Discussion: foul-smelling greasy diarrhea

Discussion: foul-smelling greasy diarrhea
Discussion: foul-smelling greasy diarrhea
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Discussion: Diagnosis of a patient with ongoing foul-smelling , greasy diarrhea
PART No. 1:
A five-month-old Caucasian female is brought into the clinic as the parent complain that she has been having ongoing foul-smelling , greasy diarrhea. She seems to be small for her age and a bit sickly but, her parent’s state that she has a huge appetite. Upon examination you find that the patient is wheezing and you observe her coughing.
· Write a differential diagnosis of at least three (3) disorders and explain why each might be a possibility and any potential weaknesses of each differential.
· Why is it that the later in age this disease manifest itself, the less severe the disease is?
· What tests would you run to clarify your differential and potentially come to a definitive diagnosis?
· If the same child was African in ancestry would this change your initial differential? Why or why not?
Symptoms of EPI are similar to other conditions that affect your stomach and digestion
Many people do not realize the pancreas plays an important role in digestion and that problems with the pancreas can result in digestive issues. When you have exocrine pancreatic insufficiency (EPI), your body is missing the enzymes it needs to digest food, which causes important nutrients to pass through the body unabsorbed.2
This can lead to a number of signs and symptoms that may vary from person to person. People with EPI may have one, two, or several of the symptoms listed.
EPI symptoms may include2,3:
Foul-smelling, greasy stools (steatorrhea)
People with EPI cannot absorb all of the fat that they eat. The undigested fat that passes through the digestive system may cause oily or greasy-looking stools. These stools may also smell really bad, float, and be difficult to flush.
Not all people experience steatorrhea, but it is the most common sign of EPI. Tell your doctor if you notice oil droplets in the toilet bowl or if your stools have the appearance of salad dressing or motor oil.
Unexplained weight loss
People with EPI cannot properly digest or absorb the fats, proteins, and carbohydrates found in food, which can result in weight loss.
Gas and bloating
Because people with EPI cannot properly digest food, it can cause uncomfortable symptoms such as gas and bloating.
Stomach pain
The gas and bloating that sometimes happen with EPI can cause stomach pain.
Frequent diarrhea
Undigested food may move too quickly through the digestive system, resulting in diarrhea.