Case Study: A 23-Year-Old Male with Chronic Watery Diarrhea and Postprandial Discomfort

Case at a Glance

A 23-year-old male presents with a four-month history of daily, watery diarrhea accompanied by abdominal cramping and bloating immediately after any oral intake. An initial trial of simethicone proved ineffective, necessitating further investigation by a specialist.

Patient's Story

The patient is a 23-year-old male (height 5'9", weight 132 lbs, BMI approx. 19.5) who reports a four-month history of persistent and debilitating gastrointestinal symptoms. His chief complaint is chronic diarrhea, which he describes as occurring daily. The episodes are frequent, often happening in clusters, and the stool is consistently watery. A particularly distressing symptom is the immediate onset of abdominal cramps and significant bloating following the consumption of any food or liquid, including water.

Initial Assessment

The patient sought initial medical care at an urgent care clinic. Based on his reported symptoms of gas and bloating, he was advised to take an over-the-counter simethicone preparation (Gas-X). However, the patient reported that this treatment did not provide any relief and, in fact, seemed to exacerbate his symptoms. No laboratory or imaging studies were performed during this visit.

The Diagnostic Journey

Due to the chronicity of the symptoms and the failure of the initial symptomatic treatment, a more comprehensive diagnostic workup was recommended. The patient was advised to consult his primary care physician to initiate an investigation, with a probable subsequent referral to a gastroenterologist. The differential diagnosis is broad and includes conditions such as Inflammatory Bowel Disease (IBD), Irritable Bowel Syndrome with Diarrhea (IBS-D), malabsorption syndromes, or chronic infection. A thorough evaluation would likely involve blood work, stool analysis, and potentially endoscopic procedures to visualize the gastrointestinal tract.

Final Diagnosis

Awaiting Diagnosis. The patient has not yet undergone a full diagnostic workup, and the underlying etiology of his symptoms remains undetermined.

Treatment Plan

The initial treatment with simethicone was discontinued due to ineffectiveness. A definitive, long-term treatment plan is pending the final diagnosis. Immediate management focuses on hydration and seeking specialist care.

Outcome and Follow-up

The patient's symptoms are ongoing. He is in the process of scheduling an appointment with a primary care physician to begin a formal diagnostic evaluation. Close follow-up with a gastroenterologist will be essential to establish a diagnosis, initiate appropriate therapy, and improve his quality of life.