PATIENT PRESENTATION MARKER

Diarrhoea symptoms

What this marker measures

The degree to which Rome IV criteria are met/not for functional diarrhoea. This does not constitute a diagnosis.

Health categories/Interpretations informed by this marker

Gut function
● Pancreatic insufficiency: diarrhoea is a common clinical feature of pancreatic exocrine insufficiency.^1–3
‍
Clinical features
‍● Lower GI symptoms: diarrhoea symptoms are a commonly-reported lower GI symptom cluster that can affect quality of life.
^‍

Interpreting the result

PRESENT

Questionnaire responses indicate the same as Partially Present but for 6 months or more.

PARTIALLY PRESENT

Questionnaire responses indicate loose or watery stools more than 25% of the time, with abdominal pain and bloating less than 1 day per week or never.

NOT PRESENT

Questionnaire responses do not indicate diarrhoea symptoms.

Patient management insights

DIETARY STRATEGIES

Add psyllium husk: psyllium husk may reduce stool frequency, improve stool consistency, and reduce urgency in chronic diarrhoea.⁴
GRADE D

CLINICAL MANAGEMENT

Trial pancreatic enzyme replacement therapy (PERT) (Present, with borderline low pancreatic elastase): PERT may improve diarrhoea or malabsorption symptoms when borderline pancreatic elastase is accompanied by clinical features suggestive of pancreatic exocrine insufficiency.^1–3
GRADE D

Tips for patients discussion

"Your questionnaire responses show that you're experiencing some diarrhoea symptoms. These are common and can affect how you feel day to day. We'll look at your other results together to work out the best next step, which may include a fibre supplement such as psyllium husk."

Source references for all clinical associations, interpretation definitions, and patient management insights on this card.

1. Mathew, A., Fernandes, D. & Andreyev, H. J. N. What is the significance of a faecal elastase-1 level between 200 and 500 μg/g? Frontline Gastroenterol 14, 371–376 (2023).
2. Campbell, J. A. et al. Should we investigate gastroenterology patients for pancreatic exocrine insufficiency? A dual centre UK study. J Gastrointestin Liver Dis 25, 303–309 (2016).
3. Evans, K. E. et al. Pancreatic insufficiency in adult celiac disease: do patients require long-term enzyme supplementation? Dig Dis Sci 55, 2999–3004 (2010).
4. Qvitzau, S., Matzen, P. & Madsen, P. Treatment of chronic diarrhoea: loperamide versus ispaghula husk and calcium. Scand J Gastroenterol 23, 1237–1240 (1988).