The patient who is 30 year old presented with a complaint of chronic diarrhea for 3 weeks. The coproculture is negative. I think of irritable bowel syndrome. I would like to get a second opinion about the diagnosis and treatment of the same.
What is the frequency of diarrhea daily ,
is it associated with mucus , foul smell , abdominal cramps or occasional fever .
Is he taking any medications .
any significant past Medical /Surgical history .
is the patient male or female
socio economic status of the patient
is it aggravating or relieving by any kind of measures
any positive clinical findings
Hello Dr.Arshad,
The patient is a female. She has a frequency of one-two time of watery diarrhea daily,not associated with mucus or foul odor.
Not associated with abdominal cramps.
No surgical or medical history.
Till now she have been using Imodium and probiotics without any results.
The social status of the patient is very good.
How should I proceed with the diagnosis?
Thank you in advance.
Hello, Dr. Dorina Sokol Gurabardhi.,
The commonest cause of diarrhea is irritable bowel syndrome and malabsorption syndromes in which food cannot be digested and absorbed, and chronic infections. Increase bile in colon causes watery diarrhea. In irritable bowel syndrome having both diarrhea and constipation.
Hello Dr Potnuru Srinivaasa Sudhakar,
thank you for your suggestions.The patient does not have any episode of constipation so it's not an irritable bowel syndrome.
I will ask for a blood test to see for any chronic infection.
Hello Dr. Sultan,
the patient has no familiar or personal history of autoimmune disease but anyway I'll ask her celiac serology just for confirmation. Thank you!
Thanks Dr Dorina for valuing my opinion. Actually the recent guidlines recommend that before labelling a patient with Irritable Bowel Syndrome, celiac disease must be ruled out by serology.
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