Physical examination

A. Assessment of volume status. Dehydration is suggested bydrymucous membranes, orthostatic hypotension, tachycardia, mental status changes, and acute weight loss.

B. Abdominal tenderness, mild distention and hyperactive bowel sounds are common in acute infectious diarrhea. The presence of peritoneal signs or rigidity suggests toxic megacolon or perforation, requiring radiologic examination of the abdomen.

C. Evidence of systemic atherosclerosis suggests ischemia. Lower extremity edema suggests malabsorption or protein loss.

Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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