Calc Function

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    Stool Osmolar/Osmotic Gap

    Determines if chronic diarrhea is osmotic or secretory in nature.
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    When to Use
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    mEq/L
    mEq/L
    mOsm/kg

    Result:

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    Evidence
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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!
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