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Year : 2022  |  Volume : 68  |  Issue : 4  |  Page : 239-242

Chronic diarrhea - The poetic masquerade

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
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jpgm.jpgm_1169_21

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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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Online since 12th February '04
2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow