At the gastroenterology clinic, the medical team begins a diagnostic workup to identify the source of Daniel’s excessive diarrhea and unintentional weight loss. The team probes for his medical...

At the gastroenterology clinic, the medical team begins a diagnostic workup to identify the source of Daniel’s excessive diarrhea and unintentional weight loss. The team probes for his medical history, which reveals no previous gastrointestinal disorder or surgery. In addition, Daniel confirms that although his stool is watery and frequent, there are no signs of excess fat in the feces that would indicate steatorrhea. There is no presence of blood in the stool. Daniel also reveals that his diarrhea is accompanied by considerable abdominal pain that is not always relieved by defecation. In addition, his bowel movements are preceded by extreme urgency. When questioned on his personal history, Daniel does not report any alarming psychosocial abnormalities. He reports experiencing fatigue and moderate stress at his job, but no symptoms of anxiety or depression. Daniel claims no history of substance abuse, but does have a 4-year history of tobacco use and consumes alcohol on occasion.

 1. Think back to the case presentation. Do you agree with your original description of Daniel’s illness?

2. There are many sources of malabsorption that are indicated by excessive diarrhea and weight loss. What distinguishing features of Daniel ‘s symptoms are important? Are there any specific questions you would ask, biochemical lab values you would consider, or other procedures you would require to confirm a diagnosis?