Chronic diarrhea physical examination

Some of the physical findings of chronic diarrhea are orthostatic hypotension, dehydration, neuropathy, muscle wasting, edema, malnutrition, urticaria pigmentosa, dermatographism, pinch purpura, macroglossia, hyperpigmentation, Addison’s disease, and migratory necrotizing erythema.

There are several features that can be identified on the physical examination of a patient with chronic diarrhea. These features can help to identify the cause and management of the disease.^[1]

• Patient may appears ill, lethargic, or dehydrated depending on the severity of the underlying disease.

• Orthostasis
• Hypotension
• Fever

• Urticaria pigmentosa

• Dermatographism

• Hyperpigmentation seen with Addison’s disease

• Dermatitis herpetiformis seen with celiac disease

• Migratory necrotizing erythema seen with glucagonoma

• Flushing seen with carcinoid syndrome

• Thyroid nodule
• Lymphadenopathy in case of hyperthyroidism

• Wheezing in carcinoid syndrome

• Heart murmur in hyperthyroidism and carcinoid syndrome

• Hepatomegaly

• Abdominal bruit

• Anal sphincter weakness

• Tremor

• Lid lag seen with hyperthyroidism

• Arthritis

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