Abstract
Chronic diarrhoea affects up to 14% of adults, it impacts on quality of life and its cause can be variable. Patients with chronic diarrhoea are presented with a plethora of dietary recommendations, often sought from the internet or provided by those who are untrained or inexperienced. In this review, we summarise the possible causes of chronic diarrhoea that can be managed by diet, the symptom improvement and quality of life benefits but also the potential risks of such dietary treatments. Clinicians need to consider both the benefits and risks of dietary treatments before making dietary recommendations to manage chronic diarrhoea. The pivotal role that dietitians have in ensuring optimal symptom improvement without jeopardising nutritional and overall health is discussed.
Highlights
Introduction the Pearls andPitfalls of the DietaryChronic diarrhoea is variably defined but usually includes stools ranging from type 5 to type 7 on the Bristol stool form scale, a duration of more than four weeks, and frequency of stools [1]
When dietitians are faced with patients with chronic diarrhoea, it is imperative that a diagnosis is pursued and that sinister diagnoses are excluded
This review addresses the diet-responsive causes of chronic diarrhoea, provides an evidence-based overview of diet-based therapies, explores the pearls and pitfalls of each therapy and outlines the role that dietitians have in ensuring the nutritional adequacy and safety of dietary changes
Summary
Chronic diarrhoea is variably defined but usually includes stools ranging from type 5 to type 7 on the Bristol stool form scale, a duration of more than four weeks, and frequency of stools (usually >25% of the time) [1]. In a population of older adults, 14% were classified as having chronic diarrhoea based on increased stool frequency and the absence of abdominal pain [3]. This may include patients with structural or functional causes such as microscopic colitis or chronic diseases such as diabetes. When dietitians are faced with patients with chronic diarrhoea, it is imperative that a diagnosis is pursued and that sinister diagnoses are excluded. This will involve referral to, and collaboration with, the patient’s General Practitioner or Gastroenterologist. Chronic diarrhoea may impact on quality of life, with increased incidence of depression described in populations of both young [2] and older adults [6]
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