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Spectrum of chronic small bowel diarrhea with malabsorption in Indian subcontinent: is the trend really changing?
- Source :
- Intestinal Research, Vol 14, Iss 1, Pp 75-82 (2016), Intestinal Research
- Publication Year :
- 2016
- Publisher :
- Korean Association for the Study of Intestinal Diseases, 2016.
-
Abstract
- Background/Aims: This study aimed to document the recent etiological spectrum of chronic diarrhea with malabsorption and also to compare features that differentiate tropical sprue from parasitic infections, the two most common etiologies of malabsorption in the tropics. Methods: We analyzed 203 consecutive patients with malabsorption. The etiological spectrum and factors that differentiated tropical sprue from parasitic infections were analyzed. Results: The most common etiology was tropical sprue (n=98, 48.3%) followed by parasitic infections (n=25, 12.3%) and tuberculosis (n=22, 10.8%). Other causes were immunodeficiency (n=15, 7.3%; 12 with human immunodeficiency virus and 3 with hypogammaglobulinemia), celiac disease (n=11, 5.4%), Crohn’s disease (n=11, 5.4%), small intestinal bacterial overgrowth (n=11, 5.4%), hyperthyroidism (n=4, 1.9%), diabetic diarrhea (n=4, 1.9%), systemic lupus erythematosus (n=3, 1.4%), metastatic carcinoid (n=1, 0.5%) and Burkitt’s lymphoma (n=1, 0.5%). On multivariate analysis, features that best differentiated tropical sprue from parasitic infections were larger stool volume (P =0.009), severe weight loss (P =0.02), knuckle hyperpigmentation (P =0.008), low serum B12 levels (P =0.05), high mean corpuscular volume (P =0.003), reduced height or scalloping of the duodenal folds on endoscopy (P =0.003) and villous atrophy on histology (P =0.04). Presence of upper gastrointestinal (GI) symptoms like bloating, nausea and vomiting predicted parasitic infections (P =0.01). Conclusions: Tropical sprue and parasitic infections still dominate the spectrum of malabsorption in India. Severe symptoms and florid malabsorption indicate tropical sprue while the presence of upper GI symptoms indicates parasitic infections. (Intest Res 2016;14:75-82)
- Subjects :
- 0301 basic medicine
Tropical sprue
medicine.medical_specialty
Malabsorption
Parasitic infections
030106 microbiology
lcsh:Medicine
Gastroenterology
Sprue
Hypogammaglobulinemia
03 medical and health sciences
0302 clinical medicine
Bloating
Internal medicine
Small intestinal bacterial overgrowth
medicine
lcsh:RC799-869
Immunodeficiency
business.industry
lcsh:R
medicine.disease
Diarrhea
Sprue, tropical
B12 deficiency
Original Article
030211 gastroenterology & hepatology
lcsh:Diseases of the digestive system. Gastroenterology
medicine.symptom
business
Villous atrophy
Subjects
Details
- Language :
- English
- ISSN :
- 22881956 and 15989100
- Volume :
- 14
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Intestinal Research
- Accession number :
- edsair.doi.dedup.....6a25f0d860e4c2ff0bb5f3ba0e0a65cf