Radiation Enteritis: Or something else? Differential Diagnosis

Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99).

  • Abetalipoproteinemia (synonym: homozygous familial hypobetalipoproteinemia, ABL/HoFHBL) – genetic disorder with autosomal recessive inheritance; severe form of familial hypobetalipoproteinemia characterized by deficiency of apolipoprotein B48 and B100; defect in the formation of chylomicrons leading to fat digestion disorders in children, resulting in malabsorption (disorder of food absorption).
  • Cronkhite-Canada syndrome (CCS) – gastrointestinal polyposis syndrome (polyps in the gastrointestinal tract), which, in addition to the clustered occurrence of intestinal polyps, leads, among other things, to changes in the skin and skin appendages such as alopecia (hair loss), hyperpigmentation and nail formation disorders; Symptoms do not appear until after the age of fifty; initial symptoms include watery diarrhea (diarrhea), loss of taste and appetite, abnormal weight loss, and hypoproteinemia (decreased levels of proteins in the blood); sporadic occurrence

Blood, blood-forming organs – immune system (D50-D90).

  • Hypogammaglobulinemia – deficiency of immunoglobulins characterized by immunodeficiencies.

Endocrine, nutritional and metabolic diseases (E00-E90).

  • Abetalipoproteinemia – rare, autosomal recessive disorder of lipid metabolism characterized by deficiency of apolipoprotein B48 and B100; this leads to malabsorption (disorder of food absorption).
  • Amyloidosis – extracellular (“outside the cell”) deposits of amyloids (degradation-resistant proteins) that can lead to cardiomyopathy (heart muscle disease), neuropathy (peripheral nervous system disease), and hepatomegaly (liver enlargement), among other conditions.
  • Diabetes mellitus
  • Disaccharidase deficiency – deficiency of the enzyme that cleaves the two-saccharides.
  • Hyperthyroidism (hyperthyroidism).
  • Lactose intolerance (lactose intolerance) – congenital or acquired metabolic disorder that makes lactose cleavage impossible.
  • Addison’s disease – primary adrenocortical insufficiency (adrenal insufficiency), which leads to a failure of cortisol and aldosterone production.
  • Cystic fibrosis (ZF) – genetic disease with autosomal recessive inheritance, characterized by the production of secretions in various organs to be tamed.

Cardiovascular system (I00-I99).

  • Lymphatic drainage disorders from the gastrointestinal tract, especially after trauma or infection

Infectious and parasitic diseases (A00-B99).

  • Bacterial infections – mainly caused by the bacteria Staphylococcus aureus, Campylobacter and Salmonella.
  • Lamblia-induced diarrhea – diarrheal disease caused by the protozoan Giardia lamblia.
  • Legionellosis – infectious disease caused by the bacterium Legionella pneumophila, usually occurring in late summer and autumn; symptoms are mainly pneumonias (lung infections).
  • Listeriosis – infectious disease caused by the bacterium Listeria monocytogenes and manifests itself mainly in weakened immune systems.
  • Opportunistic infection in HIV or other immunosuppressive diseases.
  • Pseudomembranous enterocolitis/pseudomembranous colitis – inflammation of the mucous membrane of the large intestine, which usually occurs after taking antibiotics; the cause is an overgrowth of the intestine with the bacterium Clostridium difficile.
  • Toxic-shock syndrome (TSS) – serious infectious disease caused by enterotoxin of the bacterium Staphylococcus aureus; it has been observed mainly during the use of tampons, but also after surgical wound infections
  • Viral hepatitis (inflammation of the liver).
  • Viral infection – especially with rotavirus.

Liver, gallbladder and bile ducts – pancreas (pancreas) (K70-K77; K80-K87).

Mouth, esophagus (food pipe), stomach and intestines (K00-K67; K90-K93).

