AAzad
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THIS IS A REAL CASE, PLEASE POST AN ANSWER.
THANKS
84 y.o. male caucasian.with chr. diarrhea of 6 years , with Dg of Diverticulosis and Polips Based on colonoscopy,has 6-10 times of very soft and loos stool /day.very fatigue and weak.
What is the best treatment/s for his conditions?
Thanks
good luck
Edited by AAzad on 10/07/06 - 09:35 AM
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AAzad
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| AAzad
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THIS IS A REAL CASE , PLZ POST AN ANSWER
THANKS
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AAzad
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| ssrpk
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well before considering any treatment, the etiology shud be evaluated!
there cud lots of diff. reasons for chronic diarrhea, polyps and diverticula per se won't result in diarrhea, so probably incidental findings, so don't place ur bets with these, get the biopsy report and r/o crohn's, rule out malabsorption [chk fecal fat content], screen for carcinoid or other neuroendocrine tumors, does the pt has history of ulcers???? etc etc
theres bunch of differentials with this scenario!
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| sarika
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partial colectomy
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| robin082006
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colectomy
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| ssrpk
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why colectomy? plz explain
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| star1
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colectomy because of Pt age and polyps..................
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| sarika
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it just came as a gut feeling...i have no experience and it may very well b wrong but what i thought was two things, polyp can b malignant or pre malignant and since he is old and very weak he may have some occult blood in his stool. Also diverticuli can bleed putting him on increased risk for Cardiac emergency...but it was just a thought....I am not sure...but then i think if they did colonoscopy they must have done biopsy of polyps so we should wait for the result. Also carcinoid syndrome or vipoma will have other symptoms too.
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| AAzad
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Thanks all
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AAzad
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| AAzad
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I started metro and Psyllium for 10 days,and first 2 days of treatment I gave him Diphenoxylate 1 tab x4,not realy very as per books, Ha?but from the prax days I figured this combinations , so far very good results .it is day 20 Diarhea free.
I just wanted to share withyou .
thanks and
GOOD LUCK
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| Guptashutosh
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if i had visited this Q earlier, i wd have suggested to rule out diverticulitis
colectomy is a major surgery for pt aged 84 ,
first u shd proceed with colonoscopy and biopsy
Good Luck
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| chemamr
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ssrkp: with the colonoscopy + maybe some biopsies AAzad ruled out several differentials. Diverticulosis/diverticulitis can cause diarrhea with/without blood.
So: 1st try conservative treatment with antibiotics and diet support. 2nd choice would be selective colectomy.
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| ssrpk
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hmmm i figured!
thanks for the discussion guyz 
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| mjl1717
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In addition: a forty year old friend of mine was admitted for diverticulitis recently//{some right here on this forum may have diverticulosis} and he was given metronidazole for sure and cipro as I remember.
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