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Drug-induced diarrhea
Other Resources UpToDate PubMed

Drug-induced diarrhea

Contributors: Michael W. Winter MD, Paritosh Prasad MD
Other Resources UpToDate PubMed


Diarrhea is a side effect associated with many medications but most commonly associated with antimicrobial use. It is one of the most frequent adverse effects of antibiotic therapy and can range from mild abdominal discomfort to severe diarrhea and colitis. Most cases are mild and self-limited, particularly after cessation of therapy. Drug-induced diarrhea should be distinguished from Clostridioides difficile colitis, which is an infectious complication of antibiotic use in which the suppression of normal flora allows for cytotoxin-producing C difficile to flourish. It is important to establish whether the diarrhea is a side effect of the medication or is related to C difficile or an alternative infectious etiology, as the management strategy may be different.

Some medications (eg, checkpoint inhibitors) can trigger development of a colitis similar to inflammatory bowel disease that may warrant treatment with immune suppressant therapy. In this instance, diarrhea will persist beyond the cessation of the offending agent, and further workup with colonoscopy will likely reveal the diagnosis.

Other medications injure the lining of the bowel causing mucositis, such as chemotherapy, and hence cause diarrhea.


K52.1 – Toxic gastroenteritis and colitis

62315008 – Diarrhea

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Inflammatory bowel disease (eg, Crohn disease, Ulcerative colitis)
  • Clostridioides difficile colitis
  • Infectious Gastroenteritis (bacterial, Viral gastroenteritis, or fungal)
  • Protein-losing enteropathy
  • Microscopic colitis
  • Irritable bowel syndrome
  • Celiac disease (celiac sprue)
  • Eosinophilic gastroenteritis
  • Ischemic colitis
  • Secretory tumor
  • Bile acid diarrhea
  • Blind loop syndrome
  • Lactose intolerance
  • Chronic pancreatitis / pancreatic insufficiency

Best Tests

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Management Pearls

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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Last Reviewed:08/09/2018
Last Updated:10/17/2022
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Drug-induced diarrhea
A medical illustration showing key findings of Drug-induced diarrhea : Diarrhea
Copyright © 2024 VisualDx®. All rights reserved.