MDCalc

Stool Osmolar/Osmotic Gap

Determines if chronic diarrhea is osmotic or secretory in nature.

Result:

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Advice
  • Osmotic diarrhea is generally treated by avoidance of the offending agent.
  • Treatment for secretory diarrhea is targeted at and specific to the underlying cause.
Management

Symptom management is also dependent on the underlying cause. Some options include:

  • Increasing dietary fiber
  • Low FODMAP (Fermentable Oligo-Di-Monosaccharides and Polyols) diet
  • Active culture yogurt and probiotics
  • Bile acid resins (cholestyramine)
  • Bismuth
  • Anticholinergics
  • Empiric antibiotics (metronidazole, rifaximin)
  • Antimotility agents (loperamide, diphenoxylate/atropine, codeine); must rule out infection first!