AGA Technical Review on the Evaluation and Management of Chronic Diarrhea☆

Fine, Kenneth D.; Schiller, Lawrence R.

doi:10.1016/s0016-5085(99)70513-5

Cited by 326 publications

(193 citation statements)

References 171 publications

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“…As Fine and Schiller reported that serial biopsy helps in establishing a histopathological diagnosis in 15% of patients with diarrhoea lasting over four weeks [13]. Also, Kagueyama reported that patients with diarrhoea lasting 15-30 days displayed a high incidence of hitological changes [10].…”

Section: Discussionmentioning

confidence: 98%

Role of Mucosal Colonic Biopsy in Patients with Chronic Unexplained Diarrhoea who their Colonoscopy is Normal

Badary¹,

Hafez²

2017

Mol Biol

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Objective: We sought to determine the importance of histopathological assessment in patients with chronic diarrhoea who had macroscopically normal colonic endoscopies. Methods:Of 300 consecutive patients undergoing colonoscopy by one endoscopist during a five year period, biopsies were taken in 200 cases of unexplained diarrhoea of at least 6 weeks and their colorectal mucosa appeared macroscopically normal. All biopsies were reviewed by one pathologist. Results:Of the 200 patients enrolled, 36 (18%) cases were classified as unremarkable histopathological diagnosis and 164 (82%) cases showed histopathological changes: 121 (73.78%) non-specific inflammation, 19 (11.58%) ulcerative colitis, 11 (6.7%) collagenous colitis, 7 (4.26%) lymphocytic colitis, and 6 (3.65%) bilharzial colitis. Conclusion:We conclude that the role of biopsies in chronic diarrhoea patients with grossly normal colon at endoscopy is high as yielding a histological diagnosis in 21.5% of patients is so benefit to them as they may had modified the therapy received after identification of a specific cause as collagenous colitis, lymphocytic colitis, ulcerative colitis and bilharzial colitis. So Patients should be subject to colonoscopy and biopsy to aid specific diagnoses.

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Section: Discussionmentioning

confidence: 98%

Role of Mucosal Colonic Biopsy in Patients with Chronic Unexplained Diarrhoea who their Colonoscopy is Normal

Badary¹,

Hafez²

2017

Mol Biol

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“…In a retrospective study, we randomly selected 54 European Caucasian outpatients (18 men and 36 women; General Hospital Linz, Austria) with a mean (SD) age of 55.8 (20.5) years (range 18 -87 years) for LPH C3 T Ϫ13910 genotyping based on a positive LBHT result obtained after the appearance of abdominal symptoms suggesting lactose intolerance, such as diarrhea (19 ). Routine LBHT was performed with 50 g of lactose, and breath hydrogen (H 2 ) excretion was recorded on the EC60 Gastrolyzer 2 (Bedfont Scientific Ltd) (20 ).…”

Section: Genotyping Of the Lactase-phlorizin Hydrolase ؊13910mentioning

confidence: 99%

Genotyping of the Lactase-Phlorizin Hydrolase −13910 Polymorphism by LightCycler PCR and Implications for the Diagnosis of Lactose Intolerance

et al. 2006

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Background: Hypolactasia and lactose intolerance are common conditions worldwide. Hypolactasia seems to be strongly correlated with genotype C/C of the genetic variant C→T−13910 upstream of the lactase phlorizin hydrolase (LPH) gene. We developed a rapid genotyping assay for LPH C→T−13910 and investigated the relationship of positive lactose breath hydrogen test (LBHT) results suggesting lactose intolerance with LPH C→T−13910 genotype. Methods: Using automated DNA purification on the MagNA Pure LC and real-time PCR on the LightCycler, we examined samples from 220 individuals to estimate genotype frequencies; we then determined LPH C→T−13910 genotype in samples from 54 Caucasian patients with a positive LBHT result and symptoms of lactose intolerance. Results: Genotyping of 220 individuals revealed frequencies of 21.4%, 41.8%, and 36.8% for genotypes C/C, C/T, and T/T. Of the patients with positive LBHT results, only 50% had the C/C genotype suggestive of primary adult hypolactasia in our study population. The other patients had various degrees of secondary hypolactasia or symptoms of lactose intolerance. Patients with C/C genotype had a mean (SD) peak H2 increase in the LBHT [108 (58) ppm] that was significantly higher than in patients with the C/T [65 (54) ppm] and T/T [44 (34) ppm] genotypes. Conclusions: The new real-time PCR assay provides a rapid, labor-saving means for the genotyping of LPH C→T−13910. Use of the assay may assist in differentiating patients with primary hypolactasia from those with secondary hypolactasia and lactose intolerance, who may need further clinical examinations to diagnose their underlying primary diseases.

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“…□ 1 week □ 2 weeks □ 3 weeks □ 4 weeks Chronic diarrhea is defined as looser stools for more than 4 weeks, 1 a period that allows most cases of acute, self-limited, infectious diarrhea to resolve.…”

mentioning

confidence: 99%

“…2 Based on the definition of having excessive stool frequency, the prevalence in the United States is about 5%. 1 In developing countries, the most common cause of chronic diarrhea is infection. In developed nations, irritable bowel syndrome, inflammatory bowel disease, malabsorption syndrome, and chronic infection predominate.…”

mentioning

confidence: 99%