Stool Osmolar/Osmotic Gap
Determines if chronic diarrhea is osmotic or secretory in nature.
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!