Evaluation of chronic secretory diarrhea
- Because there are many causes of chronic secretory diarrhea, an extensive evaluation is necessary.
- Rare cases of infection should be excluded by bacterial culture and examination of stool for parasites or tests for protozoal antigens.
- Stimulant laxative abuse is best excluded by looking for laxatives in the urine or stool.
- Structural disease and internal fistulas can be evaluated with small bowel radiography or computed tomography (CT) scanning of the abdomen and pelvis.
- Endoscopic examination of the upper gastrointestinal tract and colon is routine and should include biopsy of even normal-appearing mucosa, looking for microscopic evidence of disease.
- Systemic diseases such as hyperthyroidism, adrenal insufficiency, and defective immunity can be evaluated with appropriate tests.
