Recognizing and Reacting to Abdominal Pain

Total Page:16

File Type:pdf, Size:1020Kb

Recognizing and Reacting to Abdominal Pain WELLNESS COUNCIL OF AMERICA PRESENTS ISSUE #7 ActivelyInvolvedTHE BEST CARE IS SELF-CARE Recognizing and Reacting to abdominal Pain ost abdominal pain is not serious, although FRequently asked questions Mit can be extremely uncomfortable. Diarrhea, constipation, and excessive gas are common causes of I hear that a normal person has a bowel movement abdominal pain. at least once a day. Is this true? Fortunately, these conditions can be treated at home } No. In fact, anywhere from three times a day to using simple self-care techniques. Treatment depends on three times a week is considered “normal.” What which of these conditions you are experiencing. you should be most concerned with is what is most normal for you. Your Signs & Symptoms bowel frequency may Oftentimes, the symptoms of diarrhea, constipation, and change slightly from time to time, which is nothing gas can be similar, and may even be experienced together. to worry about. Drastic Take a closer look at the symptoms outlined here to changes, however, may determine which condition you may be experiencing. be cause to seek medical advice. Diarrhea } More than three or four loose, watery stools per day What’s the best way to } Cramping or pain in the abdomen prevent gas? } Bloating } There’s no single way to Constipation prevent gas altogether, } Difficulty passing stools but paying close attention to what } Firm, hard bowel movements you eat, and how } Cramping and pain in the rectum your body reacts to it, is a good first step. Gas Watch also what you } Rumbling in the stomach drink. Carbonated } Excessive flatulence (more than 20 per day) drinks such as soda } Inability to pass gas and beer can cause } Bloating gas. Be sure to get plenty of exercise, as this will help your Home treatment for most abdominal body eliminate gas in a healthy, natural way. pain is relatively straightforward, and most often involves taking an over- the-counter medication to relieve symptoms. 17002 Marcy Street, Suite 140 | Omaha, NE 68118 | PH: 402-827-3590 | FX: 402-827-3594 | www.welcoa.org 1 ISSUE #7 Home Treatment When to seek caRe Home treatment for most abdominal pain is relatively straightforward, and most often involves taking an over- Most abdominal pain is more of an annoyance than a the-counter medication to relieve symptoms. serious medical condition. However, there are times when your condition may indicate the presence of a Diarrhea more serious health problem. Seek medical attention } Drink eight, 8 oz. glasses of water or other clear if you’re experiencing any of the following symptoms. fluids such as clear soda, juices, or tea each day. } As your diarrhea clears, add semisolid and low- diarrhea fiber foods to your diet. } If you have diarrhea that lasts longer than one week } Avoid dairy products, fatty, or seasoned foods. } If you become dehydrated—symptoms include Stay away from caffeine and nicotine. little or no urination, weakness or dizziness, and an } Try an over-the-counter medication such as excessively dry mouth Pepto-Bismol or Imodium. } If stools are bloody Constipation } If you have a fever of 101.5°F or higher with diarrhea } Eat on a regular schedule if possible, and consume more high-fiber foods such as fruits constipation and vegetables. } If stools are thin and pencil-like (can indicate the } Drink eight, 8 oz. glasses of water or other clear presence of a tumor in the lower bowel) fluids such as clear soda, juices, or tea each day. } Increase your level of physical activity. } If your constipation lasts longer than three weeks } If necessary, try a laxative such as Metamucil or } If stools are bloody Milk of Magnesia. (Be sure to follow label directions as excessive use of laxatives can actually be } If you are reliant on laxatives for bowel movements harmful and make your constipation