 |
|
|
|
|
 |
|
Updated: 08/21/07 12:51 PM
|
|
|
|
 |
|
|
| HOME |
HEAL |
EDUCATE |
RESEARCH |
DIRECTORY |
OUTREACH |
|
|
|
|
Thirteen healthy volunteers continued their free choice diet. Stools were collected for 2 days (control) and for 2 days after a single dose of lactulose 20 g, 58 mmols. Lactulose, galactose-fructose, is not digested or absorbed by the small intestine. This 4 day study was repeated when subjects were taking ampicillin 500 mg four times a day.
| |
Control |
Ampicillin |
| Before lactulose: |
|
|
| Stool weight (g/d) |
190 |
273 |
| % unformed stools |
6 |
54 |
| |
|
|
| After lactulose: |
|
|
| Stool weight (g/d) |
195 |
391 |
| % unformed stools |
10 |
70 |
- How would you explain these data?
|
|
|
|
A 40-year old fishing guide has been unable to work in the past six months because of troubling diarrhea. He says that he passes 8 to 10 stools a day whose consistency is like soup and whose color is reddish-brown. His intestinal troubles began five years ago when he was told that he had ulcerative colitis on the basis of a sigmoidoscope examination. He describes his present health as poor, largely because he feels tired and weak. He has, on occasion, soiled his neoprene waders because he was not able to retreat in time from the stream side into the nearby bushes. On examination, he appears pale and undernourished. His stools are rust brown in color and hemoccult positive. General screening examination reveals an iron deficiency anemia and a serum albumin less than normal.
- Why would this patient have liquid-frequent stools?
- Why is he incontinent?
- How would you investigate this patient?
- Why might he have an iron deficiency anemia, or a low serum albumin?
|
|
|
|
A 64-year old housewife visits her family physician because she is feeling run down and fatigued. A general physical exam is unremarkable except for pallor. Screening laboratory tests reveal anemia, which has the characteristics of iron deficiency. Supplemental oral iron salts are prescribed, and one month later, the patient is feeling considerably better, although not completely well.
- How would you evaluate this woman?
|
|
|
|
A 75-year old retired Professor is brought by ambulance to the Emergency Room. He was in reasonably good health until two hours before arrival when he passed a large liquid burgundy stool containing some material which looked like raw liver. His past history is relevant for two episodes within the last year of boring left-sided abdominal pain which responded to oral antibiotics. He was told he had diverticulitis.
- How would you evaluate this woman?
- Why is diverticulitis sometimes referred to as “left-sided appendicitis”?
- What is the pathogenesis of bleeding in diverticular disease? Patients who present with diverticular bleeding do not have diverticulitis.
|
|
|
|
Theoretically, one should be able to use the colon’s absorptive functions to provide water, electrolytes, and calories to patients who are unable to eat or drink. Explain if the following interventions might or might not be helpful. Assume that the enemas reach the cecum and that they are isotonic with plasma.
- enemas of sodium chloride
- enemas of table sugar and sodium chloride
- enemas of sodium acetate
- enemas of corn oil in saline
|
|
| © Copyright University of Washington Division of Gastroenterology 1999-2008
|
