Diarrhea Symposium

Question 1

What causes crypt distortion?

Answer 1

Chronic mucosal injury - usu. IBD.

Question 2

What causes melanosis coli?

Answer 2

Brown colon mucosa - caused by excessive laxative use damaging mucosa.
(in the case, was in the context of something bulemia-like)

Question 3

What does a positive Guaiac test mean?

Answer 3

There’s occult blood in the stool.

Question 4

What things are most likely to cause discreet purulent lesions in the colon?

Answer 4

Not UC, probably not bacteria.
Viruses
Parasites - entameba
Aspergillus can do this...
(in this case, it was CMV)

Question 5

Can a colon look grossly normal and not be microscopically normal? 2 examples of processes in which this can happen?

Answer 5

Yep.
Collagenous colitis
Lymphocytic colitis
(both of which can cause non-osmotic diarrhea)

Question 6

Review: What does the stool osmotic gap tell you about the type of diarrhea someone has?

Answer 6

Large gap (>50): Osmotic - something osmotically active is pulling water into the bowels.
Small gap: Non-osmotic - can be secretion of electrolytes, or lack of absorption of electrolytes/water.