TABLE 3-4.
Diagnosis of Specific Chronic Diarrheal Disorders
| Diarrhea | Diagnostic test/procedure | |
|---|---|---|
| Small Bowel Type | ||
| Exocrine, pancreatic insufficiency | Serum trypsin-like immunoreactivity (TLI) | |
| Chronic inflammatory small bowel disease | ||
| Eosinophilic enteritis | Eosinophilia, biopsy | |
| Lymphocytic-plasmacytic enteritis | Biopsy | |
| Serum protein electrophoresis | ||
| Immunoproliferative enteropathy of basenjis | Radiography, biopsy | |
| Granulomatous enteritis | ||
| Lymphangiectasia | Lymphopenia, biopsy | |
| Villous atrophy | ||
| Gluten enteropathy | Response to gluten-free diet | |
| Idiopathic | Biopsy | |
| Histoplasmosis | Serology, cytology, biopsy | |
| Lymphosarcoma | Biopsy | |
| Small intestinal bacterial overgrowth (SIBO) | Culture intestinal aspirate, folate, response to antibiotics | |
| Giardiasis | Fecal examinations, response to parasiticides | |
| Lactase deficiency | Response to lactose-free diet | |
| Large Bowel Type | ||
| Chronic colitis | Colonoscopy, colon biopsy | |
| Idiopathic | ||
| Histiocytic | ||
| Eosinophilic | ||
| Abrasive colitis | Dietary history, inspection of feces | |
| Whipworm colitis | Fecal flotation, colonoscopy, response to fenbendazole | |
| Protozoan colitis | Saline fecal smears | |
| Amebiasis | ||
| Balantidiasis | ||
| Trichomoniasis | ||
| Histoplasma colitis | Fecal cytology, colon biopsy, serology, culture | |
| Salmonella colitis | Culture | |
| Campylobacter colitis | Culture | |
| Protothecal colitis | Colon biopsy | |
| Rectocolonic polyps | Digital palpation, barium enema | |
| Colonic adenocarcinoma | Colonoscopy, barium enema, possibly abdominal ultrasound | |
| Colonic lymphosarcoma | Barium enema, colonoscopy | |
| Functional diarrhea (irritable colon) | History, diagnostic workup excludes all other diseases | |