Specific Etiologies of Chronic Diarrhea in Infancy
نویسنده
چکیده
Diarrhea is one of the most common symptoms of illness in pediatric practice. It usually appears in the form of acute diarrhea, but it may also progress to a chronic state. The differential diagnosis of chronic diarrhea is very extensive (Table 1). Regardless of specific etiology, the major pathogenetic mechanisms are osmotic diarrhea, increased intestinal secretion, inhibition of active ion absorption, and abnormalities of motility (1). In Israel, most cases of chronic diarrhea can be attributed to a limited group of etiologies, namely, postinfectious gastroenteritis, parasitic infestation, disaccharidase deficiencies, celiac disease, and chronic nonspecific diarrhea. The work-up of patients with chronic diarrhea can be very tedious, and at times, even after sophisticated studies, the exact diagnosis cannot be reached. In such cases the patients should be treated symptomatically, bypassing the pathophysiologic disturbances. This enables the infants to grow and develop and in some cases to overcome the ill effects of malabsorption secondary to the chronic diarrhea. In this chapter, I try to summarize some of the specific etiologies of chronic diarrhea in infancy and childhood, with emphasis on pathophysiology and approaches to therapy.
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