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Differentiation of osmotic and secretory diarrhoea by stool carbohydrate and osmolar gap measurements

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dc.contributor.author Castro-Rodriguez, José Antonio
dc.contributor.author Salazar Lindo, Eduardo
dc.contributor.author Leon Barua, Raúl
dc.date.accessioned 2022-10-09T22:16:53Z
dc.date.available 2022-10-09T22:16:53Z
dc.date.issued 1997
dc.identifier.uri https://hdl.handle.net/20.500.12866/12307
dc.description.abstract Clinical features and laboratory tests that determine carbohydrate in faeces were evaluated to determine which was best able to distinguish between osmotic and secretory diarrhoea in infants and children. For this purpose 80 boys aged 3 to 24 months, with acute watery diarrhoea, were studied prospectively. The faecal osmolar gap (FOG) was calculated as: serum osmolarity-[2 x (faecal sodium + potassium concentration)]. Fifty eight patients were classified as having predominantly osmotic diarrhoea (FOG > 100 mosmol/l), and 22 as having predominantly secretory diarrhoea (FOG < or = 100 mosmol/l). The two groups were comparable in their clinical features on admission, in the results of blood and urine tests, and in the evolution of their diarrhoeal illness. Evidence of steatorrhoea (by positive Sudan III test) and of acid faecal pH on admission were significantly more frequent in patients with osmotic diarrhoea. Mean (SD) faecal osmolarity was not significantly different between the two groups (319 (80) mosmol/l in secretory diarrhoea v 361 (123) mosmol/l in osmotic diarrhoea). Tests for reducing substances in faeces such as Benedict's test--with and without hydrolysis--and glucose strip, all showed a positive and significant association with osmotic diarrhoea (p < 0.05, < 0.025, < 0.05, respectively). The presence of excess reducing substances (Benedict's test with hydrolysis > 2+) on admission was the most sensitive and specific test with the best predictive value for differentiating between the two types of watery diarrhoea. en_US
dc.language.iso eng
dc.publisher BMJ Publishing Group
dc.relation.ispartofseries Archives of Disease in Childhood
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject diarrhoea en_US
dc.subject faecal osmolar gap en_US
dc.subject carbohydrate malabsorption en_US
dc.title Differentiation of osmotic and secretory diarrhoea by stool carbohydrate and osmolar gap measurements en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1136/adc.77.3.201
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.03
dc.relation.issn 1468-2044


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