Some patients are asymptomatic.
These are the classic signs and symptoms and they typically start 9-15 days
after exposure but they can start sooner.
They include greasy, foul-smelling stools, gas, abdominal cramps, nausea and vomiting,
weight loss due to the diarrhea, fatigue, difficulty absorbing lactose, vitamin A, folate, and vitamin B12.
In children, we may see failure to thrive and these acute symptoms can last 2-6 weeks.
However, diarrhea, this is the hallmark symptom
and this can persist for weeks to months if untreated.
On exam, first we gather a complete health history.
Then we perform the physical exam and this includes a general observation of your patient.
We're gonna focus the exam on the GI tract and here you can see on the right,
the different four quadrants of the abdomen.
You know you're gonna go an order during these exams
and you're gonna start by listening at the right lower quadrant.
You're gonna progress up to the right upper quadrant along that ascending colon
and then go along the transverse colon to the left upper quadrant.
Then you'll go down to the left lower quadrant along the descending colon
to make sure you hear bowel sounds in all four quadrants.
This dedicated GI exam can take several minutes.
Next you'll do your cardiac and respiratory exams.
So this is the order for the complete abdominal exam.
First, remember, you just inspect. You're going to look at your patient's abdomen.
You're gonna look for the shape and the contour.
Next you'll check the skin for the color and if there's any venous distention.
Next, you'll look for herniations including the umbilical area,
the inguinal area, and the femoral regions.
Next, you'll auscultate and this is a different order than what you typically do on the body.
Remember, with the GI system, we auscultate first.
You're gonna do the bowel sounds and listen for peristalsis.
You want to listen before touching because as soon as you touch that patient's abdomen,
the sounds are gonna change.