35 yrs. Old male

Doctor, I have passed 6 months since morning, just like water, with severe cramps in the abdomen..

Watery motions?

That’s dangerous. Dehydration can set in very fast.

Are the motions watery, or with mucus & blood? “Doctor, it is watery.” (That’s bacterial diarrhea, not amoebiasis. This can cause dehydration.)

Have you vomited also? “Yes, 2-3 times” (vomiting will interfere with oral dehydration. This fellow will need I.V. fluids.)

Have you passed urine since morning? “Very little.” (Oh! Dehydration has already started).

Do you feel thirsty? “Yes, doctor”  ( a sign of dehydration)

Did you have fever? “Yes”  (That’s feature of infection, not amoebiasis)

First see whether he is dehydrated.

Sunken eyeballs.

Dry tongue.

Skin, if pinched takes time to flatten i.e. Loss of turgor.

Check the pulse & B.P.

BP should be recorded repeatedly, till the loose motions are controlled as watery diarrheas cause severe dehydration, even during treatment.

Look for colonic tenderness and general abdominal tenderness.

Key points for diarrhea: watery or mucus, degree of dehydration.

Action:

Admit the patient, since he is showing signs of dehydration.

Orolyte and rapid infusion of I.V. fluids. (Electrolyte solutions = RL, NS, DNS)

Antibiotics: systemic + Intestinal. Use Ciproflox + Tinidazole if mixed infection.

Kaolin, Lomotil, Anti-spasmodics and Anti-emetics.