worse.) gas Gas } If your gas is accompanied by crushing or squeezing } Avoid eating spicy or fatty foods. chest pain (possible sign of a heart attack) } Eat slowly, and avoid excessive air intake. } If gas is associated with pain that spreads to the } Cut down on carbonated drinks and beer. upper abdomen, back, jaw, or arms (possible sign } Avoid lying down immediately after eating. of a heart attack) } Increase your level of physical activity. } If your gas is accompanied by severe, steady pain in } Try an over-the-counter medication such as the upper abdomen Gas-X to relieve symptoms. AI is youR stomach Pain Appendicitis? Appendicitis is an inflammation of the appendix, a small, hollow sac attached to the large intestine. The appendix is located in the lower right area of the abdomen. Fortunately, a very specific sequence of events will usually occur if you have appendicitis. If appendicitis is the cause of your pain, the first symptom you will most likely experience is pain near the belly button or just below the breastbone. Next, you may experience nausea and vomiting. You may also lose your appetite. The third symptom you will most likely experience with appendicitis is pain in the lower, right corner of your abdomen. Finally, you will experience a fever between 100°F and 102°F. Remember, these are the classic signs and symptoms of appendicitis—if you suspect you have appendicitis, contact your healthcare provider right away. 17002 Marcy Street, Suite 140 | Omaha, NE 68118 | PH: 402-827-3590 | FX: 402-827-3594 | www.welcoa.org 2 ISSUE #7 Recognizing and Reacting to NAUSEA & VOMITING About Nausea & Vomiting Two uncomfortable feelings in life are nausea and vomiting. Nausea is an unpleasant, churning sensation felt down inside the stomach, whereas vomiting is the expulsion of stomach contents through the esophagus and out of the mouth. Oftentimes, vomiting is preceded and even caused by an intense feeling of nausea. Vomiting and nausea, though not diseases in and of themselves, often indicate the presence of a common viral infection— known as gastroenteritis—in the intestines. Other causes of nausea and vomiting may include adverse reactions to certain medications, food poisoning, pregnancy, and motion sickness. If not cared for properly, nausea and vomiting can lead to other complications that include dehydration (lack of water in the body), aspiration (food lodged in the windpipe), or even serious damage to your body including tearing of the food pipe. The rest of this section is dedicated to helping you treat and manage bouts of nausea and vomiting. Each year, 76 million cases of food-borne illness are reported, and 325,000 people are hospitalized due to tainted food. 17002 Marcy Street, Suite 140 | Omaha, NE 68118 | PH: 402-827-3590 | FX: 402-827-3594 | www.welcoa.org 3 ISSUE #7 When to seek caRe Signs & Symptoms The signs and symptoms of nausea and vomiting are Even though nausea and vomiting are usually not serious, easy to identify. Often a nauseated person will feel the sometimes a trip to the doctor may be necessary. Seek medical attention immediately in the following situations: following symptoms. } If you notice blood in the vomit. Blood may sometimes } Fatigue look like coffee grounds when partially digested. } A warm or sweaty feeling } If you get dehydrated (signs of dehydration include dry } Excessive saliva in the mouth mouth, sticky saliva, and dark, yellow urine). While nausea and vomiting are usually symptoms of } If you develop a stiff neck. other medical conditions, there are a number of triggers } If you experience any chest pain. that can make a person feel nauseous or vomit: } If you have been vomiting for more than a few days and/ } Gastroenteritis (a common viral condition or symptoms are becoming more frequent and severe. passed easily from person to person) } Adverse reactions to medications about Food Poisoning } Excessive consumption of alcohol } Colds