Which condition is identified as a primary lymphatic disorder associated with chronic diarrhea?

• A. Chronic inflammatory enteropathy
• B. Primary lymphangiectasia
• C. Short bowel syndrome
• D. Chronic foreign body

Answer: (B)

A primary lymphatic disorder of the gut causes lymphatic dilation (lymphangiectasia) that leaks protein-rich lymph into the intestinal lumen, leading to protein-losing enteropathy and fat malabsorption. This mechanism explains why chronic diarrhea occurs with a lymphatic defect: the lymphatic vessels fail to transport chyle properly, so fats are malabsorbed and proteins are lost, producing persistent diarrhea, edema from hypoalbuminemia, and sometimes steatorrhea. This is a congenital or developmental (primary) abnormality of the intestinal lymphatics, distinct from inflammatory, structural, or obstructive causes of diarrhea.

Chronic inflammatory enteropathy involves inflammation of the gut mucosa rather than a primary lymphatic problem, so it doesn’t center on lymphatic abnormalities. Short bowel syndrome results from loss of absorptive surface area after extensive resections, not from lymphatic vessel defects. Chronic foreign body can cause irritation or obstruction, but again it’s not a primary lymphatic disorder. The hallmark here is a primary lymphatic abnormality presenting with chronic diarrhea due to lymph leakage and fat/protein loss.