What are the next best steps for work up of his diarrhea? Pick all options that apply
Switch to an elemental tube feed formula
Try again! Diarrhea can occur in 40- 68% of patients receiving enteral nutrition. Diarrhea can be from a variety of causes including infection, lactose intolerance, antibiotics and medication side effects. Often, diarrhea is unrelated to the enteral feeding formula, so it is premature to stop tube feeds or switch to an elemental formula until other etiologies are ruled out.
Check stool studies for infections including C. difficile
Correct! In this patient who is hospitalized and receiving antibiotics, it is important to rule out C difficile infection as a cause of diarrhea and treat if positive
Review the patient’s medication list and stop medications which could cause diarrhea
Good choice! Reviewing the patient’s medication list for medications which can cause diarrhea including antibiotics, magnesium oxide, anti diabetic and anti-epileptic medications as well as inert fillers such as magnesium stearate, docusate sodium and sorbitol, which can all act as osmotic laxatives, is an appropriate next step in work up.
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