerance"), [celiac disease](https://www.wikidoc.org/index.php/Celiac_disease "Celiac disease") and [irritable bowel syndrome](https://www.wikidoc.org/index.php/Irritable_bowel_syndrome "Irritable bowel syndrome") (IBS). The causes of fatty diarrhea that should be differentiated from one another include [celiac sprue](https://www.wikidoc.org/index.php/Celiac_sprue "Celiac sprue"), [pancreatic insufficiency](https://www.wikidoc.org/index.php/Pancreatic_insufficiency "Pancreatic insufficiency"), [bacterial overgrowth](https://www.wikidoc.org/index.php/Bacterial_overgrowth "Bacterial overgrowth") and [maldigestion](https://www.wikidoc.org/index.php/Maldigestion "Maldigestion") problems which results from [pancreatic exocrine insufficiency](https://www.wikidoc.org/index.php/Pancreatic_insufficiency "Pancreatic insufficiency"). Finally, the [inflammatory](https://www.wikidoc.org/index.php/Inflammatory "Inflammatory") causes of chronic diarrhea such as [ulcerative colitis](https://www.wikidoc.org/index.php/Ulcerative_colitis "Ulcerative colitis") and [entamoeba histolytica](https://www.wikidoc.org/index.php/Entamoeba_histolytica "Entamoeba histolytica") must also be differentiated. Differential Diagnosis of Chronic Diarrhea from other diseases The following table outlines the major differential diagnoses of chronic diarrhea.[\[1\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-Casburn-JonesFarthing2004-1)[\[2\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-KamatMathur2006-2)[\[3\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-PfeifferDuPont2012-3)[\[4\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid24506120-4)[\[5\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid29255768-5)[\[6\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid29254859-6)[\[7\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-Yamamoto-FurushoBosques-Padilla2017-7)[\[8\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-Borb%C3%A9lyOsterwalder2017-8)[\[9\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-CrawfordRamani2017-9)[\[10\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid11068510-10)[\[11\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid4014291-11)[\[12\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid10575169-12)[\[13\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-WahnschaffeIgnatius2009-13)[\[14\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid27765536-14)[\[15\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid19365159-15)[\[16\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid23384808-16)[\[17\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid25692805-17)[\[18\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid17373914-18)[\[19\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid23384801-19)[\[20\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid3523719-20)[\[21\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid16151544-21)[\[22\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid12135027-22)[\[23\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid1702075-23)[\[24\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid14439871-24)[\[25\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid8209928-25)[\[26\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid16698746-26)[\[27\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid12700377-27)[\[28\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid8694025-28)[\[29\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid9414969-29)[\[30\]](https://www.wikidoc.org/index.php/Chronic_diarrhea_differential_diagnosis#cite_note-pmid15391722-30) Abbreviations: GI: [Gastrointestinal](https://www.wikidoc.org/index.php/Gastrointestinal_tract "Gastrointestinal tract"), CBC: [Complete blood count](https://www.wikidoc.org/index.php/Complete_blood_count "Complete blood count"), WBC: [White blood cell](https://www.wikidoc.org/index.php/White_blood_cells "White blood cells"), RBC: [Red blood cell](https://www.wikidoc.org/index.php/Red_blood_cell "Red blood cell"), Plt: [Platelet](https://www.wikidoc.org/index.php/Platelet "Platelet"), Hgb: [Hemoglobin](https://www.wikidoc.org/index.php/Hemoglobin "Hemoglobin"), ESR: [Erythrocyte sedimentation rate](https://www.wikidoc.org/index.php/Erythrocyte_sedimentation_rate "Erythrocyte sedimentation rate"), CRP: [C–reactive protein](https://www.wikidoc.org/index.php/C-reactive_protein "C-reactive protein"), IgE: [Immunoglobulin E](https://www.wikidoc.org/index.php/Immunoglobulin_E "Immunoglobulin E"), IgA: [Immunoglobulin A](https://www.wikidoc.org/index.php/Immunoglobulin_A "Immunoglobulin A"), ETEC: [Escherichia coli enteritis](https://www.wikidoc.org/index.php/Escherichia_coli_enteritis "Escherichia coli enteritis"), EPEC: [Enteropathogenic Escherichia coli](https://www.wikidoc.org/index.php/Escherichia_coli "Escherichia coli"), EIEC: [Enteroinvasive Escherichia coli](https://www.wikidoc.org/index.php/Escherichia_coli_enteritis "Escherichia coli enteritis"), EHEC: [Enterohemorrhagic Escherichia coli](https://www.wikidoc.org/index.php/Escherichia_coli "Escherichia coli"), EAEC: [Enteroaggregative Escherichia coli](https://www.wikidoc.org/index.php/Escherichia_coli_enteritis "Escherichia coli enteritis"), Nl: Normal, ASCA: [Anti saccharomyces cerevisiae antibodies](https://www.wikidoc.org/index.php/Anti_saccharomyces_cerevisiae_antibodies "Anti saccharomyces cerevisiae antibodies"), ANCA: [Anti–neutrophil cytoplasmic antibody](https://www.wikidoc.org/index.php/Anti-neutrophil_cytoplasmic_antibody "Anti-neutrophil cytoplasmic antibody"), DNA: [Deoxyribonucleic acid](https://www.wikidoc.org/index.php/DNA "DNA"), CFTR: [Cystic fibrosis transmembrane conductance regulator](https://www.wikidoc.org/index.php/Cystic_fibrosis_transmembrane_conductance_regulator "Cystic fibrosis transmembrane conductance regulator"), SLC10A2: [Solute carrier family 10 member 2](https://www.wikidoc.org/index.php/SLC10A2 "SLC10A2"), SeHCAT: [Selenium homocholic acid taurine or tauroselcholic acid](https://www.wikidoc.org/index.php/SeHCAT "SeHCAT"), IEL: Intraepithelial [lymphocytes](https://www.wikidoc.org/index.php/Lymphocyte "Lymphocyte"), MRCP: [Magnetic resonance cholangiopancreatography](https://www.wikidoc.org/index.php/Magnetic_resonance_cholangiopancreatography "Magnetic resonance cholangiopancreatography"), ANA: [Antinuclear antibodies](https://www.wikidoc.org/index.php/Antinuclear_antibodies "Antinuclear antibodies"), AMA: [Anti-mitochondrial antibody](https://www.wikidoc.org/index.php/Anti-mitochondrial_antibody "Anti-mitochondrial antibody"), LDH: [Lactate dehydrogenase](https://www.wikidoc.org/index.php/Lactate_dehydrogenase "Lactate dehydrogenase"), CPK: [Creatine phosphokinase](https://www.wikidoc.org/index.php/Creatine_phosphokinase "Creatine phosphokinase"), PCR: [Polymerase chain reaction](https://www.wikidoc.org/index.php/Polymerase_chain_reaction "Polymerase chain reaction"), ELISA: [Enzyme–linked immunosorbent assay](https://www.wikidoc.org/index.php/Enzyme_linked_immunosorbent_assay_\(ELISA\) "Enzyme linked immunosorbent assay (ELISA)"), LT: Heat–labile [enterotoxin](https://www.wikidoc.org/index.php/Enterotoxin "Enterotoxin"), ST: Heat–stable [enterotoxin](https://www.wikidoc.org/index.php/Enterotoxin "Enterotoxin"), RT-PCR: Reverse–transcriptase [polymerase chain reaction](https://www.wikidoc.org/index.php/Polymerase_chain_reaction "Polymerase chain reaction"), CD4: [Cluster of differentiation 4](https://www.wikidoc.org/index.php/CD4 "CD4"), HIV: [Human immunodeficiency virus](https://www.wikidoc.org/index.php/Human_Immunodeficiency_Virus_\(HIV\) "Human Immunodeficiency Virus (HIV)"), RUQ: [Right-upper quadrant](https://www.wikidoc.org/index.php/RUQ "RUQ"), VIP: [Vasoactive intestinal peptide](https://www.wikidoc.org/index.php/Vasoactive_intestinal_peptide "Vasoactive intestinal peptide"), GI: [Gastrointestinal](https://www.wikidoc.org/index.php/Gastrointestinal_tract "Gastrointestinal tract"), FAP: [Familial adenomatous polyposis](https://www.wikidoc.org/index.php/Familial_adenomatous_polyposis "Familial adenomatous polyposis"), HNPCC: [Hereditary nonpolyposis colorectal cancer](https://www.wikidoc.org/index.php/Hereditary_nonpolyposis_colorectal_cancer "Hereditary nonpolyposis colorectal cancer"), MTP: [Microsomal triglyceride transfer protein](https://www.wikidoc.org/index.php/Microsomal_triglyceride_transfer_protein "Microsomal triglyceride transfer protein"), Scl‑70: Anti–[topoisomerase I](https://www.wikidoc.org/index.php/Type_I_topoisomerase "Type I topoisomerase"), TSH: [Thyroid-stimulating hormone](https://www.wikidoc.org/index.php/Thyroid-stimulating_hormone "Thyroid-stimulating hormone"), T4: [Thyroxine](https://www.wikidoc.org/index.php/Thyroxine "Thyroxine"), T3: [Triiodothyronine](https://www.wikidoc.org/index.php/Triiodothyronine "Triiodothyronine"), DTR: [Deep tendon reflex](https://www.wikidoc.org/index.php/Deep_tendon_reflex "Deep tendon reflex"), RNA: [Ribonucleic acid](https://www.wikidoc.org/index.php/RNA "RNA") \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\|---\| \| Cause \| Clinical manifestation \| Lab findings \| Extra intestinal findings \| Cause/Pathogenesis \| Gold standard diagnosis \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| Symptoms \| GI signs \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| Duration \| Diarrhea \| Fever \| Abdominal pain \| Weight loss \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| Stool exam \| CBC \| Other lab findings \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| Acute \| Chronic \| Watery \| Bloody \| Fatty \| WBC \| RBC \| Ova/Parasite \| Osmotic gap \| Other \| WBC \| Hgb \| Plt \| \| \| \| \| \| \| \| \| \| \| \| [Crohn's disease](https://www.wikidoc.org/index.php/Crohns_disease "Crohns disease") \| – \| \+ \| \+ \| \+ \| \+ \| ± \| \+ \| \+ \| [Abdominal tenderness](https://www.wikidoc.org/index.php/Abdominal_tenderness "Abdominal tenderness") Oral [mucosal](https://www.wikidoc.org/index.php/Mucosal "Mucosal") lesions \| \+ \| \+ \| – \| Nl \| – \| ↑ \| ↓ \| ↑ \| [Anti saccharomyces cerevisiae antibodies](https://www.wikidoc.org/index.php/Anti_saccharomyces_cerevisiae_antibodies "Anti saccharomyces cerevisiae antibodies") (ASCA) [Vitamin B12](https://www.wikidoc.org/index.php/Vitamin_B12 "Vitamin B12") deficiency Elevated [ESR](https://www.wikidoc.org/index.php/Erythrocyte_sedimentation_rate "Erythrocyte sedimentation rate") Elevated [CRP](https://www.wikidoc.org/index.php/C-reactive_protein "C-reactive protein") \| [Uveitis](https://www.wikidoc.org/index.php/Uveitis "Uveitis") [Arthritis](https://www.wikidoc.org/index.php/Arthritis "Arthritis") [Erythema nodosum](https://www.wikidoc.org/index.php/Erythema_nodosum "Erythema nodosum") [Pyoderma gangrenosum](https://www.wikidoc.org/index.php/Pyoderma_gangrenosum "Pyoderma gangrenosum") [Amyloidosis](https://www.wikidoc.org/index.php/Amyloidosis "Amyloidosis") Venous and arterial [thromboembolism](https://www.wikidoc.org/index.php/Thromboembolism "Thromboembolism") [Renal stones](https://www.wikidoc.org/index.php/Kidney_stone "Kidney stone") [Bronchiectasis](https://www.wikidoc.org/index.php/Bronchiectasis "Bronchiectasis") \| Abnormal immune response to self [antigens](https://www.wikidoc.org/index.php/Antigens "Antigens") \| [Colonoscopy](https://www.wikidoc.org/index.php/Colonoscopy "Colonoscopy") with [biopsy](https://www.wikidoc.org/index.php/Biopsy "Biopsy") \| \| \| [Ulcerative colitis](https://www.wikidoc.org/index.php/Ulcerative_colitis "Ulcerative colitis") \| – \| \+ \| \+ \| \+ \| \+ \| ± \| \+ \| \+ \| [Abdominal tenderness](https://www.wikidoc.org/index.php/Abdominal_tenderness "Abdominal tenderness") [Blood](https://www.wikidoc.org/index.php/Blood "Blood") on [rectal examination](https://www.wikidoc.org/index.php/Rectal_examination "Rectal examination") \| \+ \| \+ \| – \| Nl \| – \| ↑ \| ↓ \| ↑ \| [Anti–neutrophil cytoplasmic antibody](https://www.wikidoc.org/index.php/Anti-neutrophil_cytoplasmic_antibody "Anti-neutrophil cytoplasmic antibody") ([P–ANCA](https://www.wikidoc.org/index.php/P-ANCA "P-ANCA")) [Hypoalbuminemia](https://www.wikidoc.org/index.php/Hypoalbuminemia "Hypoalbuminemia") [Hypokalemia](https://www.wikidoc.org/index.php/Hypokalemia "Hypokalemia") [Hypomagnesemia](https://www.wikidoc.org/index.php/Hypomagnesemia "Hypomagnesemia") Elevated [ESR](https://www.wikidoc.org/index.php/Erythrocyte_sedimentation_rate "Erythrocyte sedimentation rate") Elevated [CRP](https://www.wikidoc.org/index.php/C-reactive_protein "C-reactive protein") \| [Skin rash](https://www.wikidoc.org/index.php/Skin_rash "Skin rash") [Iritis](https://www.wikidoc.org/index.php/Iritis "Iritis") [Uveitis](https://www.wikidoc.org/index.php/Uveitis "Uveitis") Seronegative [arthritis](https://www.wikidoc.org/index.php/Arthritis "Arthritis") [Clubbing](https://www.wikidoc.org/index.php/Clubbing "Clubbing") [Erythema nodosum](https://www.wikidoc.org/index.php/Erythema_nodosum "Erythema nodosum") \| Abnormal immune response to self [antigens](https://www.wikidoc.org/index.php/Antigens "Antigens") \| [Colonoscopy](https://www.wikidoc.org/index.php/Colonoscopy "Colonoscopy") with [biopsy](https://www.wikidoc.org/index.php/Biopsy "Biopsy") \| \| \| [Celiac disease](https://www.wikidoc.org/index.php/Celiac_disease "Celiac disease") \| – \| \+ \| ± \| – \| ± \| – \| \+ \| \+ \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distention "Abdominal distention") Increased [bowel](https://www.wikidoc.org/index.php/Bowel "Bowel") sounds Oral [mucosal](https://www.wikidoc.org/index.php/Mucous_membrane "Mucous membrane") lesions [Hepatosplenomegaly](https://www.wikidoc.org/index.php/Hepatosplenomegaly "Hepatosplenomegaly") [Ascites](https://www.wikidoc.org/index.php/Ascites "Ascites") \| – \| – \| – \| Nl \| Fat droplets on [sudan stain](https://www.wikidoc.org/index.php/Sudan_stain "Sudan stain") \| Nl \| ↓ \| Nl \| [IgA](https://www.wikidoc.org/index.php/IgA "IgA") endomysial [antibody](https://www.wikidoc.org/index.php/Antibody "Antibody") Anti–tissue [transglutaminase](https://www.wikidoc.org/index.php/Transglutaminase "Transglutaminase") [antibody](https://www.wikidoc.org/index.php/Antibody "Antibody") [Anti–gliadin antibody](https://www.wikidoc.org/index.php/Anti-gliadin_antibodies "Anti-gliadin antibodies") [Fat soluble vitamins](https://www.wikidoc.org/index.php/Fat_soluble_vitamins "Fat soluble vitamins") deficiency \| [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") [Dementia](https://www.wikidoc.org/index.php/Dementia "Dementia") [Dermatitis herpetiformis](https://www.wikidoc.org/index.php/Dermatitis_herpetiformis "Dermatitis herpetiformis") \| [HLA–DQ2](https://www.wikidoc.org/index.php/HLA-DQ2 "HLA-DQ2") [HLA–DQ8](https://www.wikidoc.org/index.php/HLA-DQ8 "HLA-DQ8") Innate responses to wheat [proteins](https://www.wikidoc.org/index.php/Protein "Protein") \| [IgA](https://www.wikidoc.org/index.php/IgA "IgA") endomysial [antibody](https://www.wikidoc.org/index.php/Antibody "Antibody") Anti–tissue [transglutaminase](https://www.wikidoc.org/index.php/Transglutaminase "Transglutaminase") [antibody](https://www.wikidoc.org/index.php/Antibody "Antibody") \| \| \| Cause \| Duration \| Diarrhea \| Fever \| Abdominal pain \| Weight loss \| GI signs \| Stool exam \| CBC \| Other lab findings \| Extra intestinal findings \| Cause/Pathogenesis \| Gold standard diagnosis \| \| \| \| \| \| \| \| \| \| \| \| Acute \| Chronic \| Watery \| Bloody \| Fatty \| WBC \| RBC \| Ova/Parasite \| Osmotic gap \| Other \| WBC \| Hgb \| Plt \| \| \| \| \| \| \| \| \| \| \| \| [Cystic fibrosis](https://www.wikidoc.org/index.php/Cystic_fibrosis "Cystic fibrosis") \| – \| \+ \| – \| – \| \+ \| ± \| \+ \| \+ \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distension "Abdominal distension") [Hepatosplenomegaly](https://www.wikidoc.org/index.php/Hepatosplenomegaly "Hepatosplenomegaly") [Rectal prolapse](https://www.wikidoc.org/index.php/Rectal_prolapse "Rectal prolapse") \| – \| – \| – \| Nl \| Fat droplets on [sudan stain](https://www.wikidoc.org/index.php/Sudan_stain "Sudan stain") \| Nl \| ↓ \| Nl \| Positive [DNA](https://www.wikidoc.org/index.php/DNA "DNA") analysis for [cystic fibrosis transmembrane conductance regulator](https://www.wikidoc.org/index.php/CFTR "CFTR") [(CFTR)](https://www.wikidoc.org/index.php/CFTR "CFTR") Nasal transepithelial potential difference [Fat soluble vitamins](https://www.wikidoc.org/index.php/Fat_soluble_vitamins "Fat soluble vitamins") deficiency \| [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") Recurrent [respiratory tract infection](https://www.wikidoc.org/index.php/Respiratory_tract_infection "Respiratory tract infection") [Bronchiectasis](https://www.wikidoc.org/index.php/Bronchiectasis "Bronchiectasis") [Diabetes mellitus](https://www.wikidoc.org/index.php/Diabetes_mellitus "Diabetes mellitus") [Scoliosis](https://www.wikidoc.org/index.php/Scoliosis "Scoliosis") [Infertility](https://www.wikidoc.org/index.php/Infertility "Infertility") \| Mutations in the [cystic fibrosis transmembrane conductance regulator](https://www.wikidoc.org/index.php/Cystic_fibrosis_transmembrane_conductance_regulator "Cystic fibrosis transmembrane conductance regulator") ([CFTR](https://www.wikidoc.org/index.php/CFTR "CFTR")) protein \| Positive [genetic testing](https://www.wikidoc.org/index.php/Genetic_testing "Genetic testing") Elevated [sweat chloride](https://www.wikidoc.org/index.php/Sweat_chloride_test "Sweat chloride test") ≥60 mmol/L \| \| \| [Chronic pancreatitis](https://www.wikidoc.org/index.php/Chronic_pancreatitis "Chronic pancreatitis") \| – \| \+ \| \+ \| – \| \+ \| – \| \+ \| \+ \| [Abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") \| – \| – \| – \| Nl \| Fat droplets on [sudan stain](https://www.wikidoc.org/index.php/Sudan_stain "Sudan stain") Positive [fecal elastase](https://www.wikidoc.org/index.php/Fecal_elastase "Fecal elastase") measurement \| Nl \| Nl \| Nl \| Slightly elevated [amylase](https://www.wikidoc.org/index.php/Amylase "Amylase") and [lipase](https://www.wikidoc.org/index.php/Lipase "Lipase") Abnormal pancreatic function test [Secretin](https://www.wikidoc.org/index.php/Secretin "Secretin") stimulation test \| [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") [Diabetes mellitus](https://www.wikidoc.org/index.php/Diabetes_mellitus "Diabetes mellitus") [Pancreatic pseudocyst](https://www.wikidoc.org/index.php/Pancreatic_pseudocyst "Pancreatic pseudocyst") \| [Toxins](https://www.wikidoc.org/index.php/Toxin "Toxin") Recurrent [acute pancreatitis](https://www.wikidoc.org/index.php/Acute_pancreatitis "Acute pancreatitis") [Genetic](https://www.wikidoc.org/index.php/Genetics "Genetics") predesposition [Autoimmune](https://www.wikidoc.org/index.php/Autoimmunity "Autoimmunity") \| [Magnetic resonance cholangiopancreatography](https://www.wikidoc.org/index.php/Magnetic_resonance_cholangiopancreatography "Magnetic resonance cholangiopancreatography") ([MRCP](https://www.wikidoc.org/index.php/Magnetic_resonance_cholangiopancreatography "Magnetic resonance cholangiopancreatography")) \| \| \| [Bile acid malabsorption](https://www.wikidoc.org/index.php/Bile_acid_malabsorption "Bile acid malabsorption") \| – \| \+ \| \+ \| – \| \+ \| – \| – \| \+ \| \| – \| – \| – \| Nl \| Fat droplets on [sudan stain](https://www.wikidoc.org/index.php/Sudan_stain "Sudan stain") \| Nl \| Nl \| Nl \| Reduced [cholesterol](https://www.wikidoc.org/index.php/Cholesterol "Cholesterol") level \| [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") [Hypotension](https://www.wikidoc.org/index.php/Hypotension "Hypotension") [Tachycardia](https://www.wikidoc.org/index.php/Tachycardia "Tachycardia") \| Genetic defects in [SLC10A2](https://www.wikidoc.org/index.php/SLC10A2 "SLC10A2") \| [SeHCAT](https://www.wikidoc.org/index.php/SeHCAT "SeHCAT") test \| \| \| [Microscopic colitis](https://www.wikidoc.org/index.php/Microscopic_colitis "Microscopic colitis") \| – \| \+ \| \+ \| – \| – \| – \| \+ \| \+ \| [Abdominal tenderness](https://www.wikidoc.org/index.php/Abdominal_tenderness "Abdominal tenderness") Fecal [incontinence](https://www.wikidoc.org/index.php/Incontinence "Incontinence") \| – \| – \| – \| Nl \| – \| Nl \| ↓ \| Nl \| [Hypokalemia](https://www.wikidoc.org/index.php/Hypokalemia "Hypokalemia") Elevated [CRP](https://www.wikidoc.org/index.php/C-reactive_protein "C-reactive protein") Positive [autoantibodies](https://www.wikidoc.org/index.php/Autoantibodies "Autoantibodies") include: RF [ANA](https://www.wikidoc.org/index.php/ANA "ANA") [AMA](https://www.wikidoc.org/index.php/Anti-mitochondrial_antibody "Anti-mitochondrial antibody") [ANCA](https://www.wikidoc.org/index.php/ANCA "ANCA") \| [Arthritis](https://www.wikidoc.org/index.php/Arthritis "Arthritis") [Uveitis](https://www.wikidoc.org/index.php/Uveitis "Uveitis") [Idiopathic thrombocytopenic purpura](https://www.wikidoc.org/index.php/Idiopathic_thrombocytopenic_purpura "Idiopathic thrombocytopenic purpura") Pleuro [pericarditis](https://www.wikidoc.org/index.php/Pericarditis "Pericarditis") [Hypothyroidism](https://www.wikidoc.org/index.php/Hypothyroidism "Hypothyroidism") [Psoriasis](https://www.wikidoc.org/index.php/Psoriasis "Psoriasis") \| [Mucosal](https://www.wikidoc.org/index.php/Mucosal "Mucosal") [immune responses](https://www.wikidoc.org/index.php/Immune_responses "Immune responses") to luminal factors in a genetically predisposed individual Drug–induced \| [Colonoscopy](https://www.wikidoc.org/index.php/Colonoscopy "Colonoscopy") with [mucosal](https://www.wikidoc.org/index.php/Mucosal "Mucosal") [biopsy](https://www.wikidoc.org/index.php/Biopsy "Biopsy") with [mononuclear](https://www.wikidoc.org/index.php/Mononuclear "Mononuclear") infiltrates: [Collagenous colitis](https://www.wikidoc.org/index.php/Collagenous_colitis "Collagenous colitis") is characterized by a colonic subepithelial [collagen](https://www.wikidoc.org/index.php/Collagen "Collagen") band \>10 micrometers in diameter [Lymphocytic](https://www.wikidoc.org/index.php/Lymphocytic "Lymphocytic") [colitis](https://www.wikidoc.org/index.php/Colitis "Colitis") is characterized by ≥20 intraepithelial [lymphocytes](https://www.wikidoc.org/index.php/Lymphocytes "Lymphocytes") (IEL) per 100 surface epithelial cells \| \| \| Cause \| Duration \| Diarrhea \| Fever \| Abdominal pain \| Weight loss \| GI signs \| Stool exam \| CBC \| Other lab findings \| Extra intestinal findings \| Cause/Pathogenesis \| Gold standard diagnosis \| \| \| \| \| \| \| \| \| \| \| \| Acute \| Chronic \| Watery \| Bloody \| Fatty \| WBC \| RBC \| Ova/Parasite \| Osmotic gap \| Other \| WBC \| Hgb \| Plt \| \| \| \| \| \| \| \| \| \| \| \| [Infective colitis](https://www.wikidoc.org/index.php/Infective_colitis "Infective colitis") \| – \| \+ \| \+ \| \+ \| – \| \+ \| \+ \| \+ \| Rebound [abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") \| \+ \| \+ \| \+ \| Nl \| Positive [stool culture](https://www.wikidoc.org/index.php/Stool_culture "Stool culture") Positive fecal calprotectin Positive fecal [lactoferrin](https://www.wikidoc.org/index.php/Lactoferrin "Lactoferrin") \| ↑ \| ↓ \| ↑ \| Elevated [CRP](https://www.wikidoc.org/index.php/C-reactive_protein "C-reactive protein") Elevated [ESR](https://www.wikidoc.org/index.php/Erythrocyte_sedimentation_rate "Erythrocyte sedimentation rate") \| [Arthritis](https://www.wikidoc.org/index.php/Arthritis "Arthritis") [Uveitis](https://www.wikidoc.org/index.php/Uveitis "Uveitis") \| [Salmonella](https://www.wikidoc.org/index.php/Salmonella "Salmonella") [Shigella](https://www.wikidoc.org/index.php/Shigella "Shigella") [Campylobacter](https://www.wikidoc.org/index.php/Campylobacter "Campylobacter") [E. coli 0157:H7](https://www.wikidoc.org/index.php/Escherichia_coli "Escherichia coli") [Clostridium difficile](https://www.wikidoc.org/index.php/Clostridium_difficile "Clostridium difficile") [Entamoeba histolytica](https://www.wikidoc.org/index.php/Entamoeba_histolytica "Entamoeba histolytica") [Adenovirus](https://www.wikidoc.org/index.php/Adenoviridae "Adenoviridae") [Cytomegalovirus](https://www.wikidoc.org/index.php/Cytomegalovirus "Cytomegalovirus") [Herpes simplex virus](https://www.wikidoc.org/index.php/Herpes_simplex_virus "Herpes simplex virus") \| [Stool culture](https://www.wikidoc.org/index.php/Stool_culture "Stool culture") [Blood culture](https://www.wikidoc.org/index.php/Blood_culture "Blood culture") \| \| \| [Ischemic colitis](https://www.wikidoc.org/index.php/Ischemic_colitis "Ischemic colitis") \| \+ \| \+ \| \+ \| \+ \| – \| \+ \| \+ \| \+ \| Hyperactive then absent [bowel sounds](https://www.wikidoc.org/index.php/Stomach_rumble "Stomach rumble") [Abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") \| \+ \| \+ \| – \| Nl \| – \| ↑ \| ↓ \| ↑ \| Elevated [CRP](https://www.wikidoc.org/index.php/C-reactive_protein "C-reactive protein") Elevated [ESR](https://www.wikidoc.org/index.php/Erythrocyte_sedimentation_rate "Erythrocyte sedimentation rate") Elevated serum [lactate](https://www.wikidoc.org/index.php/Lactic_acid "Lactic acid") Elevated [lactate dehydrogenase](https://www.wikidoc.org/index.php/Lactate_dehydrogenase "Lactate dehydrogenase") ([LDH](https://www.wikidoc.org/index.php/Lactate_dehydrogenase "Lactate dehydrogenase")) Elevated [creatine phosphokinase](https://www.wikidoc.org/index.php/Creatine_kinase "Creatine kinase") ([CPK](https://www.wikidoc.org/index.php/Creatine_kinase "Creatine kinase")) Elevated [amylase](https://www.wikidoc.org/index.php/Amylase "Amylase") [Hypoalbuminemia](https://www.wikidoc.org/index.php/Hypoalbuminemia "Hypoalbuminemia") \| [IgA vasculitis](https://www.wikidoc.org/index.php/Henoch-Sch%C3%B6nlein_purpura "Henoch-Schönlein purpura") \| [Hypercoagulability](https://www.wikidoc.org/index.php/Thrombophilia "Thrombophilia") Nonocclusive [colonic ischemia](https://www.wikidoc.org/index.php/Ischemic_colitis "Ischemic colitis") [Embolic](https://www.wikidoc.org/index.php/Embolism "Embolism") and [thrombotic](https://www.wikidoc.org/index.php/Thrombosis "Thrombosis") arterial occlusion [Mesenteric vein thrombosis](https://www.wikidoc.org/index.php/Mesenteric_vein_thrombosis "Mesenteric