A patient presents with painless diarrhea. What should you do next?

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 67-year-old woman is evaluated for a 1-year history of loose stools. She reports approximately four episodes per day without abdominal pain. She has not had nausea, vomiting, weight loss, bright red blood per rectum, or melena. On physical examination, temperature is 36.7 °C (98.1 °F), blood pressure is 115/85 mm Hg, pulse rate is 76/min, and respiration rate is 18/min; BMI is 25. No rashes are noted. Abdominal examination is normal. Rectal examination demonstrates normal resting anal tone. Laboratory studies reveal a normal complete blood count, thyroid-stimulating hormone level, tissue transglutaminase IgA level, and total IgA level. Results of a routine screening colonoscopy for colon cancer done 1 year ago were normal. Which of the following is the most appropriate next step in management? A. Begin dicyclomine B. Check antigliadin antibody C. Initiate loperamide D. Perform flexible sigmoidoscopy with colon biopsies Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Conditions GI Source Type: blogs