How to Manage Chronic Diarrhoea

Abstract

The differential diagnosis of chronic diarrhoea is broad and the evaluation of these patients represents a diagnostic challenge. This review provides a practical approach to reduce unnecessary testing while minimising the oversight of an important disease. Initial investigations include a detailed history, physical examination, and basic laboratory tests. Most younger patients (<50) with normal initial screen have functional diarrhoea. In patients above age 50, colonoscopy is recommended complementary for initial evaluation. In the absence of an identifiable cause, categorizing patients by having inflammatory or non-inflammatory chronic diarrhoea is helpful in directing further evaluation.