🔄 Chronic Diarrhea · Malabsorption & Inflammatory Bowel Tool

Schwartz Clinical Handbook -- Chapter 28 · Celiac disease · Toddler's diarrhea · IBD · Giardia · CF · Food protein allergy · PLE

Select stool pattern (>2‑3 weeks), growth parameters, abdominal pain, perianal disease, extraintestinal signs, and lab clues → differentiate toddler's diarrhea, celiac disease, IBD, giardia, cystic fibrosis, food allergy, and protein‑losing enteropathy.
⚠️ Red flags: weight loss, perianal disease, nocturnal diarrhea, occult blood → prompt endoscopic evaluation.

📋 Step 1 -- Chronic diarrhea & associated features
📌 Diagnostic impressions
📖 Schwartz Ch 28

Select stool consistency (loose, greasy, bloody), growth (FTT, weight loss), perianal disease, extra‑intestinal signs (rash, arthritis), and age → system suggests toddler's diarrhea, celiac disease, IBD (Crohn/UC), cystic fibrosis, giardia, or food protein allergy, and recommends labs (fecal calprotectin, celiac panel, sweat test, endoscopy).

✔️ Toddler's diarrhea: age 6‑36 months, thriving, undigested food fragments.
✔️ Celiac: diarrhea, FTT, iron deficiency, high anti‑tTG.
✔️ IBD: bloody stools, perianal disease, weight loss, elevated CRP/ESR.
✔️ CF: greasy stools, failure to thrive, recurrent respiratory infections.
📘 Schwartz pearls (Chapter 28)
• Toddler's diarrhea: manage with increased fat/fiber, limit fruit juice.
• Celiac disease: biopsy while on gluten‑containing diet; IgA deficiency screen.
• Stool calprotectin >200 μg/g suggests IBD.
• PLE: stool α1‑antitrypsin elevated; consider lymphangiectasia.