Radiographic and Other Studies

1. Proctosigmoidoscopy or colonoscopy. Indicated if patient remains ill with negative stool cultures. Useful in determining presence of mucosal inflammation (suggesting IBD), obtaining biopsies, and examining for masses.

2. Upper GI series with small bowel follow-through. May suggest Crohn disease, celiac disease, or lymphoma.

3. Breath hydrogen lactose tolerance test. Increase in breath hydrogen approximately 2 hours after administration of a standard oral lactose dose indicates lactose intolerance.

4. D-xylose test. Abnormal in diseases involving small bowel mucosa (eg, Crohn disease, celiac disease, small bowel bacterial overgrowth, and regional enteritis). Reserve for workup of chronic or recurring diarrhea.

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