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| CASE REPORT |
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| Year : 2022 | Volume
: 68
| Issue : 4 | Page : 239-242 |
Chronic diarrhea - The poetic masquerade
S Bhattacharjee1, I Siyad2, BV Maramattom3
1 Department of Internal Medicine, Aster Medcity, Kochi, Kerala, India
2 Department of Medical Gastroenterology, Aster Medcity, Kochi, Kerala, India
3 Department of Neurology, Aster Medcity, Kochi, Kerala, India
Correspondence Address:
S Bhattacharjee
Department of Internal Medicine, Aster Medcity, Kochi, Kerala
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jpgm.jpgm_1169_21
Chronic diarrhea, by definition, is the passage of loose/liquid stools, with increased frequency (more than three times/day), or an output of over 200 g/day, lasting for a duration of four or more weeks. The clinical approach to identify the cause of chronic diarrhea generally depends on the local socioeconomic status. In high-income countries, systemic causes such as irritable bowel syndrome (IBS), inflammatory bowel disease, malabsorption syndromes (lactose intolerance/coeliac disease) are primarily considered. In mid- to low-income countries, infective causes like chronic bacterial, mycobacterial, fungal infections, HIV, bowel cancer are considered before systemic causes/malabsorption syndromes. Amyloidosis, more accurately, reactive amyloidosis is one of the rarer causes of chronic/persistent diarrhea. Inflammatory colitis secondary to POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) as a cause for chronic diarrhea has been reported only in a handful of cases and is often missed. We present such a case of chronic diarrhea in a middle-aged man, who was eventually diagnosed to have POEMS syndrome.
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