Clinical Characteristics And Etiology Analysis Of 276 Cases Of Chronic Diarrhea

Objective: The causes of chronic diarrhea are numerous,the pathogenesis is complex,and multiple system diseases can cause diarrhea.This paper retrospectively analyzes the clinical features and causes of patients with chronic diarrhea in the Department of Gastroenterology,the Second Hospital of Tianjin Medical University in recent 5 years.It aims to increase the understanding of chronic diarrhea,identify the cause early,formulate a reasonable treatment plan and improve cure rate.Methods: A retrospective study was conducted to analyze the complete clinical data of 276 patients with chronic diarrhea admitted to the Department of Gastroenterology in our hospital from January 2013 to January 2018.The clinical characteristics were analyzed and divided into young and middle-aged group and elderly group according to age and compare the clinical characteristics and etiology of diarrhea in different age groups.In this study SPSS22.0 was used for statistical analysis,the count data that conforms to a normal distribution is expressed as mean ± standard deviation,two independent sample t-tests were used for comparison between the two groups,variance analysis was used for comparison between groups.the count data was analyzed by chi-square test.P < 0.05 indicated that the difference was statistically significant.Result: 1.Among the 276 cases of chronic diarrhea,157(56.9%)were male,119(43.1%)were female,and the ratio of male to female was 1.32:1;the medical history ranged from 2 months to 40 years;the number of stools varies from 4 to 20 times;173 cases(62.7%)were in the young and middle-aged group(<65y),103 cases(37.3%)were in the elderly group(≥65y);the mean age of the young and middle-aged group was(50.8±11.7)years and the elderly group was(74.7±7.4)years.2.Among the 276 cases of chronic diarrhea,9 cases of previous tuberculosis,all of which were old tuberculosis and 45 cases of diabetes;60 cases of previous abdominal surgery,18 cases of food allergies;4 cases of antibiotics history,10 cases of special medicine history;11 cases of radiotherapy and chemotherapy.Smoking 109 cases,drinking 67 cases,2 cases of travel history before onset,28 cases of unclean diet,and 26 cases of family history of digestive tract diseases.3.Among the 276 cases of chronic diarrhea,216 cases(78.3%)were watery diarrhea,55 cases(19.9%)were inflammatory diarrhea,5 cases(1.8%)were steatorrhea.4.Among the 276 cases of chronic diarrhea,the accompanying symptoms included 156 cases(56.5%)of abdominal pain,137 cases(49.6%)of weight loss,and 61 cases(22.1%)of urgency,other symptoms include bloating,gastrointestinal bleeding,fever,vomiting,rash,joint pain,and abdominal mass.5.The analysis of 276 cases of chronic diarrhea showed that the differences of Hb,TP,ALB,A/G,Na and BUN between the young and middle-aged group and elderly group were statistically significant(P<0.05).6.Among the 276 cases of chronic diarrhea,treated with antibiotics were 56 cases(20.3%),hormones were 28 cases(10.1%),microecological preparations were 195 cases(70.7%),antidiarrheal drugs were 46 cases(16.7%),antispasmodic drugs(including atropine and anisodamine)were 27 cases(9.8%).7.Among the 276 cases of chronic diarrhea,33 cases(12.0%)were cured,186 cases(67.3%)were improved,56 cases(20.3%)were unhealed,1 cases(0.4%)was died,and the total effective rate was 79.3%.8.Among the 276 cases of chronic diarrhea,the top 5 causes were ulcerative colitis in 48 cases(17.4%),intestinal flora imbalance in 33 cases(12.0%),colorectal cancer in 32 cases(11.6 %),14 cases(5.1%)after cholecystectomy,Crohn’s disease in 9 cases(3.3%).The cause of the young and middle-aged group is mainly ulcerative colitis,and the cause of the elderly group is mainly colorectal cancer.Conclusion: The clinical manifestations of chronic diarrhea cases vary widely,the cause,clinical symptoms,laboratory indicators,treatment response,return varied with age.The etiology and pathogenesis of chronic diarrhea is complicated.In this study the main causes are ulcerative colitis,intestinal flora imbalance,colorectal cancer,cholecystectomy and Crohn’s disease,etc.Among them,the young and middle-aged group mainly were ulcerative colitis,and the elderly group mainly were colorectal cancer.