VIDEO: What physicians should know about diagnosing chronic diarrhea

BOSTON — Chronic diarrhea is an “incredibly common” condition, with about one out of 20 patients presenting with symptoms, according to Brian E. Lacy, MD, PhD, FACG, a professor of medicine at the Mayo Clinic.

At the ACP Internal Medicine Meeting, Lacy explained that the first step in diagnosing chronic diarrhea is distinguishing it from acute diarrhea. While acute diarrhea lasts about 7 days or fewer, chronic diarrhea lasts 4 weeks or more.

Lacy noted that it is important to be a “great detective” when identifying causes of chronic diarrhea.

“Let’s think about warning signs: unintentional weight loss, anemia, family history of colorectal cancer and inflammatory bowel disease, because that might put you down a different pathway” he said.

As for which diagnostic tests should be used, Lacy highlighted the “five C’s”:

• complete blood count;
• complete metabolic profile;
• c-reactive protein test;
• fecal calprotectin; and
• celiac serology.

Reference:

• Lacy B. Approach to the adult with chronic diarrhea. Presented at: ACP Internal Medicine Meeting; April 18-20, 2024; Boston.