Matuchansky C
Rev Prat. 1989 Dec 11;39(29):2590-4.
This article describes the clinical approach to the aetiological diagnosis of chronic diarrhoea in adults, with a rational ranking of investigations starting with methodical questioning and careful physical examination. The purpose of the clinical stage is to find out whether the diarrhoea is truly chronic--and not the paradoxical diarrhoea so common in constipated subjects--, to evaluate its repercussions on nutrition and hydration, to try and determine its type (malabsorption or watery diarrhoea) and to elicit an obvious or probable cause. The paraclinical stage includes screening or confirmatory examinations separating watery diarrhoeas (due to colonic hypermotility or secretory of organic origin--mainly colonic, humoral or neurological--or functional origin) from malabsorption diarrhoeas; concerning the latter, the use respiratory tests with hydrogen is emphasized and conventional tests (D-xylose, assay of faecal fats and nitrogen) are mentioned.
本文介绍了成人慢性腹泻病因诊断的临床方法，并对检查进行了合理排序，首先是有条不紊的问诊和仔细的体格检查。临床阶段的目的是确定腹泻是否真的是慢性的，而不是便秘患者中常见的矛盾性腹泻，评估其对营养和水合作用的影响，尝试确定其类型（吸收不良或水样腹泻），并找出明显或可能的病因。辅助检查阶段包括筛查或确诊检查，将水样腹泻（由于结肠运动亢进或源于有机物质的分泌性腹泻——主要是结肠、体液或神经性腹泻，或功能性腹泻）与吸收不良性腹泻区分开来；对于后者，重点强调了使用氢呼吸试验，并提及了传统检查（D-木糖、粪便脂肪和氮测定）。
