Investigation of chronic diarrhoea

Chronic diarrhoea is a symptom complex with a wide range of aetiologies. A logical approach is essential in planning investigations to minimise invasiveness to the child and maximise diagnostic yield. This review discusses various investigations used in the work up of chronic diarrhoea. The differential diagnoses vary markedly with age. Helpful diagnostic clues may be obtained with history, examination and some basic investigations. Stool microbiology should be taken into consideration in all cases. Specific investigations should be carried out when a specific diagnosis is suspected. Despite extensive investigations, a specific diagnosis may still not be identified in up to one-third of patients. Whatever the aetiology, provision of adequate hydration and nutrition by enteral and/or parenteral route to sustain life, growth and development is most important and should not be overlooked.