Analysis of the etiology of small intestinal diseases with chronic diarrhea as the main symptom

Li Kemin; Li Jingnan; Li Ji

doi:10.3760/j.issn.1673-4777.2026.03.015

Abstract：Objective To investigate the etiology,clinical characteristics,diagnosis and treatment of small intestinal diseases with chronic diarrhea as the main symptom,and to improve the understanding and timely diagnosis and treatment of related small intestinal diseases.Methods From January 2016 to January 2020,patients hospitalized in the Department of Gastroenterology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences with chronic diarrhea as the first and main symptom,without evidence of esophageal,gastric or colorectal involvement by imaging and endoscopy,and with small intestinal lesions were retrospectively enrolled.The general information,etiology,clinical manifestations,nutritional and inflammatory status of the patients were analyzed.Results A total of 23 patients were enrolled,including 17 males and 6 females,with the most patients aged 19-44 years[12 cases(52.2％)].The median time from the onset of symptoms to the final diagnosis was 1 year.The main cause was immune-related diseases[17 cases(73.9％)],followed by small intestinal malabsorption syndrome[4 cases(17.4％)]and infectious diseases[2 cases(8.7％)].In addition to chronic diarrhea,the symptoms of digestive system were often accompanied by abdominal pain[17 cases(73.9％)],hematochezia[5 cases(21.7％)],nausea and vomiting[6 cases(26.1％)].Most patients were at risk of malnutrition,mainly manifested as emaciation,anemia and hypoalbuminemia.Conclusions There is a wide spectrum of diseases with chronic diarrhea as the main manifestation and small intestinal involvement alone.Most of them are rare small intestinal diseases,such as autoimmune enteritis,which are difficult to diagnose.For patients with unexplained chronic diarrhea,we should pay attention to the etiology of small intestinal diseases and make timely diagnosis and treatment.