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Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Chronic diarrhea causes

Introduction

Overview

Overview

Depending on the socioeconomic status of the population, chronic diarrhea can be caused by several factors. In a developing nation, the most likely causes of chronic diarrhea are mycobacterial and parasitic infections, while functional disorders such as malabsorption and inflammatory bowel diseases are less likely causes. In a developed nation, however, the most likely causes of diarrhea are irritable bowel syndrome (IBS), inflammatory bowel disease, malabsorption syndromes (such as lactose intolerance and celiac disease), and chronic infections (particularly in patients who are immunocompromised).

Causes

Causes

Life threatening causes

There are no life-threatening causes of chronic diarrhea; however, complications resulting from untreated chronic diarrhea are common.

Common causes

In patients presenting with chronic diarrhea, the most frequent noninfectious causes include a mix of functional and organic disorders. Together, Functional diarrhea and Irritable Bowel Syndrome with Diarrhea (IBS-D) account for approximately 35% of cases.Other significant contributors include Lactase deficiency: 35% [1], Bile acid diarrhea: 25%–33%,[2], Celiac disease: 12% [3].

There following are some of the common causes of chronic diarrhea:[4][5][6][7][8]

Etiology Conditions
Malabsorption / Maldigestion Celiac disease, Cystic fibrosis, Disaccharidase deficiency, Short gut syndrome, Intestinal lymphangiectasis.
Functional & Inflammatory Irritable bowel syndrome (IBS), Inflammatory bowel disease (Crohn disease, Ulcerative colitis), Microscopic colitis.
Anatomic & Structural Intussusception, Hirschsprung’s disease (with/without toxic megacolon), Partial bowel obstruction, Blind loop syndrome (associated with dysmotility)
Immunodeficiency HIV, Severe combined immunodeficiency disorder (SCID), and other genetic disorders
Endocrine & Neoplastic Hyperthyroidism, Addison’s disease, Carcinoid tumors, Vipoma, Gastrinoma (Zollinger-Ellison syndrome), Mastocytosis.
Infectious & Ischemic Bacterial gastroenteritis, Viral gastroenteritis, Amebic dysentery, Infectious enteritis/colitis (non-C. diff), Ischemic colitis.
Miscellaneous Clinical Antibiotic-associated diarrhea, Pseudomembranous colitis, Hemolytic uremic syndrome, Neonatal drug withdrawal

Pharmacologic Triggers of Diarrhea [9],[10],[11]

Drug Class Common Agents
Gastrointestinal Magnesium-containing antacids, Laxatives, Cisapride, Olsalazine
Cardiovascular Digitalis, Quinidine, Procainamide, Hydralazine, Beta-blockers, ACE inhibitors, Diuretics.
Antimicrobials Clindamycin, Ampicillin, Amoxycillin, Erythromycin, Cephalosporins.
Neuropsychiatric Lithium, Fluoxetine, Alprazolam
Hypolipidemic Clofibrate, Gemfibrozil, Lovastatin
Other Agents Chemotherapeutic agents, NSAIDs, Thyroid hormones, Colchicine, Aminophylline, Salbutamol
References

References

  1. ↑ Viswanathan L, Rao SS, Kennedy K, Sharma A, Yan Y, Jimenez E (July 2020). “Prevalence of Disaccharidase Deficiency in Adults With Unexplained Gastrointestinal Symptoms”. J Neurogastroenterol Motil. 26 (3): 384–390. doi:10.5056/jnm19167. PMID 32380581 Check |pmid= value (help).
  2. ↑ Sadowski DC, Camilleri M, Chey WD, Leontiadis GI, Marshall JK, Shaffer EA, Tse F, Walters JR (January 2020). “Canadian Association of Gastroenterology Clinical Practice Guideline on the Management of Bile Acid Diarrhea”. Clin Gastroenterol Hepatol. 18 (1): 24–41.e1. doi:10.1016/j.cgh.2019.08.062. PMID 31526844.
  3. ↑ Panezai MS, Ullah A, Ballur K, Gilstrap L, Khan J, Tareen B, Kakar M, Khan J, Rasheed A, Waheed A, Ghleilib I, White J, Cason FD (December 2021). “Frequency of Celiac Disease in Patients With Chronic Diarrhea”. Cureus. 13 (12): e20495. doi:10.7759/cureus.20495. PMID 35047307 Check |pmid= value (help).
  4. ↑ Jamma S, Rubio-Tapia A, Kelly CP, Murray J, Najarian R, Sheth S; et al. (2010). “Celiac crisis is a rare but serious complication of celiac disease in adults”. Clin Gastroenterol Hepatol. 8 (7): 587–90. doi:10.1016/j.cgh.2010.04.009. PMC 2900539. PMID 20417725.
  5. ↑ Manning AP, Thompson WG, Heaton KW, Morris AF (1978). “Towards positive diagnosis of the irritable bowel”. Br Med J. 2 (6138): 653–4. PMC 1607467. PMID 698649.
  6. ↑ Mekhjian HS, Switz DM, Melnyk CS, Rankin GB, Brooks RK (1979). “Clinical features and natural history of Crohn’s disease”. Gastroenterology. 77 (4 Pt 2): 898–906. PMID 381094.
  7. ↑ 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.
  8. ↑ Veress B, Löfberg R, Bergman L (1995). “Microscopic colitis syndrome”. Gut. 36 (6): 880–6. PMC 1382626. PMID 7615277.
  9. ↑ Branski D, Lerner A, Lebenthal E (April 1996). “Chronic diarrhea and malabsorption”. Pediatr Clin North Am. 43 (2): 307–31. doi:10.1016/s0031-3955(05)70408-9. PMID 8614603.
  10. ↑ Kroschinsky F, Stölzel F, von Bonin S, Beutel G, Kochanek M, Kiehl M, Schellongowski P (April 2017). “New drugs, new toxicities: severe side effects of modern targeted and immunotherapy of cancer and their management”. Crit Care. 21 (1): 89. doi:10.1186/s13054-017-1678-1. PMID 28407743.
  11. ↑ Philip NA, Ahmed N, Pitchumoni CS (February 2017). “Spectrum of Drug-induced Chronic Diarrhea”. J Clin Gastroenterol. 51 (2): 111–117. doi:10.1097/MCG.0000000000000752. PMID 28027072.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omodamola Aje B.Sc, M.D. [2] Anum Ijaz M.B.B.S., M.D.[3]