DIARRHOEA

ACUTE:

infective:

food poisoning

viral gastro-enteritis

*traveller's diarrhoea:

enterotoxigenic E.Coli (15-70%)

other E.coli species (0-15%)

Shigella species (0-30%)

Salmonella species (0-30%)

Campylobacter species (0-35%)

viruses (rotavirus, Norwalk family) (0-35%)

Giardia lamblia and Entamoeba histolytica (0-10%)

Cryptosporidium species (0-5%)

other (Aeromonas, Vibrio cholerae, Yersinia) (0-60%)

unknown or no pathogen identified (10-50%)

drugs:

laxatives

many other drugs, e.g. antibiotics

other:

dietary indiscretion

spurious diarrhoea (constipation or faecal impaction)

CHRONIC:

inflammatory bowel disease

microscopic colitis

coeliac disease

parasitic and fungal infections

'gay bowel disease' (includes infective components)

malabsorption syndromes, e.g. chronic pancreatitis

pellagra (vitamin B6 deficiency)

gut resection

post-vagotomy

drugs (laxatives, others)

gastrointestinal neoplasia, e.g. lymphoma

bile acid malabsorption

bacterial overgrowth

faecal impaction (spurious diarrhoea)

endocrine causes:

thyrotoxicosis

diabetic neuropathy

carcinoid syndrome

pancreatic tumours, eg. glucagonoma

gastrinoma (Zollinger-Ellison syndrome)

VIPoma (WDHA syndrome)

*NB: Causative organisms in traveller's diarrhoea vary widely depending on region and season

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