Yield of Diagnostic Tests and Effects of Crofelemer for Chronic Idiopathic Diarrhea In Non-HIV Patients
Yield of Diagnostic Tests and Effects of Crofelemer for Chronic Idiopathic Diarrhea In Non-HIV Patients
The purpose of this study is to evaluate the effectiveness of the drug Crofelemer in the
 treatment of non-HIV patients with chronic idiopathic diarrhea; to determine the prevalence
 of identifiable causes of chronic diarrhea in a non-HIV patients; to assess the diagnostic
 yield, in terms of identification of treatable etiologies, of commercially available
 diagnostic evaluations in adult, non-HIV patients with chronic idiopathic diarrhea, that is,
 evaluate which tests, among the standard diagnostic tests commonly conducted as part of the
 evaluation of chronic idiopathic diarrhea, are most likely to identify a treatable cause of
 the diarrhea; and to analyze the relationship between chronic idiopathic diarrhea and
 health-related quality of life and assess the impact of crofelemer treatment on
 health-related quality of life.
Inclusion Criteria:

 -  Patients with chronic diarrhea (defined as 3 non-bloody loose stools per day or more
 than 20 non-bloody loose stools per week for more ≥ 4 weeks) and Bristol Stool Form
 Scale for stool consistency of 6/7 with >50% stool without an obvious cause after
 evaluation for organic etiologies.

 -  Patients from any ethnicity

 Exclusion Criteria:

 -  Hematochezia (potentially related to an organic cause).

 -  Subjects less than 18 years of age more than 75 years of age (safety and effectiveness
 of crofelemer has not been established in these age groups).

 -  Pregnant females (crofelemer is a Category C drug due to lack of well-controlled
 studies to study its effects in this population).

 -  Lactating females (it is unknown if crofelemer is excreted in the human milk and thus
 may have unknown adverse effects on the nursing infants).

 -  HIV positive individuals.

 -  Persons within ability to provide consent and understand the study

 -  Persons with history of alcohol abuse or binge drinking.

 -  Persons with history of surgical bowel resection or bariatric surgery in the past 12
 months.

 -  Persons who have undergone cholecystectomy (open or laparoscopic) in the past 3
 months.

 -  Persons receiving antibiotics currently or have received antimicrobials in the past 4
 weeks.

 -  Persons with end-organ failures including end-stage renal disease, end-stage liver
 disease, or severe heart failure.

 -  Persons with metastatic hematologic and oncologic malignancies.

 -  Persons receiving chemo-radiation or immune-modulators for oncologic or rheumatologic
 conditions.

 -  Persons with any other known organic gastrointestinal or non-gastrointestinal disease
 process in which diarrhea is a recognized clinical feature.

 -  Gluten free diet for previous 3 months and refusal to ingest gluten.