Al-Bayatti Sabeha M
Department of Medicine, College of Medicine, Al-Mustansiria University, Baghdad, Iraq.
Saudi Med J. 2002 Jun;23(6):675-9.
The aim is to find the common causes of chronic diarrhea in our hospital, and to find out the most useful methods for diagnosis.
This study was carried out in the medical ward at Al-Yarmouk Teaching Hospital, Baghdad, Iraq, during the period January 1999 through to August 2000. Fifty inpatients with diarrhea for 4 weeks or more were evaluated by history, physical examination and investigations which included endoscopy with biopsy.
The first cause of chronic diarrhea was ulcerative colitis (28%), the next was celiac disease (20%), followed equally by microscopical colitis (12%) and functional diarrhea (12%), amebiasis was the 5th cause (10%), followed by carcinoma of the colon (6%), Crohn's disease (2%), diabetic diarrhea (2%) and thyrotoxicosis (2%). Endoscopy (esophagoduodenoscopy, sigmoidoscopy and colonoscopy) with biopsy was the most useful method to diagnose >70% of the cases as ulcerative colitis, celiac disease, microscopic colitis, carcinoma of the colon and Crohn's disease.
This study revealed the importance of history taking, physical examination, and judious and sequential use of investigations especially endoscopic procedures to discover the cause of chronic diarrhea. Chronic bloody diarrhea should raise the high possibility of ulcerative colitis. A considerable number of patients with chronic diarrhea in our study were discovered to have microscopical colitis.
旨在找出我院慢性腹泻的常见病因，并找出最有效的诊断方法。
本研究于1999年1月至2000年8月期间在伊拉克巴格达的亚尔穆克教学医院内科病房进行。对50例腹泻持续4周或更长时间的住院患者进行了病史、体格检查及包括内镜检查并活检在内的各项检查。
慢性腹泻的首要病因是溃疡性结肠炎（28%），其次是乳糜泻（20%），显微镜下结肠炎和功能性腹泻并列第三（均为12%），阿米巴病是第五大病因（10%），随后是结肠癌（6%）、克罗恩病（2%）、糖尿病性腹泻（2%）和甲状腺毒症（2%）。对于超过70%的溃疡性结肠炎、乳糜泻、显微镜下结肠炎、结肠癌和克罗恩病病例，内镜检查（食管十二指肠镜检查、乙状结肠镜检查和结肠镜检查）并活检是最有效的诊断方法。
本研究揭示了病史采集、体格检查以及合理有序地运用各项检查尤其是内镜检查程序对于发现慢性腹泻病因的重要性。慢性血性腹泻应高度怀疑溃疡性结肠炎。本研究中相当一部分慢性腹泻患者被发现患有显微镜下结肠炎。
