Chronic diarrhea is when diarrhea persists for more than 4 weeks or even months. Depending on the clinical course of the disease causing diarrhea, different conditions may occur.
Chronic diarrhea in adolescents and young adults is usually caused by ulcerative colitis, tuberculosis, Crohn’s disease or functional bowel disorders, while chronic diarrhea in middle and older age is caused by organ damage such as colon cancers, pancreatic diseases or diverticulitis.
Consecutive episodes of constipation and diarrhea can generally be caused by colon cancers, diverticulitis, functional bowel disorders, laxative abuse, and stomach diseases.
Persistent chronic diarrhea is seen in ulcerative colitis, enteritis, intestinal fistulas, laxative abuse and stomach diseases.
Intermittent episodes of diarrhea can often be caused by functional bowel disorders, diverticulitis, allergies, or malabsorption.
If there is a decrease in abdominal cramps with defecation, large intestine diseases usually come to mind.
The occurrence of abdominal cramps after defecation is generally more common in small intestine disorders.
Diarrhea with excessive excretion of stools usually suggests diseases originating from the small intestine or the first parts of the large intestine, while chronic diarrhea with small amounts of stool is generally thought of diseases seen in the more advanced parts of the large intestine.
Diarrhea, which is seen with conditions that create a defecation stimulus in the rectum but no stool comes out, usually suggest lesions in the rectum region and inflammatory bowel diseases.
Diarrhea, which usually occurs in the morning and after meals, can be caused by stomach ailments, Crohn’s disease, ulcerative colitis, or emotional reasons. Diarrhea, which occurs only at night, is a typical symptom of diabetic neuropathies.
Hyperthyroidism or malabsorption may be considered in patients with diarrhea if weight loss is observed without loss of appetite. Inflammatory bowel diseases come to mind if fever or other systemic symptoms are seen with weight loss. If weight loss begins before diarrhea starts, cancer diseases, tuberculosis, diabetes, hyperthyroidism or malabsorption diseases may come to mind.
In some diseases such as colon cancer, weight loss may not occur until the last stage.
In patients who develop diarrhea without weight loss or any systemic symptoms, the cause of diarrhea is usually a functional bowel disorder.
The characteristics of the stool may also vary according to the causes of diarrhea. For example; Diarrhea with low water content may develop due to psychological or physiological reasons, inflammatory bowel diseases or shortened bowel condition after surgery.
If the stool is oily, foul-smelling, foamy, pale in color, semi-solid and abundant, it may be caused by malabsorption with intestinal malabsorption.
If the stool is bloody and the patient has writhing abdominal pain, it is thought to be caused by dysentery causes, ulcerative colitis or Crohn’s disease. If the patient also has bloody rectal discharge in addition to diarrhea, an inflammatory disease originating from the prostate or anus is considered.
Frequent, oily, soft stools are usually caused by stomach diseases. If there is plenty of mucus in the stool, no blood or inflammation, this chronic diarrhea is usually seen in functional bowel diseases.
In chronic diarrhea, it is the excess bile content that gives the stool its greenish color. Chronic diarrhea with green, soft or liquid stools can often be caused by excessive use of laxatives or infections.
The most common causes of chronic diarrhea are:
- Stomach diseases
- After gastric surgery
- Postvagotomy
- Hypertrophic atrophic gastritis (Menetrier’s disease)
- Pernicious anemia
- Zollinger-Ellison Syndrome
- Small intestine diseases
- Inflammatory diseases
- Crohn’s disease
- Radiation enteritis
- Whipple’s disease
- Collagen tissue diseases
- Polyatheritis nodosa
- Systemic Lupus Erythematosus
- Scleroderma
- Amyloidosis
- Malabsorption
- Gluten enteropathy
- Tropical sprue
- Disaccharidase deficiency
- Intestinal lymphoma
- Intestinal amyloidosis
- Intestinal scleroderma
- Hypogammaglobulinemia
- Intestinal lymphangiectasia
- Pancreatic insufficiency
- Intestinal obstructive causes
- Blind bowel syndrome
- Small intestinal diverticulum
- Postgastrectomy steatorrhea
- Intestinal pseudoobstruction
- Small bowel resections
- Conditions secondary to dermatological diseases
- Dermatitis herpetiformis
- Atopic dermatitis
- Chronic giardiasis
- Inflammatory diseases
- Large intestine diseases
- Ulcerative colitis
- Crohn’s disease (Granulomatous colitis)
- Ulcerative proctitis
- Diverticulitis
- Colon cancers
- Villous adenoma
- AIDS infections
- Other reasons
- Addison’s disease
- Superior mesenteric artery insufficiency
- Diabetes mellitus
- Endocrine tumors
- Hyperthyroidism