There seems to be a controversy about the usefulness of the fecal
osmotic gap:
Ladefoged et al. Scand J Gastroenterol 1987;22:813-20 did not think
it diagnostically useful in differentiating osmotic from secretory
diarrhea, in patients.
Eherer et al. Gastroenterol 1992;103:545-51 could not distinguish
phenolphtalein-induced secretory diarrhea from sodium
sulphate-induced osmotic diarrhea, unless feacal chloride
was measured. On the other hand osmotic diarrhea by Mg(OH)2, PEG,
lactulose and sorbitol always had an osmotic gap greater than 50
mOsm/kg..
Best wishes
Raymond Wulkan
Zuiderziekenhuis
Rotterdam
The Netherlands
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