설사(Diarrhea)의 문진, 진찰, 감별진단

소개글

설사 환자에 대한 문진, 진찰, 감별진단

목차

1. Acute
2. Chronic

본문내용

General
문제정의 :stool weight >200 g/d or 하루에 3회이상
acute if <2 weeks, persistent if 2?4 weeks, and chronic if >4 weeks in duration.
Dehydration, Fever 여부
혈변, 체중감소(kg/month) -> alarm sx.
Cause
1. Acute
…Vomiting, fever, abdominal pain, Travel Hx.Drug Hx.
1) Infection (m/c)
2) Medication ;다이어트약, 변비약
3) pelvicinflammation (e.g., acute appendicitis)
4) intestinal ischemia
2. Chronic
…변의 양상, 약물력, 동반질환, 수술력, 가족력,
1) Secretory :Chronic bacterial infections (eg, Aeromonas), giardiasis,
Hormone-producing tumors, Addison`s disease
2) Osmotic :Osmotic laxatives (Mg2+, PO4?3, SO4?2)
Lactase deficiencies
Nonabsorbable carbohydrates (sorbitol, lactulose, polyethylene glycol)
3) Steatorrheal :pancreatic exocrine insufficiency, bacterial overgrowth, celiac sprue, Whipple ds.
4)Inflammatory : IBD, infection, RTx
5) Dysmotile : IBS, hyperthyroidism, prokinetics

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