and flu Food poisoning is one of the most common causes of } Food poisoning nausea and vomiting. In fact, the more than 250 existing food-borne diseases account for an estimated 76 million } Overeating illnesses, 325,000 hospitalizations, and 5,200 deaths in the } Motion sickness United States each year. } Bad smells Symptoms of food poisoning often include nausea, } Migraine headaches vomiting, diarrhea, and stomach pain. Practice Food safety. The following simple guidelines on Home Treatment food preparation, handling, and storage can easily prevent Treating nausea and vomiting in your home the vast majority of food-borne illness. The following guidelines can help you avoid the nausea and vomiting can be simple and effective. The following associated with many food-borne illnesses. remedies can help calm your stomach, and } Keep foods hot or cold—room temperature is where help you feel better quickly. many bacteria grow. } Refrain from eating or drinking for } Set your refrigerator between 34°F and 40°F. several hours. (You may attempt to eat } According to the FDA, 23 percent of household small amounts of bland food like dry refrigerators are not cold enough. toast, water, crackers and rice.) } Defrost meats in the refrigerator or microwave. } Drink cool, clear fluids to prevent } Cook hamburger/ground meats thoroughly. dehydration. } Don’t eat undercooked or raw eggs. } Avoid fatty, fried, or spicy foods as well as } Refrigerate foods immediately. dairy items. Also avoid alcohol, nicotine, and } Keep all cutting boards clean. caffeine. Remember the two-hour Rule. Leaving food at room } Drink small amounts of sugared soda (sugar can temperature for more than two hours is dangerous— help calm the stomach). AI bacteria grow rapidly between 40°F and 140°F. Remember to refrigerate leftovers immediately after eating. Use shallow containers to speed cooling. Also, the USDA The information contained in this medical self-care newsletter can be used recommends that food left in the fridge for more than three to increase your personal awareness of how to manage minor health issues.
Recommended publications
  • Utility of the Digital Rectal Examination in the Emergency Department: a Review
    The Journal of Emergency Medicine, Vol. 43, No. 6, pp. 1196–1204, 2012 Published by Elsevier Inc. Printed in the USA 0736-4679/$ - see front matter http://dx.doi.org/10.1016/j.jemermed.2012.06.015 Clinical Reviews UTILITY OF THE DIGITAL RECTAL EXAMINATION IN THE EMERGENCY DEPARTMENT: A REVIEW Chad Kessler, MD, MHPE*† and Stephen J. Bauer, MD† *Department of Emergency Medicine, Jesse Brown VA Medical Center and †University of Illinois-Chicago College of Medicine, Chicago, Illinois Reprint Address: Chad Kessler, MD, MHPE, Department of Emergency Medicine, Jesse Brown Veterans Hospital, 820 S Damen Ave., M/C 111, Chicago, IL 60612 , Abstract—Background: The digital rectal examination abdominal pain and acute appendicitis. Stool obtained by (DRE) has been reflexively performed to evaluate common DRE doesn’t seem to increase the false-positive rate of chief complaints in the Emergency Department without FOBTs, and the DRE correlated moderately well with anal knowing its true utility in diagnosis. Objective: Medical lit- manometric measurements in determining anal sphincter erature databases were searched for the most relevant arti- tone. Published by Elsevier Inc. cles pertaining to: the utility of the DRE in evaluating abdominal pain and acute appendicitis, the false-positive , Keywords—digital rectal; utility; review; Emergency rate of fecal occult blood tests (FOBT) from stool obtained Department; evidence-based medicine by DRE or spontaneous passage, and the correlation be- tween DRE and anal manometry in determining anal tone. Discussion: Sixteen articles met our inclusion criteria; there INTRODUCTION were two for abdominal pain, five for appendicitis, six for anal tone, and three for fecal occult blood.
