# data[].attributes.body
35-year-old man: adult. active lifestyle, stress

comes to the clinic: not severe, concern about symptom

diarrhea: increase fluid secretion, decrease fluid absorption. acute or chronic. infection - to decrease concentration of bacterial toxin.

organs:
whole GI tract

# data[].attributes.body
HOPI
1. Site: abdominal pain
2. Onset: when does it start
3. Characteristic: contents (bloody diarrhea), volume, consistency (steatorrhea), colour, frequency
4. Radiation: radiation of the pain
5. Associated symptoms: Nausea,Vomiting, fever, weight loss, dehydration, flatulence, fatigue, loss of appetite, tenesmus
6. Time: acute or chronic, intermittent, acute on chronic
7. exacerbating factors: spicy foods, milk, gluten, antibiotic, laxatives,
relieving factor: medication for anti-diarrhea, ORS, cikite'un
8. Severity: scale 1-10

PMH
surgery, hospital administration, same symptoms in the past, metabolic syndrome, diabeter, hypertension

Medication:
antibiotic, immunosuppressant, chemotherapy

Social history:
travels, dietary habit, community outbreak, occupation (stress), smoking, drug abuse, alcohol

Family history:
similar symptoms, tumor history, metabolic syndrome

# data[].attributes.body
ACUTE:

AGE

food poisoning

Side effect of drugs (antibiotic, laxatives, NSAIDs)

food intolerance - milk, spicy foods

bacterial or viral infection (travelers diarrhea)

food allergy

CHRONIC

IBD (crohn's dss)

IBS

malabsorption syndrome

colon cancer

# data[].attributes.body
1. diarrhoea started about 2 days ago : Acute

2. loss of appetite: inflammation causing discomfort leading to loss of appetite

3. 20-minute drive to work he became nauseated and
diaphoretic: discomfort increase sympathetic activation

4. low-grade  fever; infection'

5.  abdominal cramping before one episode of vomiting: increase motility, electrolyte imbalance causing muscle spasm

6.   next 24 hours,  diarrhoea developed with 5 bowel movements: loss more fluid, progressively worsen

7. stool being watery and brown without any blood: excessive water loss. no Lower GI bleeding

8. eaten  only  food prepared at home for the last week: contaminated water, more hygiene

9. bus driver: increase risk of infection

10.  no known sick contacts: rule out poisoning

# data[].attributes.body
vital signs (BP,HR,RR,Temperature)

BMI

PE (palpate abdomen, bowel sounds (auscultation))

investigation:

Stool culture, BUSE, serology, blood test, Urea test,

# data[].attributes.body
ACUTE:

AGE

food poisoning

Side effect of drugs (antibiotic, laxatives, NSAIDs)

food intolerance - milk, spicy foods

bacterial or viral infection (travelers diarrhea)

food allergy

CHRONIC

IBD (crohn's dss)

IBS

malabsorption syndrome

colon cancer

# data[].attributes.body
1. Temp. slightly high- indicates infection
2. other vitals are normal
3. abdomen is soft and diffusely tender on palpation- inflammation, pain not localized
4. hyperactive  bowel  sounds  on  auscultation- inc. peristalsis, inc. content of bowel and motility
5. rectal exam shows brown, heme-negative stool- (bile metabolism normal, no lower GI bleeding)

# data[].attributes.body
1. 5 Bowel movements: diarrhea (Normal: 3x/week or 1-2x/day)

2. low-grade  fever: 37-38

# data[].attributes.body
investigation:

Stool culture,

BUSE,

serology,

blood test,

Urea test,

# data[].attributes.body
ACUTE:
-AGE
-bacterial or viral infection (travelers diarrhea)

# data[].attributes.body
ACUTE:
-AGE
-bacterial or viral infection (travelers diarrhea)

# data[].attributes.body
1. C-reactive protein (CRP) - acute infection
2. diagnosis of norovirus infection using multiplex polymerase chain reaction (PCR) on a stool sample
- multiplex PCR - can detect many genes
- most common organism that causes AGE
3.  acute viral gastroenteritis- self-limiting

4.directions for oral rehydration- to treat dehydration
5. reported sleeping for most of the afternoon and was well enough to return to work the next day- well rested