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Chronic Diarrhea

By Dr Ananya Mandal, MD

Diarrhea is mainly characterized by loose bowel movements that may be frequent and watery. Most of the time, the condition resolves in a few days to a week. Acute diarrhea is usually self-resolving and short term. Chronic diarrhea is defined as diarrhea that lasts for over 2 weeks. Acute diarrhea in addition is caused most commonly by an infection.

Chronic diarrhea can lead to deficiency and loss of vital nutrients. There are many possible causes of chronic diarrhea but there may be no specific cause for chronic diarrhea as well.

Symptoms of chronic diarrhea

Long term diarrhea is often associated with weight loss and symptoms of malnutrition. Stools may be loose, frequent or infrequent or watery. Chronic diarrhea can occur at any age and has multiple causes.

Causes of chronic diarrhea

  • Infections – Gastroenteritis commonly lead to acute diarrhea rather than chronic diarrhea. Infections may lead to chronic diarrhea if the infection takes long to clear up or causes damage to the intestines.

Infections include those caused by parasites (Cryptosporidium, Cyclospora, Entamoeba histolytica, Giardia, microsporidia), bacteria (Campylobacter, Clostridium difficile,  E. coli, Plesiomonas, Salmonella, Shigella) and viruses (norovirus).

  • Foods – Some foods and food allergies and intolerance may lead to chronic diarrhea. This is commonly seen in children with milk intolerance or lactose intolerance. Diarrhea may be seen in toddlers who have taken too much fruit juice.
  • Chronic diarrhea may also result from medications like antibiotics or laxatives
  • Several diseases may also lead to chronic diarrhea. These include inflammatory bowel disease (ulcerative colitis or Crohn’s disease), irritable bowel syndrome, celiac disease, or malformations of the intestines. Cystic fibrosis, chronic pancreatitis, pancreatic enzyme deficiencies, overactive thyroid gland (hyperthyroidism), tumors, immunoglobulin deficiencies or immune disorders such as HIV infection may also lead to chronic diarrhea.

Possible complications of chronic diarrhea

Malnutrition and dehydration are common long term and short term complications of chronic diarrhea.

Diagnosis and treatment

The possible causes of chronic diarrhea are evaluated and the cause is treated. Treatment and diagnosis is usually made by the gastroenterologist. Samples of stool may be examined for infection and other possible abnormalities.

Some routine blood tests may be advised. Imaging studies like X ray of the abdomen, endoscopy etc. are also advised.

Treatment for chronic diarrhea depends on the underlying cause of diarrhea. If a specific cause is identified, treatment is directed towards treating the condition.

Infections with bacteria or parasites for example are usually treated with antibiotics.

Food allergies, medications and intolerances are usually treated by avoidance of the suspicious agent in diet.

Reviewed by , BA Hons (Cantab)

Further Reading

Last Updated: Mar 24, 2013

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