Determinants of decreased fecal consistency in patients with diarrhea

doi:10.1016/0016-5085(95)90134-5

Gastroenterology

Volume 108, Issue 6, June 1995, Pages 1729-1738

https://doi.org/10.1016/0016-5085(95)90134-5 Get rights and content

Abstract

$Background/Aims :$ Loose stools are a common and troublesome feature in diarrhea. The purpose of this study was to investigate factors that determine different degrees of stool looseness in diarrhea. $Methods :$ Fecal consistency was measured visually. Stools were analyzed for content of water and solids. Water-holding capacity of insoluble solids was measured in vitro. $Results :$ Formed stools from normal subjects had a near constant ratio of water to solids despite a sevenfold variation in daily stool weight. In diarrhea, loose consistency was correlated directly with percent fecal water. For any level of percent water, steatorrhea stools were looser than nonsteatorrhea stools. Ingestion of psyllium reduced stool looseness without changing the percent water. Both the effect of fat and psyllium could be explained by consideration of the ratio of fecal water to water-holding capacity of insoluble solids. $Conclusions :$ (1) The normal intestine delivers stools that differ widely in quantity but maintains percent fecal water within a narrow range. (2) Stool looseness in diarrhea is determined by the ratio of fecal water to water-holding capacity of insoluble solids. (3) In patients with diarrhea with normal stool weight, loose stools are due to low output of insoluble solids without the concomitant reduction in water output that occurs in normal subjects when insoluble solids are low.

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^☆: Supported by U.S. Public Health Service grant 5-R01-DK37172-05 from the National Institute of Diabetes and Digestive and Kidney Diseases and the Southwest Digestive Disease Foundation. Dr. Wenzl is supported by an F. Johann Kwizda-Forschungsstipendium from the Austrian Gesellschaft fur Gastroenterologie und Hepatologie.

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Alimentary tractDeterminants of decreased fecal consistency in patients with diarrhea☆

Abstract

Am J Clin Nutr

Gastroenterology

Am J Clin Nutr

Am J Clin Nutr

Gastroenterology

Am J Med

Gastroenterology

Gastroenterology

Evaluation of patients with chronic diarrhea

N Engl J Med

Basic investigation of a patient with diarrhea

Diarrhea and constipation

Small intestinal disorders—general considerations

Correlation of radioactive and chemical fecal fat determinations in various malabsorption syndromes

Am J Med

Effect of psyllium, calcium polycarbophil and wheat bran on secretory diarrhea induced by phenolphthalein

Gastroenterology

The effect of dietary fat on fecal fat excretion and subjective symtoms in man

Gastroenterology

Fat absorption and malabsorption

Arch Intern Med

Observations on the faecal excretion of total solids, nitrogen, sodium, potassium, water and fat in the steatorrhoea syndrome

Clin Sci

Total fecal solids, fat and nitrogen. IV. A study of patients with chronic relapsing pancreatitis

Gastroenterology

Alimentary tract
Determinants of decreased fecal consistency in patients with diarrhea☆