In patients with diarrhea, anemia, and bulky stools, what is the most likely diagnosis?

Celiac disease is characterized by a sensitivity to gluten, which is a protein found in wheat, barley, and rye. In patients with celiac disease, ingestion of gluten leads to inflammation and damage to the intestinal lining, resulting in malabsorption of nutrients. This malabsorption can manifest as diarrhea, anemia due to iron deficiency or malnutrition, and bulky, pale stools that may have a foul odor due to unabsorbed fats.

In this scenario, the combination of diarrhea, anemia, and bulky stools strongly indicates malabsorption, which aligns with the gastrointestinal consequences of celiac disease. The anemia can stem from deficiencies in iron, folate, or vitamin B12 due to poor nutrient absorption. The bulky stools are often described as steatorrhea, indicating fat malabsorption.

In contrast, cystic fibrosis would typically present with similar symptoms, including bulky stools; however, it usually incorporates additional respiratory symptoms and is less likely to be the only focus of the clinical picture. Lactose intolerance may cause diarrhea but typically does not lead to anemia or bulky stools to this extent because the stool is usually not excessively bulky and is primarily watery. Inflammatory bowel disease can lead to diarrhea and anemia; however, the stools are often not bulky and