慢性腹泻诊治的临床思维

Clinical thinkings on the diagnosis and treatment of chronic diarrhea

慢性腹泻是消化系统疾病常见的临床症状,其病因多且复杂,依据病因分为肠道感染、肠道非特异性炎症、小肠吸收不良、肿瘤及功能性肠病等。慢性腹泻的病因诊断需依据所收集到的临床资料,通过正确、合理的临床思维进行综合分析,做出病因诊断。积极治疗引起腹泻的原发疾病是慢性腹泻的基本治疗原则,通过对原发疾病的有效治疗,纠正腹泻症状。

Chronic diarrhea is a common gastrointestinal symptom of various and complicated causes. The etiologies include intestinal infection, nonspecific intestinal inflammation, malabsorption, neoplasm, functional intestinal disorders and systemic diseases. Chronic diarrhea can be divided pathophysiologically into exudative, secretory, osmotic, malabsorptive and dysnlotility-associated. To make a definitive etiological diagnosis,we need reasonable and logical thinking on the overall clinical data （history, careful physical examination, and certain screening and laboratory examinations）. Treatment aimed at the etiology is the fundamental therapy for chronic diarrhea and effective therapy on the primary disease is crucial to alleviate the symptoms.