Published 14 July 2008, doi:10.1136/bmj.39490.625197.BE
Cite this as: BMJ 2008;337:a430

Practice

10-Minute Consultation

Chronic diarrhoea in a teenager

Sonia Saxena, senior lecturer and honorary consultant in primary care1, Sally G Mitton, consultant and honorary senior lecturer in paediatric gastroenterology2, Richard Pollok, consultant and honorary senior lecturer in gastroenterology3

1 Department of Primary Care and Social Medicine, Imperial College London W6 8RP, 2 Department of Child Health, St George’s University London, London SW17 0RE, 3 Department of Gastroenterology, St George’s Hospital Trust, London SW17 0QT

Correspondence to: S Saxena s.saxena@imperial.ac.uk

The first 150 words of the full text of this article appear below.

A 14 year old boy has a three year history of loose stools with intermittent abdominal pain. He is the smallest boy in his class.

Chronic diarrhoea is defined as >3 loose or liquid stools a day, lasting more than three weeks. This may indicate an underlying non-infectious diagnosis, such as coeliac or inflammatory bowel disease, particularly if accompanied by delayed development or growth retardation. A key consideration is whether the boy’s gastrointestinal symptoms and growth are pathological, and if so, whether they are related. Since issues around puberty and diarrhoea may be embarrassing for him, it may be better to conduct the consultation without his mother present.

Ask about consistency and frequency of diarrhoea. Paleness and foul smell with residual fat droplets in the toilet water suggests fat malabsorption. Blood in the stool may occur with infection or inflammatory bowel disease. Mucus and pus are more likely with inflammatory . . . [Full text of this article]


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Rapid Responses:

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chronic diarrhoea in a teenager- more history and investigations?
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bmj.com, 28 Sep 2008 [Full text]
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