  • Autoimmune enteropathy – disorders of the intestinal tract due to autoantibody formation against intestinal tissue.
  • Bacterial overgrowth in the intestine
  • Ulcerative colitischronic inflammatory bowel disease.
  • Intestinal motility disorders – disorders in the involuntary movements of the intestine to transport food.
  • Intestinal stenosis (narrowing)
  • Colon polyps – mucosal protrusions in the area of the colon.
  • Diverticulitis – inflammation of diverticula (mucosal protrusion through a muscle gap in a hollow organ, usually in the colon).
  • Small intestinal diverticula – mucosal protrusions through muscle gaps in a hollow organ, here the small intestine.
  • Small bowel subileus – motility disorder of the small intestine, which is considered an early stage of ileus (intestinal obstruction).
  • Dysbacteria (dysbiosis) – bacterial overgrowth of the intestine.
  • Enterocolic fistulas – abnormal connections between the small and large intestine.
  • Ischemic colitis – inflammation of the mucosa of the colon due to vascular occlusion of the supplying arteries.
  • Short bowel syndrome
  • Gastrocolonic fistula – abnormal duct between the stomach and the large intestine, through which undigested food components can be trafficked.
  • Microscopic colitis or microscopic colitis (synonyms: collagenous colitis; collagen colitis, collagen colitis) – chronic, somewhat atypical inflammation of the mucosa of the colon (large intestine), the cause of which is unclear and which is clinically accompanied by violent watery diarrhea (diarrhea)/4-5 times a day, even at night; some patients suffer from abdominal pain (abdominal pain) in addition; 75-80% are women/females > 50 years of age; correct diagnosis is only possible with colonoscopy (colonoscopy) and step biopsies (taking tissue samples in the individual sections of the colon), i.e. i.e. by a histological (fine tissue) examination to put.
  • Crohn’s diseasechronic inflammatory bowel disease; it usually progresses in episodes and can affect the entire digestive tract; characteristic is the segmental affection of the intestinal mucosa, that is, several intestinal sections may be affected, which are separated by healthy sections.
  • Waldmann’s disease (genuine intestinal lymphangiectasia) – congenital or acquired dilatation of lymphatic vessels with impaired lymphatic drainage.
  • Whipple’s disease (synonyms: Whipple’s disease, intestinal lipodystrophy; English : Whipplés disease) – rare systemic infectious disease; caused by the gram-positive rod bacterium Tropheryma whippelii (from the group of actinomycetes), which can affect various other organ systems in addition to the obligately affected intestinal system and is a chronic recurrent disease; symptoms: Fever, arthralgia (joint pain), brain dysfunction, weight loss, diarrhea (diarrhea), abdominal pain (abdominal pain), and more.
  • Food allergy
  • Constipation (constipation) – this is a paradoxical diarrhea.
  • Proctitis (inflammation of the rectum)
  • Irritable bowel syndrome (irritable colon)
  • Tropical sprue – diarrheal disease occurring in the tropics due to folic acid and vitamin B12 deficiency.
  • Celiac disease (gluten-induced enteropathy) – chronic disease of the mucosa of the small intestine (small intestinal mucosa), which is based on hypersensitivity to the cereal protein gluten.

Musculoskeletal system and connective tissue (M00-M99).

  • Behçet’s disease (synonym: Adamantiades-Behçet’s disease; Behçet’s disease; Behçet’s aphthae) – multisystem disease of the rheumatic type associated with recurrent, chronic vasculitis (vascular inflammation) of the small and large arteries and mucosal inflammation; The triad (the occurrence of three symptoms) of aphthae (painful, erosive mucosal lesions) in the mouth and aphthous genital ulcers (ulcers in the genital region), as well as uveitis (inflammation of the middle eye skin, which consists of the choroid (choroid), the ray body (corpus ciliare) and the iris) is stated as typical for the disease; a defect in cellular immunity is suspected

Neoplasms – tumor diseases (C00-D48).

