Evaluation of osmotic diarrhea

a. Trial of lactose withdrawal.

b. Trial of an antibiotic (metronidazole) for small-bowel bacterial overgrowth.

c. Screening for celiac disease (anti-endomysial antibody, antigliadin antibody).

d. Fecal fat measurement (72 hr) for pancreatic insufficiency.

e. Trial of fructose avoidance.

f. Stool test for phenolphthalein and magnesium if laxative abuse is suspected.

g. Hydrogen breath analysis to identify disaccharidase deficiency or bacterial overgrowth.

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