    [Show full text]
  • General Signs and Symptoms of Abdominal Diseases
    General signs and symptoms of abdominal diseases Dr. Förhécz Zsolt Semmelweis University 3rd Department of Internal Medicine Faculty of Medicine, 3rd Year 2018/2019 1st Semester • For descriptive purposes, the abdomen is divided by imaginary lines crossing at the umbilicus, forming the right upper, right lower, left upper, and left lower quadrants. • Another system divides the abdomen into nine sections. Terms for three of them are commonly used: epigastric, umbilical, and hypogastric, or suprapubic Common or Concerning Symptoms • Indigestion or anorexia • Nausea, vomiting, or hematemesis • Abdominal pain • Dysphagia and/or odynophagia • Change in bowel function • Constipation or diarrhea • Jaundice “How is your appetite?” • Anorexia, nausea, vomiting in many gastrointestinal disorders; and – also in pregnancy, – diabetic ketoacidosis, – adrenal insufficiency, – hypercalcemia, – uremia, – liver disease, – emotional states, – adverse drug reactions – Induced but without nausea in anorexia/ bulimia. • Anorexia is a loss or lack of appetite. • Some patients may not actually vomit but raise esophageal or gastric contents in the absence of nausea or retching, called regurgitation. – in esophageal narrowing from stricture or cancer; also with incompetent gastroesophageal sphincter • Ask about any vomitus or regurgitated material and inspect it yourself if possible!!!! – What color is it? – What does the vomitus smell like? – How much has there been? – Ask specifically if it contains any blood and try to determine how much? • Fecal odor – in small bowel obstruction – or gastrocolic fistula • Gastric juice is clear or mucoid. Small amounts of yellowish or greenish bile are common and have no special significance. • Brownish or blackish vomitus with a “coffee- grounds” appearance suggests blood altered by gastric acid.
    [Show full text]
  • Diagnostic Approach to Chronic Constipation in Adults NAMIRAH JAMSHED, MD; ZONE-EN LEE, MD; and KEVIN W
    Diagnostic Approach to Chronic Constipation in Adults NAMIRAH JAMSHED, MD; ZONE-EN LEE, MD; and KEVIN W. OLDEN, MD Washington Hospital Center, Washington, District of Columbia Constipation is traditionally defined as three or fewer bowel movements per week. Risk factors for constipation include female sex, older age, inactivity, low caloric intake, low-fiber diet, low income, low educational level, and taking a large number of medications. Chronic constipa- tion is classified as functional (primary) or secondary. Functional constipation can be divided into normal transit, slow transit, or outlet constipation. Possible causes of secondary chronic constipation include medication use, as well as medical conditions, such as hypothyroidism or irritable bowel syndrome. Frail older patients may present with nonspecific symptoms of constipation, such as delirium, anorexia, and functional decline. The evaluation of constipa- tion includes a history and physical examination to rule out alarm signs and symptoms. These include evidence of bleeding, unintended weight loss, iron deficiency anemia, acute onset constipation in older patients, and rectal prolapse. Patients with one or more alarm signs or symptoms require prompt evaluation. Referral to a subspecialist for additional evaluation and diagnostic testing may be warranted. (Am Fam Physician. 2011;84(3):299-306. Copyright © 2011 American Academy of Family Physicians.) ▲ Patient information: onstipation is one of the most of 1,028 young adults, 52 percent defined A patient education common chronic gastrointes- constipation as straining, 44 percent as hard handout on constipation is 1,2 available at http://family tinal disorders in adults. In a stools, 32 percent as infrequent stools, and doctor.org/037.xml.
    [Show full text]
  • Abdominal Pain - Gastroesophageal Reflux Disease
    ACS/ASE Medical Student Core Curriculum Abdominal Pain - Gastroesophageal Reflux Disease ABDOMINAL PAIN - GASTROESOPHAGEAL REFLUX DISEASE Epidemiology and Pathophysiology Gastroesophageal reflux disease (GERD) is one of the most commonly encountered benign foregut disorders. Approximately 20-40% of adults in the United States experience chronic GERD symptoms, and these rates are rising rapidly. GERD is the most common gastrointestinal-related disorder that is managed in outpatient primary care clinics. GERD is defined as a condition which develops when stomach contents reflux into the esophagus causing bothersome symptoms and/or complications. Mechanical failure of the antireflux mechanism is considered the cause of GERD. Mechanical failure can be secondary to functional defects of the lower esophageal sphincter or anatomic defects that result from a hiatal or paraesophageal hernia. These defects can include widening of the diaphragmatic hiatus, disturbance of the angle of His, loss of the gastroesophageal flap valve, displacement of lower esophageal sphincter into the chest, and/or failure of the phrenoesophageal membrane. Symptoms, however, can be accentuated by a variety of factors including dietary habits, eating behaviors, obesity, pregnancy, medications, delayed gastric emptying, altered esophageal mucosal resistance, and/or impaired esophageal clearance. Signs and Symptoms Typical GERD symptoms include heartburn, regurgitation, dysphagia, excessive eructation, and epigastric pain. Patients can also present with extra-esophageal symptoms including cough, hoarse voice, sore throat, and/or globus. GERD can present with a wide spectrum of disease severity ranging from mild, intermittent symptoms to severe, daily symptoms with associated esophageal and/or airway damage. For example, severe GERD can contribute to shortness of breath, worsening asthma, and/or recurrent aspiration pneumonia.
