Chronic diarrhea in tropics.

Diarrheal diseases continue to be very frequent in the tropics. Upto 40% of mortality associated with diarrheal diseases is associated with prolonged episodes of diarrhea and accompanying malnutrition. Prolonged diarrheal episodes can basically be divided into three main types: a) acute onset prolonged diarrhea or persistent diarrhea; b) insidious onset chronic diarrhea and c) recurrent diarrhea. Epidemiology, risk factors, etiological factors, gut pathophysiology and management of persistent diarrhea has been extensively reviewed in the article. Chronic diarrhea in tropics has entirely different etiological considerations than those observed in Western countries. Most of these factors are associated with poor sanitary and living conditions and gastrointestinal infections. Celiac disease is also identified as an important cause of chronic diarrhea in Indian settings. Chronic diarrhea needs to be differentiated from chronic non specific diarrhea wherein no adverse nutritional effects are seen in the patient.