Recommendations for the diagnosis and management of patients with chronic idiopathic diarrhea: Belgian multidisciplinary expert discussion based on a modified Delphi method.
T Vanuytsel, J Arts, V Casneuf, F de Clerck, D De Looze, H Deschepper, K Geboes, M Hiele, T Holvoet, H Louis, S Kindt, P Latour, F Mokaddem, S Nullens, H Piessevaux, M Surmont, J Tack, R Bisschops
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引用次数: 0
Abstract
Background: Chronic diarrhea is one of the more common reasons for referral to a gastro-enterologist. Chronic diarrhea can have a broad range of causes, making it a disease entity with a very extensive differential diagnosis. In a proportion of patients, however, a cause for the chronic diarrhea cannot be found and these patients are said to have chronic idiopathic diarrhea (CID).
Methods: A Delphi model was used to establish a diagnostic strategy for patients presenting with chronic diarrhea that maximizes the chance for a positive diagnosis while minimizing the number and invasiveness of the investigations. In addition, the participating experts sought consensus on the different treatment options that can be used in these patients.
Results: While a general consensus was reached on the required diagnostic tests for CID, marked differences were observed on the treatment preferences and strategies for these patients among the different experts. The main reason for this is the lack of solid scientific evidence with the different treatment options in this setting (i.e., most data have been generated in patients with IBS-D).
Conclusion: the Delphi-like process that was used for this initiative proved to be a useful vehicle to fuel discussions on the management of CID among experts with different backgrounds and to sketch the current clinical practice.
期刊介绍：
The Journal Acta Gastro-Enterologica Belgica principally publishes peer-reviewed original manuscripts, reviews, letters to editors, book reviews and guidelines in the field of clinical Gastroenterology and Hepatology, including digestive oncology, digestive pathology, as well as nutrition. Pure animal or in vitro work will not be considered for publication in the Journal. Translational research papers (including sections of animal or in vitro work) are considered by the Journal if they have a clear relationship to or relevance for clinical hepato-gastroenterology (screening, disease mechanisms and/or new therapies). Case reports and clinical images will be accepted if they represent an important contribution to the description, the pathogenesis or the treatment of a specific gastroenterology or liver problem. The language of the Journal is English. Papers from any country will be considered for publication. Manuscripts submitted to the Journal should not have been published previously (in English or any other language), nor should they be under consideration for publication elsewhere. Unsolicited papers are peer-reviewed before it is decided whether they should be accepted, rejected, or returned for revision. Manuscripts that do not meet the presentation criteria (as indicated below) will be returned to the authors. Papers that go too far beyond the scope of the journal will be also returned to the authors by the editorial board generally within 2 weeks. The Journal reserves the right to edit the language of papers accepted for publication for clarity and correctness, and to make formal changes to ensure compliance with AGEB’s style. Authors have the opportunity to review such changes in the proofs.
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