Secretory diarrhoea clinical features
- Stool volume > 1 litre/day
- Stool is watery in consistency
- Stool does not contain pus or blood
- Diarrhoea continuous, even when patient fasts for 24-48 hours but stops when agents causing fatty acid malabsorption or laxatives are not ingested.
- Osmotic gap < 50 milliosm/ L. In mixture of osmotic and secretary diarrhoea the osmotic gap will be between 50 and 125.
Causes of secretory diarrhea
- Infections due to enterotoxigenic bacteria, chronic mycobacterial fungal or parasitic infections.
- Intestinal resections
- Inflammatory bowel diseases
- Coeliac sprue
- Lymphoma of small intestine
- Zollinger-Ellison syndrome, VIPoma, glucagonoma
- Malignant carcinoid syndrome
- Hyperthyroidism
- Collagen vascular diseases (SLE, scleroderma, MCTD)
- Following use or abuse of stimulant laxatives.
