1 ORIGINAL ARTICLE The Role of Laboratory Diagnosis in Children with Chronic Diarrhea Deddy S Putra*, Muzal Kadim**, Pramita GD**, Badriul Hegar**, Aswitha Boediharso**, Agus Firmansyah** * Department of Pediatrics, Faculty of Medicine, University of Riau, Arifin Achmad General Hospital, Riau ** Department of Pediatrics, Faculty of Medicine, University of Indonesia dr. Cipto Mangunkusumo General Hospital, Jakarta ABSTRACT Background: Etiology of chronic diarrhea can be established through non-invasive examination such as stool analysis and stool culture. Colonoscopy is an invasive method, which is occasionally needed to discover the etiology of chronic diarrhea. Objective: To recognize the characteristics of chronic diarrhea based on stool examination and colonoscopy results. Method: Descriptive study on patients with chronic diarrhea who came to Cipto Mangunkusumo Hospital since 1 June to 31 August 2005. Laboratory tests were conducted in accordance with clinical indication. Data was presented in distribution tables. Results: There were 41 patients with chronic diarrhea. Stool analyses were performed only in 38 patients with negative-Gram infection (86.8%). Stool cultures were performed in 27 patients with positive results of non-pathogenic E. coli (85.2%). Stool parasite analyses and concentration tests were performed in 17 patients, with 47.0% positive results as follow: Microsporidia 29.4%, Blastocystis hominis 11.8% and Giardia lamblia 5.9%. Colonoscopy examinations were performed in 6 patients and all patients indicated ulcerative colitis appearance with 50% histopathological impression of infective colitis. Conclusion: Stool analysis in chronic diarrhea primarily indicates positive infection. Bacterial stool culture mostly includes non-pathogenic E. coli, while parasite stool culture largely includes Microsporidia. Biopsy examination tends to reveal infective colitis. Keywords: chronic diarrhea, parasite stool, colonoscopy INTRODUCTION Chronic diarrhea is defined as diarrhea which has occurred for more than 14 days and if it is caused by infection, then it is known as persistent diarrhea. The incidence rate of persistent diarrhea in some developing countries is ranged between 3-23%. 1,2 In order to establish diagnosis and to provide treatment of chronic or persistent diarrhea, we need a simple and non-invasive examination such as stool analysis. It should be continued with stool culture and stool parasite analysis to discover the etiologic pathogenic bacteria or parasite. 3,4 Invasive examination such as colonoscopy is occasionally needed in order to discover infective colitis grossly and to obtain colon biopsy at once to differentiate infection and non-specific inflammation. 5 This study is aimed to recognize the result of stool examination and colonoscopy in patients with persistent diarrhea in Department of Pediatrics Cipto Mangunkusumo hospital for three months period.