    [Show full text]
  • Acute Abdomen
    Acute abdomen: Shaking down the Acute abdominal pain can be difficult to diagnose, requiring astute assessment skills and knowledge of abdominal anatomy 2.3 ANCC to discover its cause. We show you how to quickly and accurately CONTACT HOURS uncover the clues so your patient can get the help he needs. By Amy Wisniewski, BSN, RN, CCM Lehigh Valley Home Care • Allentown, Pa. The author has disclosed that she has no significant relationships with or financial interest in any commercial companies that pertain to this educational activity. NIE0110_124_CEAbdomen.qxd:Deepak 26/11/09 9:38 AM Page 43 suspects Determining the cause of acute abdominal rapidly, indicating a life-threatening process, pain is often complex due to the many or- so fast and accurate assessment is essential. gans in the abdomen and the fact that pain In this article, I’ll describe how to assess a may be nonspecific. Acute abdomen is a patient with acute abdominal pain and inter- general diagnosis, typically referring to se- vene appropriately. vere abdominal pain that occurs suddenly over a short period (usually no longer than What a pain! 7 days) and often requires surgical interven- Acute abdominal pain is one of the top tion. Symptoms may be severe and progress three symptoms of patients presenting in www.NursingMadeIncrediblyEasy.com January/February 2010 Nursing made Incredibly Easy! 43 NIE0110_124_CEAbdomen.qxd:Deepak 26/11/09 9:38 AM Page 44 the ED. Reasons for acute abdominal pain Visceral pain can be divided into three Your patient’s fall into six broad categories: subtypes: age may give • inflammatory—may be a bacterial cause, • tension pain.
    [Show full text]
  • Review of Systems
    code: GF004 REVIEW OF SYSTEMS First Name Middle Name / MI Last Name Check the box if you are currently experiencing any of the following : General Skin Respiratory Arthritis/Rheumatism Abnormal Pigmentation Any Lung Troubles Back Pain (recurrent) Boils Asthma or Wheezing Bone Fracture Brittle Nails Bronchitis Cancer Dry Skin Chronic or Frequent Cough Diabetes Eczema Difficulty Breathing Foot Pain Frequent infections Pleurisy or Pneumonia Gout Hair/Nail changes Spitting up Blood Headaches/Migraines Hives Trouble Breathing Joint Injury Itching URI (Cold) Now Memory Loss Jaundice None Muscle Weakness Psoriasis Numbness/Tingling Rash Obesity Skin Disease Osteoporosis None Rheumatic Fever Weight Gain/Loss None Cardiovascular Gastrointestinal Eyes - Ears - Nose - Throat/Mouth Awakening in the night smothering Abdominal Pain Blurring Chest Pain or Angina Appetite Changes Double Vision Congestive Heart Failure Black Stools Eye Disease or Injury Cyanosis (blue skin) Bleeding with Bowel Movements Eye Pain/Discharge Difficulty walking two blocks Blood in Vomit Glasses Edema/Swelling of Hands, Feet or Ankles Chrohn’s Disease/Colitis Glaucoma Heart Attacks Constipation Itchy Eyes Heart Murmur Cramping or pain in the Abdomen Vision changes Heart Trouble Difficulty Swallowing Ear Disease High Blood Pressure Diverticulosis Ear Infections Irregular Heartbeat Frequent Diarrhea Ears ringing Pain in legs Gallbladder Disease Hearing problems Palpitations Gas/Bloating Impaired Hearing Poor Circulation Heartburn or Indigestion Chronic Sinus Trouble Shortness
    [Show full text]
  • Chilaiditi's Syndrome Complicated by Colon Perforation
