Digestive System Flashcards
Mr Gutteman complains of a headache, gnawing epigastric pain, and the runs (diarrhea). To pin point the problem, he is asked the following questions.
-Have you had these symptoms before? (“yes, but never this bad.”)
-Are you allergic to any foods? (“Shellfish doesn’t like me and milk give me the runs.”)
As a result of his responses, a lactose-free diet is ordered for Mr Gutteman instead of the regular diet originally prescribed.
Why is the new diet prescribed? ( what is believed to be his problem?)
Mr Gutteman’s statement about the effect milk on his digestive tract suggest that he may be deficient in lactase, a brush border enzyme that breaks down lactose (milk sugar).
Mr Gutteman’s problem continues despite the diet change. In fact, the frequency of diarrhea increases and by the end of the next day, he is complaining of severe abdominal pain. Again, he is asked some questions to probe his condition. One is whether he has travelled outside the country recently. He has not, reducing the possibility of infection with Shigella bacteria, which is associated with poor sanitation.
- Do you drink alcohol and how much (‘Little or none”)
-Have you recently eaten raw eggs or a salad containing mayonnaise at a gathering? (“No”)
-Are there certain foods that seem to precipitate these attacks? (“yes, when I have coffee and a sandwich”)
on the basis of these responses, what doe you think Mr. Gutteman’s diarrhea stems from? How will it be diagnosed and treated?
His response to the questions reduces the possibility that he has gastric ulcers. Mr Gutteman’s diarrhea may be due to gluten-sensitive enteropathy. To verify this diagnosis, Mr Gutteman should be screened for specific IgA antibodies in his blood. If these screening tests are positive, a biopsy of the intestinal mucosa would be performed. A positive diagnosis of gluten-sensitive enteropathy would lead to a lifelong dietary restriction of all grains except rice and corn. Grains should not be restricted prior to the biopsy.
