Differential diagnosis of several disorders with explanation of a possibility and any potential weaknesses of each differential
During the examination, the focus will be on the five different diseases that present similar symptoms. The five diseases that have symptoms, which are similar to those presented by the case, include pancreatic insufficiency otherwise known as Exocrine Pancreatic Insufficiency (EPI), lactose intolerance, cystic fibrosis, celiac disease, and Crohn’s disease. Sinaasappel et al. (2002) note that the symptoms associated with EPI include steatorrhea (foul and smelly stool), weight loss, and indigestion. The symptoms materialize because the condition impairs the digestive system. As such, the digestion of fats, proteins, and carbohydrates becomes ineffective.
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Therefore, the stool becomes oily and smelly. Since the majority of infants with the condition have digestion problems, they appear underweight and malnourished. The second disease that needs examination is lactose intolerance, which is associated with the inability of the colon or the large intestine to digest lactose. Inability to digest lactose implies that it moves through the large intestine and eventually causes some scale of discomfort. The symptoms linked to the disease include diarrhea and stomach problems.
The third disease, which will be utilized in the diagnosis, is cystic fibrosis that affects the digestive and respiratory systems. In most cases, individuals who suffer from the condition cough, wheeze, experience weight loss, and release smelly stool. Notably, breathing problems develop when cysts block the normal flow of air. Consequently, smelly stool and weight loss occur when mucus impairs the normal functionality of enzymes located in the small intestines. In the light of this blockage, nutrients cannot be fully utilized leading to an eventuality of foul or smelly stool. Celiac disease and Crohn’s disease comprise the fourth and fifth diseases that will be examined. When people eat food that contains gluten, they hamper the normal functionality of intestinal villus. As such, food moves through the intestines without proper absorption and digestion. The symptoms of celiac disease comprise weight loss, growth problems, malnutrition, and diarrhea (Tankova et al., 2016). Crohn’s disease leads to inflammation of the intestines, a factor that initiates weight loss, diarrhea, and anal fissures.
The correlation between the patient’s age and severeness of the disease. Tests to clarify the differential and come up to a definitive diagnosis
While most of the diseases affect infants and adolescents, they also affect adults. However, as individuals grow, they become conscious of the type of food that they consume. As a result, instances of contracting the diseases become minimal. Moreover, diseases such as cystic fibrosis may initiate different symptoms among adults unlike in children. Sinaasappel et al. (2002) explain that as individuals grow, their immunity to diseases like cystic fibrosis and EPI improves. Improved immunity minimizes the effect of these diseases among adults. Therefore, the diseases are not as severe among adults as they are among children and adolescents. To achieve a definitive diagnosis, some of the tests that I would run include genetic tests, lactose tolerance tests, sweat, hydrogen breath tests, intestinal biopsy, endoscopy, and MRI. By undertaking the tests, I will be in a good position to identify the ailment that relates to the case in question.
Patient’s ancestry and initial differential
Apparently, if the case before me concerned a child with African ancestry, the course of my differential would not change. It is fundamental to allude that although some conditions such as cystic fibrosis are more prevalent among Caucasians, issues associated with genetics could lead to development of the disease among children with African ancestry. Tankova et al. (2016) explain that genetic linkage could lead to development of cystic fibrosis among individuals with African and Asian ancestries. Therefore, even if the child presented before me was from a different ancestry such as African Americans, I would still analyze the diseases and would not rule out the possibility of the conditions. Moreover, I would focus much on the genetic link and ascertain whether the child’s family has a background associated with the condition.
Sinaasappel, M., Stern, M., Littlewood, J., Wolfe, S., Steinkamp, G., Heijerman, H., & Döring, G. (2002). Nutrition in patients with cystic fibrosis: A European consensus. Journal of cystic fibrosis, 1(2), 51-75.
Tankova, L., Gerova, V., Getsov, P., Penkov, N., Taneva, G., Terziev, I., & Nakov, R. (2016). The Association of Crohn’s Disease, Celiac Disease, and selective deficiency. International journal of Celiac Disease, 4(1), 30-33.