A 22-year-old woman presents with chronic diarrhea. She has no abdominal discomfort, feels well, and reports no weight loss or systemic symptoms. Physical examination reveals a healthy young woman who is 5’7” tall and weighs 150 lb. The complete physical examination is normal. Which of the following is the most likely cause of a secretory diarrhea in this young woman?
(A) surreptitious use of stimulant laxatives
(B) carcinoid tumor
© ulcerative colitis
(D) lactose deficiency
(E) celiac disease
Although carcinoid tumor can cause diarrhea, it is very uncommon. This young woman is overweight, suggesting an eating disorder, which is associated with laxative abuse. Abuse of stimulant laxatives such as senna can cause a secretory diarrhea. Magnesium-based laxatives will cause an osmotic diarrhea