The Clinical Problem Solvers Episode 418 – #IDLove – Colitis
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Sep 10, 2025 Delve into the complexities of diagnosing diarrhea in young adults, weighing infectious versus non-infectious causes. Discover the intricacies of travel-related diseases through a patient's case from Bogota. The conversation highlights how gastrointestinal issues can stem from various pathogens post-travel. A deep dive into differential diagnoses emphasizes the critical role of lab results. The session kicks off with a compelling case study of a young man's gastrointestinal symptoms, blending clinical reasoning with real-world scenarios.
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Systematic Diarrhea History
- Obtain a detailed diarrhea history: travel, antibiotics, sexual practices, food, and sick contacts.
- Assess alarm features and hydration early to guide urgent testing and disposition.
Symptoms Localize To Proctitis
- Tenesmus and rectal pain point toward distal colitis or proctitis rather than diffuse enteritis.
- Localizing symptoms should reshape the initial diagnostic priorities and tests.
Ask Specific Sexual Exposure Questions
- For suspected proctitis, ask detailed sexual exposure questions including receptive anal sex and condom use.
- Consider gonorrhea, chlamydia, syphilis and tailor testing accordingly.
