Clinical Case Study Digestive System Remember Mr. Gutteman, the gentleman who was dehydrating? It seems that his tremendous output of urine was only one of his current problems. Today, he complains of a headache, gnawing epigastric pain, and "the runs" (diarrhea). To pinpoint the problem, he is asked the following questions. • Have you had these symptoms previously? (Response: "Yes, but never this bad.") • Are you allergic to any foods? (Response: "Shellfish doesn't like me and milk gives me the runs.") As a result of his responses, a lactose-free diet is ordered for Mr. Gutteman instead of the regular diet originally prescribed
1. Why is the new diet prescribed? (What is believed to be his problem?)
Mr. Gutteman’s problem continues despite the diet change. In fact, the
frequency of diarrhea increases and by the end of the next day, he is
complaining of severe abdominal pain. Again, he is asked some questions to probe his condition. One is whether he has traveled outside the country
recently. He has not, reducing the possibility of infection with Shigella bacteria, which is associated with poor sanitation. Other questions: ● Do you drink alcohol and how much? (Response: “Little or none.”) ● Have you recently eaten raw eggs or a salad containing mayonnaise at a gathering?
(Response: “No.”) ● Are there certain foods that seem to precipitate these attacks? (Response: “Yes, when I have coffee and a sandwich.”) 2. On the basis of these responses, what do you think Mr. Gutteman’s diarrhea might stem from? How will it be diagnosed and treated?
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