Center for Digestive Diseases

UNM Hospitals Center
for Digestive Diseases

1001 Martin Luther King Ave. NE
Albuquerque, New Mexico 87106

(505)272-2530 or

UNMH: (505)272-6839
CDD: (505)925-7849

Chronic Diarrhea

What is chronic diarrhea?

Chronic diarrhea is loose watery stools that last at least four weeks.   These symptoms may be constant or may come and go.  Diarrhea may cause dehydration or electrolyte abnormalities.

What causes diarrhea?

Many conditions can cause chronic diarrhea, including intake of poorly absorbed foods (lactose intolerance), celiac disease, medications, inflammatory bowel disease (crohn’s disease and ulcerative colitis), irritable bowel disease, microscopic colitis (inflammation of the colon) infections and small intestinal bacterial overgrowth.    

How is diarrhea evaluated?

Obtaining a careful clinical history and performing a physical examination is the first step in evaluating diarrhea.  Your doctor may order stool tests to determine if there is a bacterial or parasitic infection, colonoscopy with colon biopsies to evaluate for microscopic colitis or possible inflammatory bowel disease.  Blood test scan evaluate for possible celiac disease.  An elimination diet can rule out lactose or fructose intolerance.  Alternatively, specialized breath tests can evaluate for lactose or fructose intolerance.  Small intestinal bacterial overgrowth can also be evaluated by lactulose breath test.

What is the treatment for diarrhea?

Depending on the cause of diarrhea the treatment may involve antibiotics, avoiding lactose or fructose, medications that treat inflammatory bowel disease, steroids or anti-diarrheal medications.  Infections are treated with targeted antibiotics.  Small intestinal bacterial overgrowth is also treated with antibiotics. Dietary recommendations in order to avoid lactose or fructose may be provided.  For treatment of inflammatory bowel disease, see “crohn’s disease” and “ulcerative colitis” under the “about your diagnosis” tab.  Microscopic colitis is treated with steroids (usually budesonide) or anti-inflammation medications (such as mesalamine).  Antidiarrheal medications may include:  diphenoxylate (Lomotil), loperamide (Immodium), and codeine.