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osmotic diarrhea
Etiology:
- lactase deficiency (most common)
- may occur secondary to recent food poisoning or gastroenteritis
- fructose malabsorption
Clinical manifestations:
- associated with eating
- responds to fasting
- generally, not nocturnal
- lesser stool volumes than secretory diarrhea (< 1 L/day)
Laboratory:
- stool osmolality > 340 mOsm/kg
- fecal osmotic gap > 100 mOsm/kg
Management:
- withdrawal of osmotically active agent
- lactase deficiency: avoid lactose
- - fructose malabsorption: avoid fructose
General
diarrhea
References
- Medical Knowledge Self Assessment Program (MKSAP) 14, 16, 18, 19.
American College of Physicians, Philadelphia 2006, 2012, 2018, 2021.