    CASE REPORT Chilaiditi’s syndrome complicated by colon perforation: a case report Turan Acar, M.D., Erdinç Kamer, M.D., Nihan Acar, M.D., Ahmet Er, M.D., Mustafa Peşkersoy, M.D. Department of Surgery, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir ABSTRACT Hepatodiaphragmatic interposition of the small or large intestine is known as Chilaiditi syndrome, whichis a rare disease diagnosed incidentally. Chilaiditi syndrome is typically asymptomatic, but it can be associated with symptoms ranging from intermittent, mild ab- dominal pain to acute intestinal obstruction, constipation, chest pain and breathlessness. A 54-year-old male patient was admitted to the hospital with a history of abdominal pain, nausea and vomiting. Chest X-ray revealed an elevation of the right hemidiaphragma caused by the presence of a dilated colonic loop below. The patient underwent urgent surgery with perforation as preliminary diagnosis. The pa- tient underwent right hemicolectomy and ileocolic anastomosis because of the intestinal obstruction related to Chilaiditi’s Syndrome. Due to the rarity of this syndrome and typical radiological findings, this case was aimed to be presented. Key words: Abdominal pain; Chilaiditi’s syndrome; surgery. INTRODUCTION CASE REPORT Interposition of the bowel (usually transverse colon or he- A 54-year-oldmale patient was admitted to the Emergency patic flexura) or the small intestine between the liver and Department of Surgery, Izmir Katip Celebi University Ataturk diaphragm, which is a rare anomaly, was first defined by the Training and Research Hospital with a 24-hour history of right Greek radiologist Demetrius Chilaiditi in 1910.[1,2] It is inci- upper abdominal pain, nausea and vomiting.
    [Show full text]
  • En 17-Chilaiditi™S Syndrome.P65
    Nagem RG et al. SíndromeRELATO de Chilaiditi: DE CASO relato • CASE de caso REPORT Síndrome de Chilaiditi: relato de caso* Chilaiditi’s syndrome: a case report Rachid Guimarães Nagem1, Henrique Leite Freitas2 Resumo Os autores apresentam um caso de síndrome de Chilaiditi em uma mulher de 56 anos de idade. Mesmo tratando-se de condição benigna com rara indicação cirúrgica, reveste-se de grande importância pela implicação de urgência operatória que representa o diagnóstico equivocado de pneumoperitônio nesses pacientes. É realizada revisão da li- teratura, com ênfase na fisiopatologia, propedêutica e tratamento desta entidade. Unitermos: Síndrome de Chilaiditi; Sinal de Chilaiditi; Abdome agudo; Pneumoperitônio; Espaço hepatodiafragmático. Abstract The authors report a case of Chilaiditi’s syndrome in a 56-year-old woman. Although this is a benign condition with rare surgical indication, it has great importance for implying surgical emergency in cases where such condition is equivocally diagnosed as pneumoperitoneum. A literature review is performed with emphasis on pathophysiology, diagnostic work- up and treatment of this entity. Keywords: Chilaiditi’s syndrome; Chilaiditi’s sign; Acute abdomen; Pneumoperitoneum; Hepatodiaphragmatic space. Nagem RG, Freitas HL. Síndrome de Chilaiditi: relato de caso. Radiol Bras. 2011 Set/Out;44(5):333–335. INTRODUÇÃO RELATO DO CASO tricos, com pressão arterial de 130 × 90 mmHg. Abdome tenso, doloroso, sem irri- Denomina-se síndrome de Chilaiditi a Paciente do sexo feminino, 56 anos de tação peritoneal, com ruídos hidroaéreos interposição temporária ou permanente do idade, foi admitida na unidade de atendi- preservados. De imediato, foram solicita- cólon ou intestino delgado no espaço he- mento imediato com quadro de dor abdo- dos os seguintes exames: amilase: 94; PCR: patodiafragmático, causando sintomas.
