Which essential questions will you ask a pediatric patient or his or her caregiver when the
presenting complaint is bloody diarrhea? Will these questions vary depending upon the
child’s age? Why or why not? Which dia
...
Which essential questions will you ask a pediatric patient or his or her caregiver when the
presenting complaint is bloody diarrhea? Will these questions vary depending upon the
child’s age? Why or why not? Which diagnostic studies will you initially order and why?
Bloody diarrhea is an uncommon symptom in children, and it may indicate the presence
of serious disease. The non-specialist should be aware of the likely causes, initial management,
and indications for specialist referral. The emphasis is on children in the developed world,
although traveler’s diarrhea is also considered. The epidemiology and management of this
condition are different in the developing world, where infectious causes predominate (Murphy,
2016). Hence a complaint of bloody diarrhea from a patient or parent requires further
investigation. The provider should be sure to clarify what the parent means by diarrhea. Infants
normally have a liquid diet hence it is not uncommon for them to have stools that are not all
solids. Diarrhea is stool that is frequent and watery in consistency. The assessment should start
by taking a detailed history of present illness. A complete history can often identify a
presumptive GI bleeding source and direct an efficient workup. For example, NEC in most
neonates are diagnosed based on history and clinical presentation.
Ask age- and etiology-specific questions. Ask about acuteness or chronicity of bleeding,
color and quantity of the blood in stools or emesis, antecedent symptoms, history of straining,
abdominal pain, and trauma. Murphy (2016) recommends assessing the severity, other
associated symptoms, and signs or symptoms of a possible systemic illness or abdominal
complications. Ask about acutene
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