Open AccessEndoscopic diagnosis of chronic diarrhea
Author(s) -
Kinoshita Yoshikazu,
Ariyoshi Ryusuke,
Fujigaki Seiji,
Tanaka Katsuhide,
Morikawa Teruhisa,
Sanuki Tsuyoshi
Publication year - 2022
Publication title -
den open
Language(s) - English
Resource type - Journals
ISSN - 2692-4609
DOI - 10.1002/deo2.53
Subject(s) - medicine , diarrhea , bloody diarrhea , etiology , colonoscopy , microscopic colitis , gastroenterology , pathological , biopsy , chronic diarrhea , endoscopy , eosinophilic gastroenteritis , disease , inflammatory bowel disease , colorectal cancer , cancer
The prevalence of chronic diarrhea in the general population is reported to be 4%–5%. Since various pathological conditions cause diarrheal symptoms, etiological diagnosis of chronic diarrhea is difficult in many cases. Medical history taking, physical examinations, and laboratory testing are not adequately sensitive or specific, thus a colonoscopic investigation is frequently employed for etiological evaluation. However, for cases with non‐bloody chronic diarrhea, the diagnostic yield of a colonoscopy procedure is reported to be not high enough. Furthermore, endoscopically identifiable findings are not adequately specific for the diagnosis of diarrheal disease, except for inflammatory bowel disease, while microscopic colitis, amyloidosis, eosinophilic gastroenteritis, celiac disease, and bile acid diarrhea are difficult to definitively diagnose using endoscopic findings. Thus, a histopathological examination of biopsy samples obtained with endoscopy is critically important. Endoscopists should consider obtaining biopsy samples from even normal‐appearing gastrointestinal mucosa for chronic diarrhea diagnosis.