vein thrombosis") \| Abdominal [CT scan](https://www.wikidoc.org/index.php/Computed_tomography "Computed tomography") \| \| \| [Lactose intolerance](https://www.wikidoc.org/index.php/Lactose_intolerance "Lactose intolerance") \| \+ \| \+ \| \+ \| – \| – \| – \| \+ \| – \| [Abdominal tenderness](https://www.wikidoc.org/index.php/Abdominal_tenderness "Abdominal tenderness") [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distention "Abdominal distention") \| – \| – \| – \| ↑ \| – \| Nl \| Nl \| Nl \| Lactose tolerance test Genetic testing \| [Headache](https://www.wikidoc.org/index.php/Headache "Headache") [Vertigo](https://www.wikidoc.org/index.php/Vertigo "Vertigo") [Memory impairment](https://www.wikidoc.org/index.php/Memory_impairment "Memory impairment") [Lethargy](https://www.wikidoc.org/index.php/Lethargy "Lethargy") \| Reduction of lactase enzyme activity or inability to produce persistent [lactase](https://www.wikidoc.org/index.php/Lactase "Lactase") Congenital [lactase deficiency](https://www.wikidoc.org/index.php/Lactase_deficiency "Lactase deficiency") Secondary lactose malabsorption \| [Small bowel](https://www.wikidoc.org/index.php/Small_bowel "Small bowel") [biopsy](https://www.wikidoc.org/index.php/Biopsy "Biopsy") Lactose breath hydrogen test \| \| \| [Irritable bowel syndrome](https://www.wikidoc.org/index.php/Irritable_bowel_syndrome "Irritable bowel syndrome") \| – \| \+ \| ± \| – \| ± \| – \| ± \| – \| [Abdominal tenderness](https://www.wikidoc.org/index.php/Abdominal_tenderness "Abdominal tenderness") [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distention "Abdominal distention") Normal [bowel sounds](https://www.wikidoc.org/index.php/Stomach_rumble "Stomach rumble") \| – \| – \| – \| Nl \| – \| Nl \| Nl \| Nl \| Nl \| [Anxiety](https://www.wikidoc.org/index.php/Anxiety "Anxiety") [Palpitation](https://www.wikidoc.org/index.php/Palpitation "Palpitation") \| Unknown \| Diagnosis of exclusion \| \| \| Cause \| Duration \| Diarrhea \| Fever \| Abdominal pain \| Weight loss \| GI signs \| Stool exam \| CBC \| Other lab findings \| Extra intestinal findings \| Cause/Pathogenesis \| Gold standard diagnosis \| \| \| \| \| \| \| \| \| \| \| \| Acute \| Chronic \| Watery \| Bloody \| Fatty \| WBC \| RBC \| Ova/Parasite \| Osmotic gap \| Other \| WBC \| Hgb \| Plt \| \| \| \| \| \| \| \| \| \| \| \| [Whipple's disease](https://www.wikidoc.org/index.php/Whipple%27s_disease "Whipple's disease") \| – \| \+ \| \+ \| – \| \+ \| ± \| \+ \| \+ \| [Hepatosplenomegaly](https://www.wikidoc.org/index.php/Hepatosplenomegaly "Hepatosplenomegaly") [Ascites](https://www.wikidoc.org/index.php/Ascites "Ascites") \| – \| – \| – \| Nl \| Positive [fecal fat](https://www.wikidoc.org/index.php/Fecal_fat "Fecal fat") \| ↓ \| ↓ \| ↓/↑ \| [Hypoalbuminemia](https://www.wikidoc.org/index.php/Hypoalbuminemia "Hypoalbuminemia") [Fat soluble vitamins](https://www.wikidoc.org/index.php/Fat_soluble_vitamins "Fat soluble vitamins") deficiency \| [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") [Abnormal extraocular movement](https://www.wikidoc.org/index.php/Ocular_motility_disorders "Ocular motility disorders") [Lymphadenopathy](https://www.wikidoc.org/index.php/Lymphadenopathy "Lymphadenopathy") [Hyperpigmentation](https://www.wikidoc.org/index.php/Hyperpigmentation "Hyperpigmentation") [Uveitis](https://www.wikidoc.org/index.php/Uveitis "Uveitis") [Endocarditis](https://www.wikidoc.org/index.php/Endocarditis "Endocarditis") [Encephalitis](https://www.wikidoc.org/index.php/Encephalitis "Encephalitis") [Dementia](https://www.wikidoc.org/index.php/Dementia "Dementia") [Pleural effusion](https://www.wikidoc.org/index.php/Pleural_effusion "Pleural effusion") \| [Tropheryma whipplei](https://www.wikidoc.org/index.php/Tropheryma_whipplei "Tropheryma whipplei") \| [Small intestine](https://www.wikidoc.org/index.php/Small_intestine "Small intestine") [biopsy](https://www.wikidoc.org/index.php/Biopsy "Biopsy") for [Tropheryma whipplei](https://www.wikidoc.org/index.php/Tropheryma_whipplei "Tropheryma whipplei") testing [PCR](https://www.wikidoc.org/index.php/PCR "PCR") testing \| \| \| [Tropical sprue](https://www.wikidoc.org/index.php/Tropical_sprue "Tropical sprue") \| \+ \| \+ \| \+ \| – \| \+ \| \+ \| \+ \| \+ \| Angular [stomatitis](https://www.wikidoc.org/index.php/Stomatitis "Stomatitis") Oral mucosal lesion \| \+ \| – \| – \| Nl \| Positive [stool culture](https://www.wikidoc.org/index.php/Stool_culture "Stool culture") \| Nl \| ↓ \| Nl \| [Fat soluble vitamins](https://www.wikidoc.org/index.php/Fat_soluble_vitamins "Fat soluble vitamins") deficiency [Vitamin B12 deficiency](https://www.wikidoc.org/index.php/Vitamin_B12_deficiency "Vitamin B12 deficiency") [Folate deficiency](https://www.wikidoc.org/index.php/Folate_deficiency "Folate deficiency") [Hypokalemia](https://www.wikidoc.org/index.php/Hypokalemia "Hypokalemia") \| [Myalgia](https://www.wikidoc.org/index.php/Myalgia "Myalgia") [Neuropathy](https://www.wikidoc.org/index.php/Neuropathy "Neuropathy") [Edema](https://www.wikidoc.org/index.php/Edema "Edema") \| [Escherichia coli](https://www.wikidoc.org/index.php/Escherichia_coli "Escherichia coli") [Klebsiella pneumoniae](https://www.wikidoc.org/index.php/Klebsiella_pneumoniae "Klebsiella pneumoniae") [Enterobacter cloacae](https://www.wikidoc.org/index.php/Enterobacter_cloacae "Enterobacter cloacae") \| Diagnosis of exclusion \| \| \| [Small bowel bacterial overgrowth](https://www.wikidoc.org/index.php/Small_bowel_bacterial_overgrowth_syndrome "Small bowel bacterial overgrowth syndrome") \| – \| \+ \| \+ \| – \| \+ \| – \| \+ \| \+ \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distension "Abdominal distension") \| \+ \| – \| – \| Nl \| Positive [stool culture](https://www.wikidoc.org/index.php/Stool_culture "Stool culture") Positive [fecal fat](https://www.wikidoc.org/index.php/Fecal_fat "Fecal fat") \| Nl \| ↓ \| Nl \| [Hypoalbuminemia](https://www.wikidoc.org/index.php/Hypoalbuminemia "Hypoalbuminemia") Abnormal [hydrogen breath test](https://www.wikidoc.org/index.php/Hydrogen_Breath_Test "Hydrogen Breath Test") [Lactic acidosis](https://www.wikidoc.org/index.php/Lactic_acidosis "Lactic acidosis") \| [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") [Rosacea](https://www.wikidoc.org/index.php/Rosacea "Rosacea") \| Excess bacteria in the [small intestine](https://www.wikidoc.org/index.php/Small_intestine "Small intestine") Alterations in [intestinal](https://www.wikidoc.org/index.php/Intestine "Intestine") [anatomy](https://www.wikidoc.org/index.php/Anatomy "Anatomy") or GI motility \| Diagnosis of exclusion \| \| \| Cause \| Duration \| Diarrhea \| Fever \| Abdominal pain \| Weight loss \| GI signs \| Stool exam \| CBC \| Other lab findings \| Extra intestinal findings \| Cause/Pathogenesis \| Gold standard diagnosis \| \| \| \| \| \| \| \| \| \| \| \| Acute \| Chronic \| Watery \| Bloody \| Fatty \| WBC \| RBC \| Ova/Parasite \| Osmotic gap \| Other \| WBC \| Hgb \| Plt \| \| \| \| \| \| \| \| \| \| \| \| [Salmonellosis](https://www.wikidoc.org/index.php/Salmonellosis "Salmonellosis") \| \+ \| \+ \| \+ \| \+ \| – \| \+ \| \+ \| – \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distention "Abdominal distention") Diffuse [abdominal tenderness](https://www.wikidoc.org/index.php/Abdominal_tenderness "Abdominal tenderness") [Hepatosplenomegaly](https://www.wikidoc.org/index.php/Hepatosplenomegaly "Hepatosplenomegaly") \| \+ \| \+ \| – \| Nl \| Positive [stool culture](https://www.wikidoc.org/index.php/Stool_culture "Stool culture") Positive serologic testing \| ↑ \| Nl \| ↑ \| [Hypokalemia](https://www.wikidoc.org/index.php/Hypokalemia "Hypokalemia") [Hypernatremia](https://www.wikidoc.org/index.php/Hypernatremia "Hypernatremia") [Hyponatremia](https://www.wikidoc.org/index.php/Hyponatremia "Hyponatremia") [Hypercalciuria](https://www.wikidoc.org/index.php/Hypercalciuria "Hypercalciuria") [Hypocitraturia](https://www.wikidoc.org/index.php/Hypocitraturia "Hypocitraturia") \| [Post–infectious arthritis](https://www.wikidoc.org/index.php/Post-infectious_arthritis "Post-infectious arthritis") [Obtundation](https://www.wikidoc.org/index.php/Obtundation "Obtundation") [Bacteremia](https://www.wikidoc.org/index.php/Bacteremia "Bacteremia") [Pericarditis](https://www.wikidoc.org/index.php/Pericarditis "Pericarditis") [Pyelonephritis](https://www.wikidoc.org/index.php/Pyelonephritis "Pyelonephritis") [Brain abscess](https://www.wikidoc.org/index.php/Brain_abscess "Brain abscess") \| [Salmonella](https://www.wikidoc.org/index.php/Salmonella "Salmonella") \| [Stool culture](https://www.wikidoc.org/index.php/Stool_culture "Stool culture") \| \| \| [Escherichia coli enteritis](https://www.wikidoc.org/index.php/Escherichia_coli_enteritis "Escherichia coli enteritis") \| [EPEC](https://www.wikidoc.org/index.php/EPEC "EPEC") \| \+ \| \+ \| \+ \| \+ \| – \| \+ \| \+ \| \+ \| Diffuse [abdominal tenderness](https://www.wikidoc.org/index.php/Abdominal_tenderness "Abdominal tenderness") \| \+ \| \+ \| – \| Nl \| Positive [stool culture](https://www.wikidoc.org/index.php/Stool_culture "Stool culture") \| ↑ \| Nl \| Nl \| – \| – \| [Enteropathogenic E. coli](https://www.wikidoc.org/index.php/Enteropathogenic_E._coli "Enteropathogenic E. coli") \| [DNA probe](https://www.wikidoc.org/index.php/Hybridization_probe "Hybridization probe") or [polymerase chain reaction](https://www.wikidoc.org/index.php/Polymerase_chain_reaction "Polymerase chain reaction") ([PCR](https://www.wikidoc.org/index.php/Polymerase_chain_reaction "Polymerase chain reaction")) of the EPEC adherence factor [Stool culture](https://www.wikidoc.org/index.php/Stool_culture "Stool culture") \| \| [EAEC](https://www.wikidoc.org/index.php/EAEC "EAEC") \| \+ \| \+ \| \+ \| \+ \| – \| – \| \+ \| – \| Diffuse [abdominal tenderness](https://www.wikidoc.org/index.php/Abdominal_tenderness "Abdominal tenderness") \| \+ \| \+ \| – \| Nl \| Positive [stool culture](https://www.wikidoc.org/index.php/Stool_culture "Stool culture") \| ↑ \| ↓ \| ↓ \| – \| Chronic infection in [immunocompromised](https://www.wikidoc.org/index.php/Immunodeficiency "Immunodeficiency") patients \| [Enteroaggregative E. coli](https://www.wikidoc.org/index.php/Escherichia_coli_enteritis "Escherichia coli enteritis") \| [Stool culture](https://www.wikidoc.org/index.php/Stool_culture "Stool culture") \| \| \| [Aeromonas](https://www.wikidoc.org/index.php/Aeromonas "Aeromonas") \| \+ \| \+ \| \+ \| \+ \| – \| \+ \| \+ \| – \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distention "Abdominal distention") Hyperactive [bowel sounds](https://www.wikidoc.org/index.php/Stomach_rumble "Stomach rumble") Diffuse [abdominal tenderness](https://www.wikidoc.org/index.php/Abdominal_tenderness "Abdominal tenderness") \| \+ \| \+ \| – \| Nl \| Positive [stool culture](https://www.wikidoc.org/index.php/Stool_culture "Stool culture") \| ↑ \| Nl \| Nl \| – \| Wound [infection](https://www.wikidoc.org/index.php/Infection "Infection") [Bacteremia](https://www.wikidoc.org/index.php/Bacteremia "Bacteremia") [Hemolytic uremic syndrome](https://www.wikidoc.org/index.php/Hemolytic-uremic_syndrome "Hemolytic-uremic syndrome") [Meningitis](https://www.wikidoc.org/index.php/Meningitis "Meningitis") [Ocular](https://www.wikidoc.org/index.php/Ocular "Ocular") infection [Pneumonia](https://www.wikidoc.org/index.php/Pneumonia "Pneumonia") [Urinary tract infection](https://www.wikidoc.org/index.php/Urinary_tract_infection "Urinary tract infection") [Osteomyelitis](https://www.wikidoc.org/index.php/Osteomyelitis "Osteomyelitis") [Peritonitis](https://www.wikidoc.org/index.php/Peritonitis "Peritonitis") [Acute cholecystitis](https://www.wikidoc.org/index.php/Acute_cholecystitis "Acute cholecystitis") [Opportunistic infections](https://www.wikidoc.org/index.php/Opportunistic_infection "Opportunistic infection") in [immunocompromised](https://www.wikidoc.org/index.php/Immunodeficiency "Immunodeficiency") patients \| [Aeromonas](https://www.wikidoc.org/index.php/Aeromonas "Aeromonas") virulence factors including [endotoxins](https://www.wikidoc.org/index.php/Endotoxin "Endotoxin"), [hemolysins](https://www.wikidoc.org/index.php/Hemolysin "Hemolysin"), [enterotoxins](https://www.wikidoc.org/index.php/Enterotoxin "Enterotoxin"), and adherence factors \| [Blood culture](https://www.wikidoc.org/index.php/Blood_culture "Blood culture") Wound [culture](https://www.wikidoc.org/index.php/Culture_collection "Culture collection") \| \| \| Cause \| Duration \| Diarrhea \| Fever \| Abdominal pain \| Weight loss \| GI signs \| Stool exam \| CBC \| Other lab findings \| Extra intestinal findings \| Cause/Pathogenesis \| Gold standard diagnosis \| \| \| \| \| \| \| \| \| \| \| \| Acute \| Chronic \| Watery \| Bloody \| Fatty \| WBC \| RBC \| Ova/Parasite \| Osmotic gap \| Other \| WBC \| Hgb \| Plt \| \| \| \| \| \| \| \| \| \| \| \| [Mycobacterium avium complex](https://www.wikidoc.org/index.php/Mycobacterium_avium_complex "Mycobacterium avium complex") \| \+ \| \+ \| \+ \| \+ \| – \| \+ \| \+ \| – \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distension "Abdominal distension") [Hepatosplenomegaly](https://www.wikidoc.org/index.php/Hepatosplenomegaly "Hepatosplenomegaly") \| \+ \| \+ \| – \| Nl \| – \| ↓ \| ↓ \| Nl \| Elevated [liver enzymes](https://www.wikidoc.org/index.php/Liver_function_tests "Liver function tests") \| [Opportunistic infection](https://www.wikidoc.org/index.php/Opportunistic_infection "Opportunistic infection") in [immunocompromised](https://www.wikidoc.org/index.php/Immunodeficiency "Immunodeficiency") patients [Pulmonary](https://www.wikidoc.org/index.php/Pulmonary "Pulmonary") [infection](https://www.wikidoc.org/index.php/Infection "Infection") [Adenopathy](https://www.wikidoc.org/index.php/Lymphadenopathy "Lymphadenopathy") [Night sweats](https://www.wikidoc.org/index.php/Sleep_hyperhidrosis "Sleep hyperhidrosis") \| [Mycobacterium avium complex](https://www.wikidoc.org/index.php/Mycobacterium_avium_complex "Mycobacterium avium complex") \| [Blood culture](https://www.wikidoc.org/index.php/Blood_culture "Blood culture") \| \| \| [CMV colitis](https://www.wikidoc.org/index.php/CMV_colitis "CMV colitis") \| \+ \| \+ \| – \| \+ \| – \| ± \| \+ \| – \| Diffuse [abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") \| \+ \| \+ \| – \| Nl \| Viral antigen assay \| ↓ \| Nl \| Nl \| Decreased [CD4](https://www.wikidoc.org/index.php/CD4 "CD4") level Abnormal [liver function test](https://www.wikidoc.org/index.php/Liver_function_tests "Liver function tests") \| [Encephalitis](https://www.wikidoc.org/index.php/Encephalitis "Encephalitis") [Guillain–Barré syndrome](https://www.wikidoc.org/index.php/Guillain-Barr%C3%A9_syndrome "Guillain-Barré syndrome") [Pneumonia](https://www.wikidoc.org/index.php/Pneumonia "Pneumonia") [Retinitis](https://www.wikidoc.org/index.php/Retinitis "Retinitis") [Pericarditis](https://www.wikidoc.org/index.php/Pericarditis "Pericarditis") and [myocarditis](https://www.wikidoc.org/index.php/Myocarditis "Myocarditis") [Atherosclerosis](https://www.wikidoc.org/index.php/Atherosclerosis "Atherosclerosis") [Venous thrombosis](https://www.wikidoc.org/index.php/Venous_thromboembolism "Venous thromboembolism") \| [Cytomegalovirus](https://www.wikidoc.org/index.php/Cytomegalovirus "Cytomegalovirus") \| [Quantitative PCR](https://www.wikidoc.org/index.php/Quantitative_polymerase_chain_reaction "Quantitative polymerase chain reaction") tests \| \| \| [HIV](https://www.wikidoc.org/index.php/Human_Immunodeficiency_Virus_\(HIV\) "Human Immunodeficiency Virus (HIV)") \| – \| \+ \| \+ \| – \| – \| \+ \| \+ \| \+ \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distension "Abdominal distension") Diffuse [abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") \| \+ \| – \| – \| Nl \| – \| ↓ \| ↓ \| Nl \| Decreased [CD4](https://www.wikidoc.org/index.php/CD4 "CD4") level [Electrolyte imbalance](https://www.wikidoc.org/index.php/Electrolyte_disturbance "Electrolyte disturbance") \| [Lymphadenopathy](https://www.wikidoc.org/index.php/Lymphadenopathy "Lymphadenopathy") Disseminated [infection](https://www.wikidoc.org/index.php/Infection "Infection") \| [HIV](https://www.wikidoc.org/index.php/Human_Immunodeficiency_Virus_\(HIV\) "Human Immunodeficiency Virus (HIV)") \| HIV virologic (viral load) test Immunoassay \| \| \| Cause \| Duration \| Diarrhea \| Fever \| Abdominal pain \| Weight loss \| GI signs \| Stool exam \| CBC \| Other lab findings \| Extra intestinal findings \| Cause/Pathogenesis \| Gold standard diagnosis \| \| \| \| \| \| \| \| \| \| \| \| Acute \| Chronic \| Watery \| Bloody \| Fatty \| WBC \| RBC \| Ova/Parasite \| Osmotic gap \| Other \| WBC \| Hgb \| Plt \| \| \| \| \| \| \| \| \| \| \| \| [Entamoeba histolytica](https://www.wikidoc.org/index.php/Entamoeba_histolytica "Entamoeba histolytica") \| \+ \| \+ \| \+ \| \+ \| – \| \+ \| \+ \| – \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distension "Abdominal distension") Diffuse [abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") \| \+ \| \+ \| \+ \| Nl \| – \| ↑ \| Nl \| Nl \| – \| [Liver abscess](https://www.wikidoc.org/index.php/Liver_abscess "Liver abscess") Pleuropulmonary infection [Cardiac](https://www.wikidoc.org/index.php/Cardiac "Cardiac") [infection](https://www.wikidoc.org/index.php/Infection "Infection") [Brain abscess](https://www.wikidoc.org/index.php/Brain_abscess "Brain