Name
DIARRHOEA, TRAVELERS
DESCRIPTION
DETAIL
CAUSES : - INFECTIVE DIARRHOEA, BACTERIAL OR VIRAL - DIETARY INDISCRETION - DRUG INDUCED - AMOEBIC DYSENTERY - BACILLARY DYSENTERY -------------------------------------------------------------------------- DIFFERENTIAL DIAGNOSIS β’ Ulcerative colitis β’ Crohn disease β’ Drugs (cholinergic agents, agnesium-containing antacids) β’ Pseudomembranous colitis secondary to antibiotic use β’ Diverticulitis β’ Spastic (irritable) colon β’ Fecal impaction β’ Malabsorption β’ Zollinger-Ellison syndrome β’ Ischemic bowel β’ Gastrinomaβ’ CBC - increased WBC with a left shift may indicate an infectious process; decreased hemoglobin/hematocrit may indicate anemia from blood loss β’ Serum electrolytes - increased sodium from dehydration, decreased potassium from diarrhea β’ BUN, creatinine - elevated in dehydration β’ pH - hyperchloremic acidosis β’ Stool sample - occult blood (present in IBD, bowel ischemia, bacterial infections), fecal leukocytes (present in diarrhea caused by Salmonella, Campylobacter, Yersinia), bacterial culture and sensitivity (for Salmonella, Yersinia, Shigella, Campylobacter), ova and parasites, C. difficile toxin, Ziehl-Neelsen stain (for Cryptosporidium) IMAGING ; Abdominal x-rays (flat plate and upright) are indicated in patients with abdominal pain or evidence of obstruction to rule out toxic megacolon and bowel ischemia DIAGNOSTIC PROCEDURES : Sigmoidoscopy indicated in patients with bloody diarrhea or suspected pseudomembranous or ulcerative colitis
TYPENOTES
RELATED DISEASE
Not Available Disease
DISEASE
INVESTIGATION
TOTAL LEUCOCYTE COUNT, DIFF. LEUCOCYTE COUNT, STOOL ROUTINE
[DIARRHOEA, TRAVELERS]