Question:
Secretory diarrhea is NOT seen in which of the following conditions?
Secretory diarrhea is NOT seen in which of the following conditions?
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Think which one causes a fat-laden malabsorptive stool rather than active fluid secretion.
Updated On: Jun 24, 2026
- Phenolphthalein
- Celiac disease
- Cholera
- Addison's disease
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The Correct Option is B
Solution and Explanation
Step 1: Secretory diarrhea occurs when the gut actively secretes fluid and electrolytes into the lumen. It is high volume, watery, persists during fasting, and has a low stool osmotic gap. Classic causes include cholera and enterotoxigenic E. coli, non-osmotic stimulant laxatives such as phenolphthalein, endocrine tumors (VIPoma, carcinoid, gastrinoma, medullary thyroid carcinoma), bile acid effects, and Addison's disease.
Step 2: Celiac disease is the exception. It damages the small bowel mucosa, causing malabsorption of fat. The result is steatorrheal (osmotic, fat-laden) diarrhea, not a secretory process. Therefore celiac disease is NOT a cause of secretory diarrhea.
Step 3: Why the distractors are secretory: cholera toxin activates adenylate cyclase, raising cyclic AMP and driving chloride and water secretion. Phenolphthalein is a stimulant laxative that directly promotes intestinal secretion. Addison's disease (adrenal insufficiency) is listed among secretory causes due to its electrolyte and fluid handling effects.
Step 4: Hence the condition where secretory diarrhea is NOT seen is celiac disease, which instead produces steatorrhea from mucosal malabsorption.
Step 2: Celiac disease is the exception. It damages the small bowel mucosa, causing malabsorption of fat. The result is steatorrheal (osmotic, fat-laden) diarrhea, not a secretory process. Therefore celiac disease is NOT a cause of secretory diarrhea.
Step 3: Why the distractors are secretory: cholera toxin activates adenylate cyclase, raising cyclic AMP and driving chloride and water secretion. Phenolphthalein is a stimulant laxative that directly promotes intestinal secretion. Addison's disease (adrenal insufficiency) is listed among secretory causes due to its electrolyte and fluid handling effects.
Step 4: Hence the condition where secretory diarrhea is NOT seen is celiac disease, which instead produces steatorrhea from mucosal malabsorption.
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