Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (141 page)

BOOK: Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis
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   Diuretics (e.g., furosemide, thiazides), asthma (theophylline), thyroid drugs
   Cholinergic drugs (cholinesterase inhibitors, quinidine, clozapine, ACE inhibitors)
   Toxins (e.g., arsenic, mushrooms, organophosphates, alcohol)
   Infectious agents (For a discussion of infectious causes of diarrhea, see the Infectious Gastrointestinal Diseases section in this Chapter and Chapter
13
)
   Endogenous
   Hormones (serotonin, calcitonin, VIP)
   Gastric hypersecretion (Z-E syndrome, systemic mastocytosis, shortbowel syndrome)
   Bile salts (e.g., disease or resection of the terminal ileum)
   Fatty acids (e.g., disease of small intestine mucosa, pancreatic insufficiency)
   Congenital (e.g., congenital chloridorrhea, congenital sodium diarrhea)
   Laboratory Findings

Stool findings
: Watery stool, volume >1 L/day, blood and pus are absent, stool osmolality close to plasma osmolality with no anion gap.

EXUDATIVE DIARRHEA (INFLAMMATORY CAUSES)

Due to
infection, injury, ischemia, vasculitis, abscess, and/or idiopathic.

Laboratory findings
: Stool contains blood and pus.

MOTILITY DISTURBANCES

Due to

   Decreased small intestinal motility (e.g., hypothyroidism, DM, amyloidosis, scleroderma)
   Increased small intestinal motility (e.g., hyperthyroidism, carcinoid syndrome)

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