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CLINICAL PRESENTATION

CLINICAL PRESENTATION. Small bowel diarrheas large, loose stools periumbilical or RLQ pain Large bowel diarrheas frequent, small, loose stools crampy, LLQ pain or tenesmus. ACUTE DIARRHEA. Viral gastroenteritis Staphylococcus aureus Clostridium perfringens Salmonella Shigella

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CLINICAL PRESENTATION

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  1. CLINICAL PRESENTATION • Small bowel diarrheas • large, loose stools • periumbilical or RLQ pain • Large bowel diarrheas • frequent, small, loose stools • crampy, LLQ pain or tenesmus

  2. ACUTE DIARRHEA • Viral gastroenteritis • Staphylococcus aureus • Clostridium perfringens • Salmonella • Shigella • Cryptosporidiosis • Drug-induced diarrhea • Clostridium difficile

  3. TRAVELER’S DIARRHEA • Toxigenic E. coli • Entamoeba histolytica • Giardia lamblia • Choleria

  4. CHRONIC & RECURRENT DIARRHEAS • Irritable bowel syndrome • Inflammatory bowel disease • Pseudomembranous colitis • Diabetic enteropathy • Dumping syndrome • Malabsorption of lactose • Chronic laxative use

  5. HISTORY • Nature of bowel movements • Associated symptoms • Epidemiologic information • travel • food intake • personal contact • HIV status • Drug history

  6. PHYSICAL • Vital sign • Skin • Lymph nodes • Abdomen • Rectal

  7. LABORATORY TESTS • Gram’s stain for leukocytes • Stool for C&S • CBC • Electrolytes • Stool for O&P, C. difficile (if indicated) • LFTs & PT time • Amylase, glucose

  8. MANAGEMENT • Acute diarrhea • maintain hydration • absorbent products • lomotil • immodium • antibiotics • Traveler’s diarrhea • prophylactic • treatment

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