Frequent and Watery Bowel Movements: Understanding the Causes and Treatment Options

ASSIGNMENT INSTRUCTIONS:

Chief Complaint
(CC) “I am here today due to frequent and watery bowel movements”
History of Present Illness (HPI)A 37-year-old European American female presents to your practice with “loose stools” for about three days. One event about every three hours
PMHNo contributory
PSHAppendectomy at the age of 14
Drug Hx
No meds
AllergiesPenicillin
SubjectiveFever and chills, Lost appetite Flatulence No mucus or blood on stools
Objective Data
PEB/P 188/96; Pulse 89; RR 16; Temp 99.0; Ht 5,6; wt 110; BMI 17.8
Generalwell-developed female in no acute distress appears slightly fatigued
HEENTAtraumatic, normocephalic, PERRLA, EOMI, arcus sinus bilaterally, conjunctiva and sclera clear, nares patent, nasopharynx clear, edentulous.
NeckSupple
LungsCTA AP&L
CardS1S2 without rub or gallop
Abdpositive bowel sounds (BS) in all four quadrants; no masses; no organomegaly noted; diffuse, mild, bilateral lower quadrant pain noted Mild diffuse tenderness.
GU Non-contributory
Extno cyanosis, clubbing, or edema
Integumentgood skin turgor noted, moist mucous membranes
NeuroNo obvious deformities, CN grossly intact II-XII
Answer the below questions. Note that all your responses should apply to your specific patient from your assigned case study.
What other subjective data would you obtain?
What other objective findings would you look for?
What diagnostic exams do you want to order?
Name 3 differential diagnoses based on this patient presenting symptoms.
Give rationales for each differential diagnosis.
Submission Instructions:
Your initial post should be at least 500 words, formatted and cited in the current APA style with support from at least 2 academic sources other than your textbook.

HOW TO WORK ON THIS ASSIGNMENT (EXAMPLE ESSAY / DRAFT)

Chief Complaint: A 37-year-old European American female presents with a chief complaint of frequent and watery bowel movements.

Subjective Data: Apart from the patient’s chief complaint, it is important to obtain additional subjective data to better understand the patient’s condition. In this case, the patient reports having loose stools for about three days with one event occurring every three hours. The patient also reports fever and chills, loss of appetite, and flatulence. Further subjective data that could be obtained includes information about recent travel, changes in diet or medication, and exposure to infectious agents.

Objective Data: Objective data obtained from the patient’s physical examination can help to narrow down the differential diagnoses. In this case, the patient’s vital signs indicate a slightly elevated blood pressure of 188/96, a heart rate of 89, a respiratory rate of 16, and a temperature of 99.0°F. The patient appears well-developed and not in acute distress, but slightly fatigued. The head, eyes, ears, nose, and throat exam (HEENT) reveals no abnormalities, and the neck is supple. Lung examination reveals clear breath sounds, while cardiac examination reveals normal S1S2 without rub or gallop. The abdomen examination shows positive bowel sounds in all four quadrants, diffuse, mild, bilateral lower quadrant pain, and mild diffuse tenderness. The patient also reports no cyanosis, clubbing, or edema, and no obvious neurological deformities.

Diagnostic Exams: Based on the patient’s symptoms and physical examination, the following diagnostic exams may be ordered to determine the underlying cause of the patient’s symptoms:

1. Stool analysis: A stool analysis can help to determine if there is an infection present in the gut, such as a bacterial or parasitic infection.
2. Blood tests: Blood tests can help to determine if there are any underlying systemic conditions, such as inflammatory bowel disease, celiac disease, or thyroid disorders.
3. Imaging tests: Imaging tests, such as a CT scan or ultrasound, can help to identify any structural abnormalities or inflammation in the gut.

Differential Diagnoses: Based on the patient’s symptoms and physical examination, the following are three potential differential diagnoses:

1. Acute gastroenteritis: Acute gastroenteritis is a common cause of frequent and watery bowel movements. It is usually caused by a viral or bacterial infection and can result in fever, chills, and abdominal pain. The patient’s symptoms and physical examination findings are consistent with acute gastroenteritis, and stool analysis can help to confirm the diagnosis.
2. Inflammatory bowel disease (IBD): IBD is a chronic condition that causes inflammation of the gut, resulting in diarrhea, abdominal pain, and weight loss. Blood tests can help to determine if the patient has an underlying autoimmune disorder, such as Crohn’s disease or ulcerative colitis, which are common types of IBD.
3. Irritable bowel syndrome (IBS): IBS is a functional disorder of the gut that can cause diarrhea, constipation, and abdominal pain. It is often triggered by stress or changes in diet and can be diagnosed based on a patient’s symptoms and exclusion of other underlying conditions.

Rationales for Differential Diagnoses:

1. Acute gastroenteritis: The patient’s symptoms and physical examination findings are consistent with acute gastroenteritis, and stool analysis can help to confirm the diagnosis. Treatment typically involves supportive care, such as fluid and electrolyte replacement, and anti-diarrheal medication if necessary.
2. Inflammatory bowel disease (IBD): The patient’s age and lack of significant past medical history make IBD less likely, but blood tests can help to determine if the patient has an underlying autoimmune disorder. Treatment for IBD typically involves a combination

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