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| Chronic diarrhea is defined as an increased stool frequency and fluidity (looseness) lasting more than two weeks. Less common causes of chronic bloody diarrhea include ischemia, infections (Campylobacter jejuni, Clostridium difficile, Entamoeba histolytica, Yersinia and Cytomegalovirus), radiation or chemotherapy, and colon cancer or polyps (villous adenoma). Careful medication history is important since such medications as NSAIDs, antacids, elixirs (containing sorbitol and fructose), antihypertensives, cholinergic agents, antibiotics, and antiarrhythmics all can cause diarrhea in some individuals. Large volume and frequent watery stools that persist during fasting and that are associated with severe fluid and electrolyte abnormalities and dehydration characterize these endocrine neoplasms. This usually indicates a problem with the intestinal absorption of salt and water, and can be due to secretory states or to osmotic diarrheas. It is recognized as one of the safer antidiarrheal therapies because it exerts its effect only within the bowel lumen. Antimotility agents and opiates are the most effective empiric therapy for diarrhea. |
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