This week discussion involves a 37-year-old European female seen in the clinic for frequent and watery bowel movements for three days. The patient has no prior medical history besides an appendectomy at the age of 14. Blood pressure is elevated, and she denies taking any home medications. There can be many causes that leads up to loose stools. Your diet, medications, chronic conditions, etc. Loose stools often occur after eating but can also happen at other points in the day. When loose stools occur consecutively on multiple occasions throughout a day, this is described as diarrhea.
This female appears normal and overall healthy. Sometimes, the body can have problems digesting certain types of sugars, such as alcohol and lactose (Rhodes, 2021). The subjective data that I would obtain will be: Prior to the three days, how often do you have bowel movements? What form did the bowel movements appear, for example, hard, soft, formed or loose? What did you eat differently this week than normal? Did you take any over the counter medications? If so, what did you take?
The objective findings that I would look for is already displayed in assessment such as good skin turgor, active bowel sounds, moist mucus membranes, no cyanosis, etc. The diagnosis test that I would order will be a KUB, A kidney, ureter, and bladder (KUB) X-ray may be performed to assess the abdominal area for causes of abdominal pain, or to assess the organs and structures of the urinary and/or gastrointestinal (GI) system. A stool sample will be collected to test for bacterium or parasite.
Furthermore, the diagnosis that the patient can possibly have is irritable bowel syndrome (IBS), ulcerative colitis or food poisoning. IBS occurs when a properly functioning immune system attacks foreign organisms, such as viruses and bacteria, to protect the body. The cause is unknown. To rule out IBS, combination of endoscopy or colonoscopy, and imaging studies, such as contrast radiography, magnetic resonance imaging (MRI), or computed tomography (CT) will be used (CDC, 2014).
Chronic causes of colitis include inflammatory bowel diseases like ulcerative colitis and Crohn’s disease. Ulcerative colitis (UC) is a chronic condition causing inflammation in the colon and rectum. People with UC often experience loose stools and diarrhea. Other symptoms of UC include abdominal pain, frequent bowel movements, fatigue, appetite and weight loss. While ulcerative colitis is not caused by the foods you eat, you may find that once you have the disease, particular foods can aggravate the symptoms. It’s important to maintain a healthy and soothing diet that helps reduce your symptoms, replace lost nutrients, and promote healing (CDC, 2014). Loose stools can also be caused by diets high in alcohol rich and spicy foods, coffee and magnesium.
Food poisoning invades the body with Viruses, bacteria or parasites can cause inflammation in the stomach and intestines. This can cause loose stools and diarrhea, along with other symptoms including abdominal pain, vomiting, and nausea (Kornbluth, 2010). When someone is assessed with frequent diarrhea, we tend to draw labs and evaluate their electrolytes to ensure nothing is abnormal. If hospitalized, fluids will be administered. Broad spectrum antibiotics will be started, and blood cultures will be obtained.
Kornbluth A, Sachar DB; Practice Parameters Committee of the American College of Gastroenterology. Ulcerative colitis practice guidelines in adults: American College Of Gastroenterology, Practice Parameters Committee. Am J Gastroenterol. 2010 Mar;105(3):501-23. http://gi.org/guideline/ulcerative-colitis-in-adults/external icon
Rhoads, J., & Wiggins Petersen, S. (2021). Advanced Health Assessment and Diagnostic Reasoning. Burlington, MA: Jones and Bartlett Learning. ISBN: 9781284105377
The Facts About Inflammatory Bowel Diseases. New York, NY: Crohn’s and Colitis Foundation of America; center for disease control ( CDC) 2014 .http://www.crohnscolitisfoundation.org/assets/pdfs/updatedibdfactbook.pdf pdf icon[PDF-2.32MB]external icon.
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