Chronic Diarrhea: Causes and When to See a Gastroenterologist

Most diarrhea clears up within a few days. Diarrhea that lasts more than four weeks is called chronic diarrhea and usually has a specific, treatable cause.

Common causes

• Irritable bowel syndrome (IBS) with diarrhea
• Food intolerances, such as lactose or certain sugars
• Microscopic colitis
• Celiac disease
• Ulcerative colitis and Crohn's disease
• Small intestinal bacterial overgrowth (SIBO)
• Infections, including C. difficile after antibiotics
• Medicines such as metformin, magnesium, and some antibiotics
• Bile acid diarrhea, often after gallbladder removal
• Problems absorbing fat, such as from the pancreas

Warning signs

• Blood in the stool
• Weight loss
• Diarrhea that wakes you up at night
• Fever or anemia
• A family history of colon cancer, celiac disease, or IBD

Evaluation

We review your diet, medicines, and history, then use blood and stool tests. Many patients need a colonoscopy with biopsies, because microscopic colitis can only be seen under the microscope. Celiac blood tests, breath tests, or imaging may also be ordered.

Treatment

Treatment depends on the cause, from diet changes and stopping a medicine to targeted treatment for celiac disease, IBD, microscopic colitis, or bacterial overgrowth. Stay well hydrated while symptoms continue.

Make an appointment

Our gastroenterologists in Temple City care for patients from Arcadia, San Gabriel, Pasadena, Monrovia, Monterey Park, and across the San Gabriel Valley. We accept most PPO plans (see accepted insurances), and our doctors speak English, Vietnamese, and Mandarin. Schedule an appointment or call 626-898-4560.

This article is for general education and is not a substitute for medical advice. Talk with your doctor about your own health.