Chapter 22, Problem 2CCS

Remember Mr. Gutteman, the gentleman who was dehydrating? It seems that his tremendous output of urine was only one of his current problems. Mr. Gutteman, a 70-year-old man, was in a bus accident and suffered a brain injury that resulted in excess urine output and dehydration. He was admitted to the hospital and treated. 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.

On the basis of these responses, what do you think Mr. Gutteman’s diarrhea might stem from? How will it be diagnosed and treated?