You have determined that a patient has a secretory diarrhea disorder. Which of the following is known to be a possible cause of a secretory disorder?

You have determined that a patient has a secretory diarrhea disorder. Which of the following is known to be a possible cause of a secretory disorder?

• A. Extensive small bowel resection
• B. Ingestion of milk products in someone who is lactose intolerant
• C. Someone who is gluten intolerant
• D. Bacterial infections & substances secreted by select tumors

Answer: (D)

Secretory diarrhea occurs when the intestine actively secretes electrolytes and water into the lumen, usually due to toxins or secretagogues such as bacterial toxins or hormone-secreting tumors. This is why bacterial infections and substances secreted by select tumors are classic causes—the toxins (for example, certain bacteria) stimulate secretion, and hormones produced by tumors like VIP can drive watery stools independent of food intake. In contrast, extensive small bowel resection reduces absorptive surface and tends to cause malabsorption- or osmotic-type diarrhea, lactose ingestion in someone who is lactose intolerant draws water into the gut (osmotic diarrhea), and gluten intolerance leads to malabsorption from mucosal damage rather than active secretion.

Secretory diarrhea occurs when the intestine actively secretes electrolytes and water into the lumen, usually due to toxins or secretagogues such as bacterial toxins or hormone-secreting tumors. This is why bacterial infections and substances secreted by select tumors are classic causes—the toxins (for example, certain bacteria) stimulate secretion, and hormones produced by tumors like VIP can drive watery stools independent of food intake. In contrast, extensive small bowel resection reduces absorptive surface and tends to cause malabsorption- or osmotic-type diarrhea, lactose ingestion in someone who is lactose intolerant draws water into the gut (osmotic diarrhea), and gluten intolerance leads to malabsorption from mucosal damage rather than active secretion.