abscess") [Cutaneous infection](https://www.wikidoc.org/index.php/Skin_and_soft-tissue_infections "Skin and soft-tissue infections") \| [Entamoeba histolytica](https://www.wikidoc.org/index.php/Entamoeba_histolytica "Entamoeba histolytica") \| Antigen testing Serology \| \| \| [Giardia](https://www.wikidoc.org/index.php/Giardia_lamblia "Giardia lamblia") \| – \| \+ \| \+ \| – \| \+ \| – \| \+ \| \+ \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distension "Abdominal distension") Diffuse [abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") \| – \| – \| \+ \| Nl \| – \| Nl \| Nl \| Nl \| – \| [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") [Urticaria](https://www.wikidoc.org/index.php/Urticaria "Urticaria") [Depression](https://www.wikidoc.org/index.php/Depression "Depression") \| [Giardia lamblia](https://www.wikidoc.org/index.php/Giardia_lamblia "Giardia lamblia") \| Antigen detection assays \| \| \| [Cryptosporidium](https://www.wikidoc.org/index.php/Cryptosporidium "Cryptosporidium") \| – \| \+ \| \+ \| – \| – \| – \| \+ \| \+ \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distension "Abdominal distension") Diffuse [abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") \| – \| – \| \+ \| Nl \| Positive stool microscopy \| Nl \| Nl \| Nl \| Elevated [alkaline phosphatase](https://www.wikidoc.org/index.php/Alkaline_phosphatase "Alkaline phosphatase") \| Chronic, life–threatening illness in [immunocompromised](https://www.wikidoc.org/index.php/Immunodeficiency "Immunodeficiency") patients \| [Cryptosporidium](https://www.wikidoc.org/index.php/Cryptosporidium "Cryptosporidium") \| Polymerase chain reaction \| \| \| [Microsporidia](https://www.wikidoc.org/index.php/Microsporidia "Microsporidia") \| \+ \| \+ \| \+ \| – \| – \| \+ \| \+ \| – \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distension "Abdominal distension") Diffuse [abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") \| – \| – \| \+ \| Nl \| Positive stool microscopy \| Nl \| Nl \| Nl \| Decreased [CD4](https://www.wikidoc.org/index.php/CD4 "CD4") count \| [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") [Keratitis](https://www.wikidoc.org/index.php/Keratitis "Keratitis") [Seizure](https://www.wikidoc.org/index.php/Seizure "Seizure") [Myositis](https://www.wikidoc.org/index.php/Myositis "Myositis") \| [Microsporidia](https://www.wikidoc.org/index.php/Microsporidia "Microsporidia") \| Antigen detection assays \| \| \| [Isospora](https://www.wikidoc.org/index.php/Isospora "Isospora") \| \+ \| \+ \| \+ \| – \| \+ \| \+ \| \+ \| \+ \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distension "Abdominal distension") Diffuse [abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") \| \+ \| \+ \| \+ \| Nl \| Positive stool microscopy Positive [fecal fat](https://www.wikidoc.org/index.php/Fecal_fat "Fecal fat") \| ↑ \| Nl \| Nl \| Elevated [eosinophils](https://www.wikidoc.org/index.php/Eosinophil_granulocyte "Eosinophil granulocyte") [Hypokalemia](https://www.wikidoc.org/index.php/Hypokalemia "Hypokalemia") Increased [creatinine](https://www.wikidoc.org/index.php/Creatinine "Creatinine") \| Chronic illness in [immunocompromised](https://www.wikidoc.org/index.php/Immunodeficiency "Immunodeficiency") patients \| [Isospora](https://www.wikidoc.org/index.php/Isospora "Isospora") \| Detecting oocysts in the feces \| \| \| Cause \| Duration \| Diarrhea \| Fever \| Abdominal pain \| Weight loss \| GI signs \| Stool exam \| CBC \| Other lab findings \| Extra intestinal findings \| Cause/Pathogenesis \| Gold standard diagnosis \| \| \| \| \| \| \| \| \| \| \| \| Acute \| Chronic \| Watery \| Bloody \| Fatty \| WBC \| RBC \| Ova/Parasite \| Osmotic gap \| Other \| WBC \| Hgb \| Plt \| \| \| \| \| \| \| \| \| \| \| \| [Carcinoid tumor](https://www.wikidoc.org/index.php/Carcinoid_syndrome "Carcinoid syndrome") \| – \| \+ \| \+ \| \+ \| – \| – \| \+ \| \+ \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distention "Abdominal distention") \| – \| \+ \| – \| ↓ \| – \| Nl \| Nl \| Nl \| Elevated urinary [5–hydroxyindoleacetic acid](https://www.wikidoc.org/index.php/5-Hydroxyindoleacetic_acid "5-Hydroxyindoleacetic acid") ([5–HIAA](https://www.wikidoc.org/index.php/5-Hydroxyindoleacetic_acid "5-Hydroxyindoleacetic acid")) level High [chromogranin A](https://www.wikidoc.org/index.php/Chromogranin_A "Chromogranin A") \| [Facial flushing](https://www.wikidoc.org/index.php/Flushing "Flushing") [Jaundice](https://www.wikidoc.org/index.php/Jaundice "Jaundice") [Edema](https://www.wikidoc.org/index.php/Edema "Edema") [Valvular heart disease](https://www.wikidoc.org/index.php/Valvular_heart_disease "Valvular heart disease") [Right–sided heart failure](https://www.wikidoc.org/index.php/Congestive_heart_failure "Congestive heart failure") \| Well–differentiated [neuroendocrine tumor](https://www.wikidoc.org/index.php/Neuroendocrine_tumors "Neuroendocrine tumors") \| Blood [chromogranin A](https://www.wikidoc.org/index.php/Chromogranin_A "Chromogranin A") level \| \| \| [VIPoma](https://www.wikidoc.org/index.php/VIPoma "VIPoma") \| \+ \| \+ \| \+ \| – \| \+ \| – \| \+ \| \+ \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distention "Abdominal distention") Abdominal [RUQ](https://www.wikidoc.org/index.php/RUQ "RUQ") [tenderness](https://www.wikidoc.org/index.php/Tenderness "Tenderness") [Nausea](https://www.wikidoc.org/index.php/Nausea "Nausea") [Vomiting](https://www.wikidoc.org/index.php/Vomiting "Vomiting") \| – \| – \| – \| ↓ \| – \| Nl \| Nl \| Nl \| Elevated [VIP](https://www.wikidoc.org/index.php/VIP "VIP") level [Hypokalemia](https://www.wikidoc.org/index.php/Hypokalemia "Hypokalemia") [Hypochlorhydria](https://www.wikidoc.org/index.php/Hypochlorhydria "Hypochlorhydria") or [achlorhydria](https://www.wikidoc.org/index.php/Achlorhydria "Achlorhydria") Low osmotic gap (\<50 mOsm/kg) \| [Rash](https://www.wikidoc.org/index.php/Rash "Rash") [Facial flushing](https://www.wikidoc.org/index.php/Facial_flushing "Facial flushing") [Dehydration](https://www.wikidoc.org/index.php/Dehydration "Dehydration") [Lethargy](https://www.wikidoc.org/index.php/Lethargy "Lethargy") [Muscle weakness](https://www.wikidoc.org/index.php/Muscle_weakness "Muscle weakness") \| Primary secretory tumor \| Blood [VIP](https://www.wikidoc.org/index.php/VIP "VIP") levels Followed by imaging \| \| \| [Zollinger–Ellison syndrome](https://www.wikidoc.org/index.php/Zollinger-Ellison_syndrome "Zollinger-Ellison syndrome") \| – \| \+ \| \+ \| \+ \| \+ \| – \| \+ \| \+ \| [Epigastric tenderness](https://www.wikidoc.org/index.php/Tenderness "Tenderness") \| – \| – \| – \| ↓ \| – \| Nl \| ↓ \| Nl \| Positive [secretin](https://www.wikidoc.org/index.php/Secretin "Secretin") stimulation test Elevated serum [chromogranin A](https://www.wikidoc.org/index.php/Chromogranin_A "Chromogranin A") \| [Jaundice](https://www.wikidoc.org/index.php/Jaundice "Jaundice") \| [Gastrin](https://www.wikidoc.org/index.php/Gastrin "Gastrin") producing [tumor](https://www.wikidoc.org/index.php/Tumor "Tumor") mainly in [duodenum](https://www.wikidoc.org/index.php/Duodenum "Duodenum") \| [Secretin](https://www.wikidoc.org/index.php/Secretin "Secretin") stimulation test \| \| \| [Somatostatinoma](https://www.wikidoc.org/index.php/Neuroendocrine_tumors "Neuroendocrine tumors") \| – \| \+ \| \+ \| – \| – \| – \| \+ \| \+ \| [Epigastric tenderness](https://www.wikidoc.org/index.php/Tenderness "Tenderness") \| – \| – \| – \| ↓ \| – \| Nl \| Nl \| Nl \| Elevated fasting plasma [somatostatin](https://www.wikidoc.org/index.php/Somatostatin "Somatostatin") \| [Diabetes mellitus](https://www.wikidoc.org/index.php/Diabetes_mellitus "Diabetes mellitus") [Cholelithiasis](https://www.wikidoc.org/index.php/Gallstone_disease "Gallstone disease") [Jaundice](https://www.wikidoc.org/index.php/Jaundice "Jaundice") \| [Neuroendocrine tumors](https://www.wikidoc.org/index.php/Neuroendocrine_tumors "Neuroendocrine tumors") of D–cell origin \| Plasma [somatostatin](https://www.wikidoc.org/index.php/Somatostatin "Somatostatin") level Followed by imaging \| \| \| Cause \| Duration \| Diarrhea \| Fever \| Abdominal pain \| Weight loss \| GI signs \| Stool exam \| CBC \| Other lab findings \| Extra intestinal findings \| Cause/Pathogenesis \| Gold standard diagnosis \| \| \| \| \| \| \| \| \| \| \| \| Acute \| Chronic \| Watery \| Bloody \| Fatty \| WBC \| RBC \| Ova/Parasite \| Osmotic gap \| Other \| WBC \| Hgb \| Plt \| \| \| \| \| \| \| \| \| \| \| \| [Lymphoma](https://www.wikidoc.org/index.php/Lymphoma "Lymphoma") \| – \| \+ \| \+ \| \+ \| – \| \+ \| \+ \| \+ \| Diffuse [abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") [Hepatosplenomegaly](https://www.wikidoc.org/index.php/Hepatosplenomegaly "Hepatosplenomegaly") \| – \| \+ \| – \| Nl \| – \| Nl \| ↓ \| Nl \| [Paraproteinemia](https://www.wikidoc.org/index.php/Paraproteinemia "Paraproteinemia") \| [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") [Lactose intolerance](https://www.wikidoc.org/index.php/Lactose_intolerance "Lactose intolerance") [Ascites](https://www.wikidoc.org/index.php/Ascites "Ascites") \| Primary [tumor](https://www.wikidoc.org/index.php/Tumor "Tumor") of GI tract \| [Colonoscopy](https://www.wikidoc.org/index.php/Colonoscopy "Colonoscopy") with [biopsy](https://www.wikidoc.org/index.php/Biopsy "Biopsy") \| \| \| [Colorectal cancer](https://www.wikidoc.org/index.php/Colorectal_cancer "Colorectal cancer") \| – \| \+ \| \+ \| \+ \| \+ \| – \| \+ \| \+ \| Diffuse [abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") \| – \| \+ \| – \| Nl \| – \| Nl \| ↓ \| Nl \| Positive [carcinoembryonic antigen](https://www.wikidoc.org/index.php/Carcinoembryonic_antigen "Carcinoembryonic antigen") \| [Metastasis](https://www.wikidoc.org/index.php/Metastasis "Metastasis") \| [FAP gene](https://www.wikidoc.org/index.php/FAP "FAP") [HNPCC gene](https://www.wikidoc.org/index.php/Hereditary_nonpolyposis_colorectal_cancer "Hereditary nonpolyposis colorectal cancer") \| [Colonoscopy](https://www.wikidoc.org/index.php/Colonoscopy "Colonoscopy") and [biopsy](https://www.wikidoc.org/index.php/Biopsy "Biopsy") \| \| \| Medications [ACE inhibitors](https://www.wikidoc.org/index.php/ACE_inhibitor "ACE inhibitor") [Digoxin](https://www.wikidoc.org/index.php/Digoxin "Digoxin") [Cephalosporins](https://www.wikidoc.org/index.php/Cephalosporin "Cephalosporin") [Statins](https://www.wikidoc.org/index.php/Statins "Statins") [Thiazide diuretics](https://www.wikidoc.org/index.php/Thiazide "Thiazide") [Triptans](https://www.wikidoc.org/index.php/Triptans "Triptans") [Lactulose](https://www.wikidoc.org/index.php/Lactulose "Lactulose") [Anti retroviral agents](https://www.wikidoc.org/index.php/HIV_AIDS_medical_therapy "HIV AIDS medical therapy") [Chemotherapeutic agents](https://www.wikidoc.org/index.php/Chemotherapy "Chemotherapy") [Antifungals](https://www.wikidoc.org/index.php/Antifungal_drug "Antifungal drug") [Magnesium](https://www.wikidoc.org/index.php/Magnesium "Magnesium") \| \+ \| \+ \| \+ \| – \| ± \| ± \| \+ \| \+ \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distention "Abdominal distention") [Dehydration](https://www.wikidoc.org/index.php/Dehydration "Dehydration") \| – \| – \| – \| ↑/↓ \| – \| ↑ \| Nl \| Nl \| Elevated plasma level of drug \| – \| [Inflammation](https://www.wikidoc.org/index.php/Inflammation "Inflammation") [Pseudomembranous colitis](https://www.wikidoc.org/index.php/Pseudomembranous_enterocolitis "Pseudomembranous enterocolitis") \| Clinical evaluation after discontinuation of the drugs \| \| \| Factitious diarrhea \| \+ \| \+ \| \+ \| – \| – \| – \| \+ \| \+ \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distention "Abdominal distention") \| – \| – \| – \| ↑/↓ \| – \| Nl \| Nl \| Nl \| [Hypokalemia](https://www.wikidoc.org/index.php/Hypokalemia "Hypokalemia") [Metabolic alkalosis](https://www.wikidoc.org/index.php/Metabolic_alkalosis "Metabolic alkalosis") [Hypermagnesemia](https://www.wikidoc.org/index.php/Hypermagnesemia "Hypermagnesemia") \| [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") [Lethargy](https://www.wikidoc.org/index.php/Lethargy "Lethargy") [Generalized weakness](https://www.wikidoc.org/index.php/Generalized_weakness "Generalized weakness") [Acute renal failure](https://www.wikidoc.org/index.php/Acute_kidney_injury "Acute kidney injury") \| [Medications](https://www.wikidoc.org/index.php/Medication "Medication") \| Clinical evaluation after discontinuation of the drugs \| \| \| Cause \| Duration \| Diarrhea \| Fever \| Abdominal pain \| Weight loss \| GI signs \| Stool exam \| CBC \| Other lab findings \| Extra intestinal findings \| Cause/Pathogenesis \| Gold standard diagnosis \| \| \| \| \| \| \| \| \| \| \| \| Acute \| Chronic \| Watery \| Bloody \| Fatty \| WBC \| RBC \| Ova/Parasite \| Osmotic gap \| Other \| WBC \| Hgb \| Plt \| \| \| \| \| \| \| \| \| \| \| \| [Heavy metal ingestion](https://www.wikidoc.org/index.php/Heavy_metal_ingestion "Heavy metal ingestion") \| – \| \+ \| \+ \| – \| – \| – \| \+ \| \+ \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distention "Abdominal distention") \| – \| – \| – \| Nl \| – \| Nl \| Nl \| Nl \| Elevated plasma heavy metal level \| [Headache](https://www.wikidoc.org/index.php/Headache "Headache") [Numbness](https://www.wikidoc.org/index.php/Paresthesia "Paresthesia") [Alopecia](https://www.wikidoc.org/index.php/Alopecia "Alopecia") [Vertigo](https://www.wikidoc.org/index.php/Vertigo "Vertigo") \| [Heavy metal ingestion](https://www.wikidoc.org/index.php/Heavy_metal_ingestion "Heavy metal ingestion") \| Plasma level of heavy metal \| \| \| [Organophosphate poisoning](https://www.wikidoc.org/index.php/Organophosphate_poisoning "Organophosphate poisoning") \| \+ \| \+ \| \+ \| – \| – \| – \| \+ \| – \| [Salivation](https://www.wikidoc.org/index.php/Saliva "Saliva") [Vomiting](https://www.wikidoc.org/index.php/Nausea_and_vomiting "Nausea and vomiting") \| – \| – \| – \| Nl \| – \| Nl \| Nl \| Nl \| Reduced RBC acetylcholinesterase Plasma [cholinesterase](https://www.wikidoc.org/index.php/Cholinesterase "Cholinesterase") activity \| [Autonomic dysfunction](https://www.wikidoc.org/index.php/Dysautonomia "Dysautonomia") Motor deficit Sensory deficit [Bronchospasm](https://www.wikidoc.org/index.php/Bronchospasm "Bronchospasm") [Urination](https://www.wikidoc.org/index.php/Urination "Urination") [Miosis](https://www.wikidoc.org/index.php/Miosis "Miosis") [Bradycardia](https://www.wikidoc.org/index.php/Bradycardia "Bradycardia") [Lacrimation](https://www.wikidoc.org/index.php/Lacrimation "Lacrimation") [Sweating](https://www.wikidoc.org/index.php/Sweating "Sweating") [Cardiac arrhythmias](https://www.wikidoc.org/index.php/Cardiac_arrhythmia "Cardiac arrhythmia") [Acute renal injury](https://www.wikidoc.org/index.php/Acute_kidney_injury "Acute kidney injury") \| [Neurotoxins](https://www.wikidoc.org/index.php/Neurotoxin "Neurotoxin") bind to [acetylcholinesterase](https://www.wikidoc.org/index.php/ACHE "ACHE") (AChE) \| Clinical diagnosis \| \| \| [Opium withdrawal](https://www.wikidoc.org/index.php/Opium_withdrawal "Opium withdrawal") \| \+ \| \+ \| \+ \| – \| – \| – \| \+ \| – \| Hyperactive [bowel sounds](https://www.wikidoc.org/index.php/Stomach_rumble "Stomach rumble") \| – \| – \| – \| Nl \| – \| Nl \| Nl \| Nl \| [Azotemia](https://www.wikidoc.org/index.php/Azotemia "Azotemia") [Hypokalemia](https://www.wikidoc.org/index.php/Hypokalemia "Hypokalemia") [Metabolic alkalosis](https://www.wikidoc.org/index.php/Metabolic_alkalosis "Metabolic alkalosis") \| [Dysphoria](https://www.wikidoc.org/index.php/Dysphoria "Dysphoria") [Restlessness](https://www.wikidoc.org/index.php/Agitation_\(emotion\) "Agitation (emotion)") [Sweating](https://www.wikidoc.org/index.php/Perspiration "Perspiration") [Rhinorrhea](https://www.wikidoc.org/index.php/Rhinorrhea "Rhinorrhea") [Lacrimation](https://www.wikidoc.org/index.php/Tears "Tears") [Myalgia](https://www.wikidoc.org/index.php/Myalgia "Myalgia") [Arthralgia](https://www.wikidoc.org/index.php/Arthralgia "Arthralgia") \| [Opium withdrawal](https://www.wikidoc.org/index.php/Opium "Opium") \| Clinical diagnosis following [opium withdrawal](https://www.wikidoc.org/index.php/Opium_withdrawal "Opium withdrawal") \| \| \| Cause \| Duration \| Diarrhea \| Fever \| Abdominal pain \| Weight loss \| GI signs \| Stool exam \| CBC \| Other lab findings \| Extra intestinal findings \| Cause/Pathogenesis \| Gold standard diagnosis \| \| \| \| \| \| \| \| \| \| \| \| Acute \| Chronic \| Watery \| Bloody \| Fatty \| WBC \| RBC \| Ova/Parasite \| Osmotic gap \| Other \| WBC \| Hgb \| Plt \| \| \| \| \| \| \| \| \| \| \| \| [Short bowel syndrome](https://www.wikidoc.org/index.php/Short_bowel_syndrome "Short bowel syndrome") \| \+ \| \+ \| \+ \| – \| \+ \| – \| – \| \+ \| [Abdominal distention](https://www.wikidoc.org/index.php/Abdominal_distension "Abdominal distension") [Abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") \| – \| – \| – \| Nl \| Positive [fecal fat](https://www.wikidoc.org/index.php/Fecal_fat "Fecal fat") \| Nl \| ↓ \| ↑ \| [Hypoalbuminemia](https://www.wikidoc.org/index.php/Hypoalbuminemia "Hypoalbuminemia") High level of [acute phase reactant](https://www.wikidoc.org/index.php/Acute_phase_protein "Acute phase protein") Abnormal [liver function tests](https://www.wikidoc.org/index.php/Liver_function_tests "Liver function tests") \| Prior [intestinal](https://www.wikidoc.org/index.php/Intestine "Intestine") surgery [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") [Crohn's disease](https://www.wikidoc.org/index.php/Crohn%27s_disease "Crohn's disease") [Malignancy](https://www.wikidoc.org/index.php/Cancer "Cancer") Peripheral [edema](https://www.wikidoc.org/index.php/Edema "Edema") [Muscle atrophy](https://www.wikidoc.org/index.php/Muscle_atrophy "Muscle atrophy") \| Surgical [bowel resection](https://www.wikidoc.org/index.php/Bowel_resection "Bowel resection") \| Clinical diagnosis following [bowel resection](https://www.wikidoc.org/index.php/Bowel_resection "Bowel resection") \| \| \| [Radiation enteritis](https://www.wikidoc.org/index.php/Radiation_enteropathy "Radiation enteropathy") \| \+ \| \+ \| \+ \| \+ \| \+ \| – \| \+ \| \+ \| [Abdominal tenderness](https://www.wikidoc.org/index.php/Tenderness_\(medicine\) "Tenderness (medicine)") \| \+ \| \+ \| – \| Nl \| Positive [fecal fat](https://www.wikidoc.org/index.php/Fecal_fat "Fecal fat") \| Nl \| ↓ \| Nl \| Vitamin B12 deficiency [Hypoalbuminemia](https://www.wikidoc.org/index.php/Hypoalbuminemia "Hypoalbuminemia") \| Prior history of [malignancy](https://www.wikidoc.org/index.php/Cancer "Cancer") and [radiation therapy](https://www.wikidoc.org/index.php/Radiation_therapy "Radiation therapy") [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") [Telangiectasias](https://www.wikidoc.org/index.php/Telangiectasia "Telangiectasia") \| [Radiation](https://www.wikidoc.org/index.php/Radiation_therapy "Radiation therapy") \| Segmental bowel [inflammation](https://www.wikidoc.org/index.php/Inflammation "Inflammation") on [endoscopy](https://www.wikidoc.org/index.php/Endoscopy "Endoscopy") or [colonoscopy](https://www.wikidoc.org/index.php/Colonoscopy "Colonoscopy") \| \| \| [Dumping syndrome](https://www.wikidoc.org/index.php/Gastric_dumping_syndrome "Gastric dumping syndrome") \| – \| \+ \| \+ \| – \| \+ \| – \| – \| \+ \| Hyperactive [bowel sound](https://www.wikidoc.org/index.php/Bowel_sound "Bowel sound") \| – \| – \| – \| Nl \| – \| Nl \| Nl \| Nl \| [Hypoglycemia](https://www.wikidoc.org/index.php/Hypoglycemia "Hypoglycemia") [Hydrogen breath test](https://www.wikidoc.org/index.php/Hydrogen_Breath_Test "Hydrogen Breath Test") \| [Malnutrition](https://www.wikidoc.org/index.php/Malnutrition "Malnutrition") [Fat soluble vitamin](https://www.wikidoc.org/index.php/Fat_soluble_vitamins "Fat soluble vitamins") deficiency \| [Postgastrectomy](https://www.wikidoc.org/index.php/Post_operative_complications "Post operative complications") \| Clinical diagnosis following [gastrectomy](https://www.wikidoc.org/index.php/Gastrectomy "Gastrectomy") \| \| \| Cause \| Duration \| Diarrhea \| Fever \| Abdominal pain \| Weight loss \| GI signs \| Stool exam \| CBC \| Other lab findings \| Extra intestinal findings \| Cause/Pathogenesis \| Gold standard diagnosis \| \| \| \| \| \| \| \| \| \| \| \| Acute \| Chronic \| Watery \| Bloody \| Fatty \| WBC \| RBC \| Ova/Parasite \| Osmotic gap \| Other \| WBC \| Hgb \| Plt \| \| \| \| \| \| \| \| \| \| \| \| [Abetalipoproteinemia](https://www.wikidoc.org/index.php/Abetalipoproteinemia "Abetalipoproteinemia") \| – \| \+ \| \+ \| – \| \+ \| – \| \+ \| \+ \| [Abdominal distension](https://www.wikidoc.org/index.php/Abdominal_distension "Abdominal distension") \| – \| – \| – \| Nl \| – \| Nl \| Nl \| Nl \| Low [triglyceride](https://www.wikidoc.org/index.php/Triglyceride "Triglyceride") Low total [cholesterol](https://www.wikidoc.org/index.php/Cholesterol "Cholesterol") levels [Acanthocytes](https://www.wikidoc.org/index.php/Acanthocytes "Acanthocytes") Low [vitamin E](https://www.wikidoc.org/index.php/Vitamin_E "Vitamin E") levels \| [Ataxia](https://www.wikidoc.org/index.php/Ataxia "Ataxia") [Visual field defect](https://www.wikidoc.org/index.php/Visual_field_defect "Visual field defect") [Dysarthria](https://www.wikidoc.org/index.php/Dysarthria "Dysarthria") \| [Autosomal recessive](https://www.wikidoc.org/index.php/Autosomal_recessive "Autosomal recessive") disorder caused by mutations encoding the [microsomal triglyceride transfer protein](https://www.wikidoc.org/index.php/Microsomal_triglyceride_transfer_protein "Microsomal triglyceride transfer protein") (MTP) \| Clinical findings and low [triglyceride](https://www.wikidoc.org/index.php/Triglyceride "Triglyceride") and [cholesterol](https://www.wikidoc.org/index.php/Cholesterol "Cholesterol") level \| \| \| [Hyperthyroidism](https://www.wikidoc.org/index.php/Hyperthyroidism "Hyperthyroidism") \| – \| \+ \| \+ \| – \| – \| ± \| \+ \| \+ \| – \| – \| – \| – \| Nl \| Positive [fecal fat](https://www.wikidoc.org/index.php/Fecal_fat "Fecal fat") \| Nl \| Nl \| Nl \| Elevated [T4](https://www.wikidoc.org/index.php/T4 "T4") Elevated [T3](https://www.wikidoc.org/index.php/T3 "T3") Decreased [TSH](https://www.wikidoc.org/index.php/TSH "TSH") High serum [alkaline phosphatase](https://www.wikidoc.org/index.php/Alkaline_phosphatase "Alkaline phosphatase") \| Lump in the neck Lid lag [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") [Sweating](https://www.wikidoc.org/index.php/Sweating "Sweating") [Hyperpigmentation](https://www.wikidoc.org/index.php/Hyperpigmentation "Hyperpigmentation") [Proptosis](https://www.wikidoc.org/index.php/Proptosis "Proptosis") [Tremor](https://www.wikidoc.org/index.php/Tremor "Tremor") Increased [DTR](https://www.wikidoc.org/index.php/Deep_tendon_reflex "Deep tendon reflex") \| [Graves' disease](https://www.wikidoc.org/index.php/Graves%27_disease "Graves' disease") [Hashimoto's thyroiditis](https://www.wikidoc.org/index.php/Hashimoto%27s_thyroiditis "Hashimoto's thyroiditis") [Toxic adenoma](https://www.wikidoc.org/index.php/Toxic_adenoma "Toxic adenoma") \| [TSH](https://www.wikidoc.org/index.php/TSH "TSH") \| \| \| [Diabetic neuropathy](https://www.wikidoc.org/index.php/Diabetic_neuropathy "Diabetic neuropathy") \| – \| \+ \| \+ \| – \| \+ \| – \| \+ \| \+ \| [Fecal incontinence](https://www.wikidoc.org/index.php/Fecal_incontinence "Fecal incontinence") \| – \| – \| – \| Nl \| Positive [fecal fat](https://www.wikidoc.org/index.php/Fecal_fat "Fecal fat") \| Nl \| ↓ \| Nl \| [Hyperglycemia](https://www.wikidoc.org/index.php/Hyperglycemia "Hyperglycemia") [Azotemia](https://www.wikidoc.org/index.php/Azotemia "Azotemia") [Hypokalemia](https://www.wikidoc.org/index.php/Hypokalemia "Hypokalemia") \| [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") \| Unclear Disordered [motility](https://www.wikidoc.org/index.php/Motility "Motility") Increased [intestinal](https://www.wikidoc.org/index.php/Intestine "Intestine") secretion [Small intestinal bacterial overgrowth](https://www.wikidoc.org/index.php/Small_intestinal_bacterial_overgrowth "Small intestinal bacterial overgrowth") \| Clinical diagnosis in a patient with long lasting [diabetes mellitus](https://www.wikidoc.org/index.php/Diabetes_mellitus "Diabetes mellitus") \| \| \| [Systemic sclerosis](https://www.wikidoc.org/index.php/Scleroderma "Scleroderma") \| – \| \+ \| \+ \| ± \| \+ \| – \| \+ \| \+ \| [Epigastric tenderness](https://www.wikidoc.org/index.php/Abdominal_pain "Abdominal pain") [Fecal incontinence](https://www.wikidoc.org/index.php/Fecal_incontinence "Fecal incontinence") \| – \| \+ \| – \| Nl \| Positive [fecal fat](https://www.wikidoc.org/index.php/Fecal_fat "Fecal fat") \| Nl \| ↓ \| Nl \| Anti–[topoisomerase I](https://www.wikidoc.org/index.php/Type_I_topoisomerase "Type I topoisomerase") (Scl‑70) antibodies [Antinuclear antibodies](https://www.wikidoc.org/index.php/Antinuclear_antibodies "Antinuclear antibodies") ([ANA](https://www.wikidoc.org/index.php/Antinuclear_antibodies "Antinuclear antibodies")) [Anti–centromere antibodies](https://www.wikidoc.org/index.php/Anti-centromere_antibodies "Anti-centromere antibodies") Anti–[RNA polymerase III](https://www.wikidoc.org/index.php/RNA_polymerase_III "RNA polymerase III") antibody \| [Malabsorption](https://www.wikidoc.org/index.php/Malabsorption "Malabsorption") [Skin changes](https://www.wikidoc.org/index.php/Skin_changes "Skin changes") [Raynaud phenomenon](https://www.wikidoc.org/index.php/Raynaud%27s_phenomenon "Raynaud's phenomenon") [Pulmonary hypertension](https://www.wikidoc.org/index.php/Pulmonary_hypertension "Pulmonary hypertension") [Arthritis](https://www.wikidoc.org/index.php/Arthritis "Arthritis") [Telangiectasia](https://www.wikidoc.org/index.php/Telangiectasia "Telangiectasia") [Chronic renal failure](https://www.wikidoc.org/index.php/Chronic_renal_failure "Chronic renal failure") \| [Autoimmune reaction](https://www.wikidoc.org/index.php/Autoimmunity "Autoimmunity") \| Clinical diagnosis Followed by serologic tests \| \| References 1. 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