At recruitment we presented a case of a 62 year old male with >4 weeks of >1L per day stool. He was ultimately diagnosed with a VIPoma. Remember that this is an extremely rarely disease and you need to rule out other more common causes of secretory diarrhea first. Additionally, it is important to think broadly about diarrhea and distinguish between watery, inflammatory and fatty. There are diseases that can cause overlap such as IBD and certain infectious causes.
At wards 101 we discussed a case of a 45 year old male with history of diabetes, osteomyelitis and non-functioning carcinoid tumor s/p right hemicolectomy (unknown more details) who presented with 1 month of worsening abdominal pain, diarrhea and headaches. . Remember that secretory diarrhea typically do not resolve at night nor do they improve over time, a brief review of chronic diarrhea and causes of secretory diarrhea/carcinoid specifically is below (also available under case conference from 12.17.2018):