Interpretation of Guidelines for the Investigation of Chronic Diarrhoea in Adults: British Society of Gastroenterology in 2018

doi:10.12114/j.issn.1007-9572.2020.00.432

Abstract

Abstract: The 3rd edition of the Guidelines for the Investigation of Chronic Diarrhoea in Adults was published online in Gut by the British Society of Gastroenterology in April 2018，which updated the 2nd edition of the guidelines in 2003. This new edition of the guidelines describes the clinical assessment process，tumor and inflammation assessment，malabsorption test，and the management of common causes，structural/surgical causes and rare causes in chronic diarrhoea. Based on the updated contents of this guideline，this paper discusses the common misunderstandings in the diagnosis and treatment of adult chronic diarrhoea，including incomplete collection of medical history and difficulty in etiological diagnosis；failure to consider bile acid diarrhoea as a common cause of chronic diarrhoea；delayed diagnosis and treatment of celiac disease；failure to take biopsy in colonoscopy；missed diagnosis of colorectal cancer in young patients with chronic diarrhoea；non identification of overflow diarrhoea in the elderly；lack of awareness of the clinical significance of intestinal bacterial overgrowth detection method，and the corresponding countermeasures are proposed.

Key words: Diarrhoea, Adults, Guideline, Interpretation

摘要： 2018年4月英国胃肠病学会（BSG）在Gut上发表了第3版《成人慢性腹泻的调查指南》，对2003年第2版指南进行了更新，新版指南对慢性腹泻的临床评估流程、肿瘤和炎症评估、吸收不良的检测，以及常见病因、结构性/手术病因、少见病因的管理等方面进行阐述。本文结合此指南更新内容探讨成人慢性腹泻诊疗中的常见误区，包括：病史采集不全面，病因诊断困难；未把胆汁酸性腹泻作为慢性腹泻的常见病因考虑；乳糜泻诊治延迟；结肠镜检查不取活检；年轻慢性腹泻患者中漏诊结直肠癌；对老年人溢出性腹泻不识别；对小肠细菌过度生长检测方法的临床意义认知不足，针对这些误区给出相应的应对策略。

关键词: 腹泻, 成年人, 指南, 解读

ZHU Xinying,ZHAO Dongqiang. Interpretation of Guidelines for the Investigation of Chronic Diarrhoea in Adults: British Society of Gastroenterology in 2018　[J]. Chinese General Practice, 2021, 24(7): 780-783. DOI: 10.12114/j.issn.1007-9572.2020.00.432.
朱新影,赵东强. 2018年英国胃肠病学会《成人慢性腹泻的调查指南》解读[J]. 中国全科医学, 2021, 24(7): 780-783. DOI: 10.12114/j.issn.1007-9572.2020.00.432.

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