Johnson D A, Cattau E L
Am Fam Physician. 1986 May;33(5):131-4.
In approaching the differential diagnosis of unexplained diarrheal disorders, separation of osmotic and secretory causes is important. The osmotic gap between measured stool osmolality and osmolality calculated from stool sodium and potassium concentrations is low in secretory diarrhea and high in osmotic diarrhea. Cholera, villous adenoma and bile salts are among the causes of secretory diarrhea. Causes of osmotic diarrhea include monosaccharidase deficiency, disaccharidase deficiency, excessive use of sugar-free gum and excessive ingestion of magnesium antacids.
在对不明原因的腹泻性疾病进行鉴别诊断时，区分渗透性和分泌性病因很重要。在分泌性腹泻中，测得的粪便渗透压与根据粪便钠和钾浓度计算出的渗透压之间的渗透间隙较低，而在渗透性腹泻中则较高。霍乱、绒毛状腺瘤和胆盐是分泌性腹泻的病因。渗透性腹泻的病因包括单糖酶缺乏、双糖酶缺乏、过量食用无糖口香糖以及过量摄入镁抗酸剂。
