COMMON COMPLAINTS: Diarrhea and Constipation

Question 1

Chronic diarrhea in a pt w/o recent travel or changes in diet. Pt is losing weight unintentionally and has an iron defiecient microcytic anemia.
What are you thinking of testing them for?

Answer 1

Celiac

Question 2

What can increase the liklihood of fecal impaction/severe constipation?

Answer 2

Decreased mobility, opiate use, anticholinergics (like oxybutinin)

Question 3

31 yo female w/chronic diarrhea, no constipation, worsening of flatulence w/exercise. Labs show microcytosis and iron deficiency anemia. What is the likely culprit?

Answer 3

Celiac.

Note that if they force you to choose between IBS and celiac w/out any mention of wheat, people w/IBS have issues w/ both diarrhea and or constipation and also get pain releif from defecation.

Question 4

inflammatory infiltrtion of proximal bowel and villous atrophy

Answer 4

celiac

Question 5

intestinal hypermobility raises concerns for

Answer 5

IBS

Question 6

Diarrhea and steatorrhea, nausea, vomitting, severe epigatric pain, and has a hx of gall stones raises concerns for…

Answer 6

pancreatitis

Question 7

Blooooody diarrhea raises concern for what pathogens

Answer 7

camplobacteri jejuni, entamoeba histolytica, nontypoidal salmonella, shigella, yersinia enterolitica.

RECALL that ETEC (travellers) does not cause BLOODY diarrhea

Question 8

What medications can you consider for constipation management (idipathic)?

Answer 8

Psyllium

Sennosides

Polyethylene glycol

Lactulose

Docusate sodium

magnesium citrate

Question 9

Granulomatous inflamation restricted to the intestinal mucosa is characteristic of ________________ whereas granulomatous inflammation through the intestinal mucosa extending to serosa is characteristic of _______________

Answer 9

Restrited=Ulcerative Colitis
Through to Serosa=Crohns