Abdul H. Khan, MD; Christopher C. Thompson, MD, MHES; David L. Carr-Locke, MD, FRCPSeries Editor: David L. Carr-Locke, MD, FRCP

Disclosures

May 16, 2005

Abstract and Introduction

We report the case of a patient with chronic diarrhea due to infiltrative cancer to the colon from the breast. A 49-year-old woman with a history of metastatic breast cancer to the bones was admitted to hospital with 4 weeks of watery diarrhea. Computed tomography (CT) scan of the abdomen showed pancolitis. Colonoscopy showed patchy subepithelial hemorrhages, most prominently in the ascending colon and sigmoid colon, but no mass lesion. Random biopsies taken throughout the colon showed infiltrative adenocarcinoma of breast origin in multiple specimens. Infectious work-up was negative.

Chronic diarrhea is generally defined as an increased frequency of loose stools that lasts more than 4 weeks. This disorder affects between 5% and 20% of the population and its etiology can often be elicited by case history.[1] The possible causes of chronic diarrhea are considerable, and may be stratified as follows: inflammatory diarrhea, secretory diarrhea, osmotic diarrhea, and malabsorption. Basic stool studies, abdominal imaging tests, and biopsies taken via endoscopy can often be helpful in determining the diagnosis. The best approach to treatment is to address the underlying etiology. However, when no underlying etiology can be identified, antidiarrheal agents are used to control symptoms.

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