    [Show full text]
  • Today's Topic: Bloating
    Issue 1; August 2017 Dr. Rajiv Sharma attended medical school at Daya- nand Medical College, Punjab, India. He received his Undernourished, intelligence Internal Medicine training from Loma Linda Univer- sity, Loma Linda, California and received his Gastro- becomes like the bloated belly enterology Fellowship training from University of Rochester, Rochester, New York. Dr. Sharma trained of a starving child: swollen, under the mentorship of Dr. Richard G. Farmer, who is world renowned for his work on Inflammatory Bowel Disease. filled with nothing the body Rajiv Sharma, MD Dr. Sharma’s special interests include GERD, NERD, can use.” Inflammatory Bowel Disease (Crohn’s & Ulcerative Colitis), IBS, Acute and Chronic Pancreatitis, Gastro- intestinal Malignancies and Familial Cancer Syn- - Andrea Dworkin dromes. In an effort to share his extensive knowledge with the public, Dr. Sharma re- leased his first book, Pursuit of Gut Happiness: A Guide for Using Probiotics to Inside this issue Achieve Optimal Health, in 2014. In Dr. Sharma’s free time, he enjoys medical writing, watching movies, exercis- Differential Diagnosis 2 ing and spending time with his family. He believes in “whole person care” and the effect of mind, body and spirit on “wellness”. He has a special interest in nu- trition, exercise and healthy eating. He prides himself on being a “fact doctor” as Signs of a More Serious 2 he backs his opinions and works with solid scientific research while aiming to deliver a simple and clear message. Problem Lab Workup 2 Non-Pathological Bloating 2 Today’s Topic: Bloating Bloating may seem an odd topic to choose for our first newsletter.
    [Show full text]
  • Travelers' Diarrhea
    Travelers’ Diarrhea What is it and who gets it? Travelers’ diarrhea (TD) is the most common illness affecting travelers. Each year between 20%-50% of international travelers, an estimated 10 million persons, develop diarrhea. The onset of TD usually occurs within the first week of travel but may occur at any time while traveling and even after returning home. The primary source of infection is ingestion of fecally contaminated food or water. You can get TD whenever you travel from countries with a high level of hygiene to countries that have a low level of hygiene. Poor sanitation, the presence of stool in the environment, and the absence of safe restaurant practices lead to widespread risk of diarrhea from eating a wide variety of foods in restaurants, and elsewhere. Your destination is the most important determinant of risk. Developing countries in Latin America, Africa, the Middle East, and Asia are considered high risk. Most countries in Southern Europe and a few Caribbean islands are deemed intermediate risk. Low risk areas include the United States, Canada, Northern Europe, Australia, New Zealand, and several of the Caribbean islands. Anyone can get TD, but persons at particular high-risk include young adults , immunosuppressed persons, persons with inflammatory-bowel disease or diabetes, and persons taking H-2 blockers or antacids. Attack rates are similar for men and women. TD is caused by bacteria, protozoa or viruses that are ingested by eating contaminated food or beverages. For short-term travelers in most areas, bacteria are the cause of the majority of diarrhea episodes. What are common symptoms of travelers’ diarrhea? Most TD cases begin abruptly.
