A Prospective Study of Persistent Diarrhoea

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Abstract
A prospective study was undertaken in 100 patients with diarrhea to identify the causes and to better define the prevalence of irritable bowel syndrome (IBS) and to determine if there was a diagnostic symptom complex evident in patients with IBS. A diagnosis of IBS was made in 28 patients and in this group the prevalence of lactase deficiency was 40%. Pain in association with urgency was usual and urgency occurring in the absence of pain was more likely to be found in association with an organic colonic lesion. The 2 most important symptoms which distinguish IBS from other causes were blood in the motions and weight loss. Giardia lamblia were found in 9 patients and 15 patients responded to an empirical course of either metronidazole or tinidazole, without a positive diagnosis of giardiasis being made. Fourteen patients had inflammatory bowel disease and a variety of drugs was responsible for diarrhea in 10% of patients. Sigmoidoscopy and small bowel biopsy were the most valuable diagnostic investigations.

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