Reference no: EM133657057
A 14-year-old Asian American is at his primary care provider with his parents for an urgent care visit with complaints of intractable loose, watery diarrhea. His past medical history was unremarkable until last month when he first noted the development of crampy abdominal pain, multiple daily bowel movements, rectal urgency, and periods of rectal spasms. He is reporting progressive fatigue, intermittent light-headedness, diminished appetite, and a subsequent five-pound weight loss since symptom onset. He initially didn't seek medical attention for these concerns because he thought these symptoms would go away after he finished the 14-day course of amoxicillin-clavulanic acid (Augmentin) for treatment of acute bacterial sinusitis that was diagnosed by his primary care provider (PCP) three weeks ago. He denied any recent travel and close sick contacts. On physical examination, he was somewhat ill-appearing with conjunctival pallor. Left lower quadrant abdominal tenderness was elicited with deep palpation, but no rebound or guarding was detected. The remainder of his physical examination was unremarkable.
In the analysis, include specific directions you would want the patient and the parents to know about the teenager's condition.
Pathophysiology: Describe the pathophysiology of diarrhea, including the common causes and diagnostic criteria you would consider in the given case.
Treatment: Analyze the pharmacotherapeutic treatments that should be recommended for the individual in the given case. Include the following in your response:
First-line and second-line pharmacological agents
Special considerations for pediatrics
Possible complications related to pharmacological management
Patient Education: Discuss the details you would include when educating patients and parents about diarrhea, its causes, and its treatment. Consider the following in your response:
What are some actions the family can take, such as diet and lifestyle changes?
What other non-pharmacological options can they use?
What should be the frequency of follow-up care?
When will it be appropriate to refer the patient to a specialist?