    [Show full text]
  • Symptomatic Approach to Gas, Belching and Bloating 21
    20 Osteopathic Family Physician (2019) 20 - 25 Osteopathic Family Physician | Volume 11, No. 2 | March/April, 2019 Gennaro, Larsen Symptomatic Approach to Gas, Belching and Bloating 21 Review ARTICLE to escape. This mechanism prevents the stomach from becoming IRRITABLE BOWEL SYNDROME (IBS) Symptomatic Approach to Gas, Belching and Bloating damaged by excessive dilation.2 IBS is abdominal pain or discomfort associated with altered with OMT Treatment Options Many patients with GERD report increased belching. Transient bowel habits. It is the most commonly diagnosed GI disorder lower esophageal sphincter (LES) relaxation is the major and accounts for about 30% of all GI referrals.7 Criteria for IBS is recurrent abdominal pain at least one day per week in the Carly Gennaro, DO1; Helaine Larsen, DO1 mechanism for both belching and GERD. Recent studies have shown that the number of belches is related to the number of last three months associated with at least two of the following: times someone swallows air. These studies have concluded that 1) association with defecation, 2) change in stool frequency, 1 Good Samaritan Hospital Medical Center, West Islip, NY patients with GERD swallow more air in response to heartburn and 3) change in stool form. Diagnosis should be made using these therefore belch more frequently.3 There is no specific treatment clinical criteria and limited testing. Common symptoms are for belching in GERD patients, so for now, physicians continue to abdominal pain, bloating, alternating diarrhea and constipation, treat GERD with proton pump inhibitors (PPIs) and histamine-2 and pain relief after defecation. Pain can be present anywhere receptor antagonists with the goal of suppressing heartburn and in the abdomen, but the lower abdomen is the most common KEYWORDS: ABSTRACT: Intestinal gas production is a normal physiologic progress.
    [Show full text]
  • GASTROINTESTINAL COMPLAINT Nausea, Vomiting, Or Diarrhea (For Abdominal Pain – Refer to SO-501) I
    DESCHUTES COUNTY ADULT JAIL SO-559 L. Shane Nelson, Sheriff Standing Order Facility Provider: October 17, 2018 STANDING ORDER GASTROINTESTINAL COMPLAINT Nausea, Vomiting, or Diarrhea (for Abdominal Pain – refer to SO-501) I. ASSESSMENT a. History i. Onset and duration ii. Frequency of vomiting, nausea, or diarrhea iii. Blood in stool or black stools? Blood in emesis or coffee-ground appearance? If yes, refer to SO-510 iv. Medications taken – do they help? v. Do they have abdominal pain? If yes, refer to SO-501 Abdominal Pain. vi. Do they have other symptoms – dysuria, urinary frequency, urinary urgency, urinary incontinence, vaginal/penile discharge, hematuria, fever, chills, flank pain, abdominal/pelvic pain in females or testicular pain in males, vaginal or penile lesions/sores? (if yes to any of the above – refer to Dysuria SO-522) vii. LMP in female inmates – if unknown, obtain HCG viii. History of substance abuse? Are they withdrawing? Refer to appropriate SO based on substance history and withdrawal concerns. ix. History of IBS or other known medical causes of chronic diarrhea, nausea, or vomiting? Have prescriptions been used for this in the past? x. History of abdominal surgeries? xi. Recent exposure to others with same symptoms? b. Exam i. Obtain Vital signs, including temperature ii. If complaints of dizziness or lightheadedness with standing, obtain orthostatic VS. iii. Is there jaundice present? iv. Are there signs of dehydration – tachycardia, tachypnea, lethargy, changes in mental status, dry mucous membranes, pale skin color, decreased skin turgor? v. Are you concerned for an Acute Gastroenteritis? Supersedes: March 20, 2018 Review Date: October 2020 Total Pages: 3 1 SO-559 October 17, 2018 Symptoms Exam Viruses cause 75-90% of acute gastroenteritis here in the US.
    [Show full text]