Talal A H, Murray J A
University of North Carolina, Chapel Hill.
Postgrad Med. 1994 Sep 1;96(3):30-2, 35-8, 43 passim.
Diagnosing a cause of diarrhea is a challenging undertaking but can be accomplished if a systematic approach is used for evaluation. Pathophysiologic mechanisms of acute diarrhea (eg, Giardia lamblia infection, antibiotic use) are different from those of chronic diarrhea (eg, secretory dysfunction from thyrotoxicosis, lactose or fructose intolerance), so adequate history taking and physical examination are essential in narrowing the diagnosis. Laboratory investigation can then be directed using the information obtained, and the cause of the diarrhea can be established without subjecting the patient to extensive and expensive testing. Undoubtedly, some functional entities that contribute to diarrhea await discovery.
诊断腹泻的病因是一项具有挑战性的工作，但如果采用系统的评估方法，是可以完成的。急性腹泻的病理生理机制（如贾第虫感染、使用抗生素）与慢性腹泻（如甲状腺毒症引起的分泌功能障碍、乳糖或果糖不耐受）不同，因此充分的病史采集和体格检查对于缩小诊断范围至关重要。然后可以根据获得的信息进行实验室检查，在不使患者接受广泛且昂贵检查的情况下确定腹泻的病因。毫无疑问，一些导致腹泻的功能性病因仍有待发现。
