Questions Your Doctor May Ask - and Why!
During a consultation, your doctor will use various techniques in his assesment of the symptom: Diarrhea.
These may include a physical examination or other medical tests.
Your doctor may ask several questions when assessing
your condition. It is important to remember that your consultation is a two-way process and any extra information
you can share with your doctor may help them with their diagnosis.
Some of the questions your doctor may ask are listed below:
- How long have you had diarrhea?
Why: to determine if acute or chronic. Acute diarrhea (without blood) is more likely to be infectious in nature e.g. staphylococcal toxin food poisoning, giardiasis, traveler's diarrhea, a virus or contaminated food. Chronic diarrhea has a large number of causes.
- What exactly do you mean by diarrhea?
Why: the symptom diarrhea may be defined in a number of different ways. Some people complain of frequent stool (more than 3 per day being abnormal) or they may complain of a change in the consistency of the stools which have become loose or watery.
- If diarrhea is acute
- How frequent are the stools?
- What is the volume of the diarrheal stools?
Why: e.g. high volume stools may be suggestive of infection (such as E.Coli, Staphylococcus aureus, Vibrio Cholerae), carcinoid syndrome, bowel polyp, Zollinger-Ellison syndrome, magnesium antacids, lactose intolerance or after gastric surgery; small volume stools may suggest inflammatory bowel disease or colon cancer.
- What is the nature of the stools?
Why: e.g. fatty, pale colored, extremely smelly stools that float in the toilet and are difficult to flush away is called steatorrhea due to excess fat in the stool and are characteristic of malabsorption of nutrients which may be due to celiac disease, chronic pancreatitis, previous gastrectomy and cystic fibrosis.
- Does the diarrhea persist on fasting?
Why: may suggest an infection (such as E.Coli, Staphylococcus aureus, Vibrio cholerae), vasoactive intestinal polypeptide secreting tumor, Zollinger-Ellison syndrome, carcinoid syndrome and villous bowel polyp.
- If diarrhea is acute, where did you eat in the 24 hours before he diarrhea started and what food have you eaten during this time?
Why: may help in discovering the source of possible food poisoning.
- Have any other family members experienced acute diarrhea also?
Why: may suggest toxic staphylococcal gastroenteritis, Salmonella, Shigella, Campylobacter pylori.
- Has there been recent foreign travel?
Why: may suggest traveler's diarrhea, cholera, shigellosis, salmonellosis and giardiasis.
- Medications?
Why: e.g. recent antibiotics may predispose to pseudomembranous colitis; medications that can cause diarrhea include digitalis, diuretics, beta-blockers, aspirin, colchicines, other non-steroidal anti-inflammatory medications; overuse of laxative may also cause diarrhea.
- Alcohol history?
Why: it is well known that alcohol can cause diarrhea.
Questions your doctor may ask about related symptoms:
Sometimes, other symptoms may be present and may help your doctor analyse
your condition. These may include:
- Blood in the stool?
Why: If acute diarrhea, may suggest Salmonella, Shigella, Campylobacter jejuni, ulcerative colitis and amebic dysentery. If chronic diarrhea, may suggest ulcerative colitis, bowel cancer, diverticulitis, amoebiasis, Zollinger-Ellison syndrome.
- Mucous in stool?
Why: suggests ulcerative colitis, Crohn's disease and irritable bowel syndrome.
- Fever?
Why: may suggest Salmonella, Shigella, Campylobacter jejuni and ulcerative colitis, severe amoebic dysentery or pseudomembranous colitis. May get a low grade temperature with traveler's diarrhea and toxic staphylococcal gastroenteritis.
- Severe vomiting?
Why: may suggest toxic staphylococcal gastroenteritis (which follows 2-4 hours after eating food poisoned with the toxin), traveler's diarrhea and viral gastroenteritis.
- Alternating diarrhea and constipation, abdominal bloating, abdominal pain that is relieved by opening the bowels or passing wind?
Why: may suggests irritable bowel syndrome.
- Pain in joints, back pain, eye trouble or mouth ulceration?
Why: may suggest inflammatory bowel disease.
- Neurological symptoms?
Why: e.g. double vision, blurred vision, sensitivity of the eyes to light, poor coordination and difficulty with speaking - may suggest botulism caused by the neurotoxin of clostridium botulinum which flourishes in preserved anaerobic food.
» Next page: Types of Diarrhea
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