  • Bronchial carcinoid – tumor of the neuroendocrine system located in the lungs.
  • Colon carcinoma (colon cancer)
  • Mastocytosis – two main forms: cutaneous mastocytosis (skin mastocytosis) and systemic mastocytosis (whole body mastocytosis); clinical picture of cutaneous mastocytosis: Yellowish-brown spots of varying size (urticaria pigmentosa); in systemic mastocytosis, there are also episodic gastrointestinal complaints (gastrointestinal complaints), (nausea (nausea), burning abdominal pain and diarrhea (diarrhea)), ulcer disease, and gastrointestinal bleeding (gastrointestinal bleeding) and malabsorption (disorder of food absorption); in systemic mastocytosis, there is an accumulation of mast cells (cell type involved, among other things, in allergic reactions). Among other things, involved in allergic reactions) in the bone marrow, where they are formed, as well as accumulation in the skin, bones, liver, spleen and gastrointestinal tract (GIT; gastrointestinal tract); mastocytosis is not curable; course usually benign (benign) and life expectancy normal; extremely rare degeneration mast cells (= mast cell leukemia (blood cancer)).
  • Medullary thyroid carcinoma – thyroid cancer originating from the calcitonin-producing cells.
  • Metastatic gastrointestinal carcinoid – tumor of the neuroendocrine system located in the gastrointestinal tract; its metastases may cause symptoms such as diarrhea and flushing
  • Multiple endocrine neoplasia (MEN) – genetic disease that leads to various benign and malignant tumors; is divided into MEN 1 and MEN 2; MEN 1 is mainly pituitary and pancreatic tumors, MEN 2 is thyroid carcinoma and pheochromocytoma.
  • Paraneoplastic syndrome – symptoms that occur in cancer, but do not originate directly from the tumor, but are signs of remote hormonal action.
  • Somatostatinoma – neuroendocrine tumor that produces somatostatin.
  • Verner-Morrison syndrome (synonym: Water Diarrhea Hypokalemia Achlorhydria (WDHA) (also known as VIPoma in reference to the vasoactive intestinal peptide) – adenoma or (more commonly) adenocarcinoma arising from the D1 cells of the pancreas (pancreas) and belonging to the neuroendocrine tumors; accompanied by severe diarrhea (diarrhea; > 1. 000 g stool weight/day) and releases increased pancreatic enzymes and other polypeptides; sporadic occurrence.
  • Villous adenomas – benign tumors, but degenerate in more than 30% of cases and therefore should always be ablated.
  • Zollinger-Ellison syndrome – usually located in the pancreas (pancreas) neoplasm that produces increased gastrin and is manifested mainly by frequently recurring peptic ulcers (ulcers) in the upper gastrointestinal tract.

Psyche – Nervous System (F00-F99; G00-G99).

  • Alcohol dependence
  • Bulimia (binge eating disorder)
  • Munchausen syndrome – psychiatric clinical picture in which illnesses are faked in order to achieve a secondary gain of illness.

Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99).

Injuries, poisonings, and other consequences of external causes (S00-T98).

  • Graft-versus-host disease – rejection reaction of the immunocompetent graft against the host (recipient) occurring after organ transplantation.
  • Histamine intolerance – histamine is one of the inflammatory mediators and is also contained in many foods and alcohol; in the case of disturbances in histamine degradation, it can come to a wide variety of symptoms such as diarrhea, headache or tachycardia (pulse too fast)
  • Condition after gastric (partial) resection – after removal of parts of the stomach or stomach.

Further

  • Immobile persons – here is a so-called paradoxical diarrhea due to fermentation of stool by bacteria.
  • Food-induced, especially by an overdose of sorbitol or xylitol (sugar substitutes).
  • Pseudoallergies

Medications

Many medications can cause diarrhea; this list identifies the most common drug-related causes:

Environmental pollutants – intoxications (poisonings).

  • Arsenic
  • Chromium
  • Bulbous mushroom poisoning or poisoning with other mushrooms.
  • Organophosphate insecticides
  • Mercury
  • Radiation damage
  • Environmental toxins such as ciguatera in seafood.