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Abstract: A patient with a long history of heavy alcohol consumption and intermittent “dyspepsia” developed diarrhea with abdominal distension, weakness, and wasting 2 months ago. After examination, the patient was considered to have non-infectious diarrhea. After treatment with drugs, the patient’s condition was controlled, diarrhea was relieved, diet was normal, physical strength was restored, and mental status was good.
Basic information】Male, 51 years old
Type of disease】Non-infectious diarrhea
Hospital】The 988th Hospital of the People’s Liberation Army Joint Security Force
Date of consultation】February 2022
Treatment plan】Medication (Bifidobacterium tetradecane + montelukast) + comprehensive treatment (alcohol cessation + nutritional support)
Treatment period】9 days of inpatient treatment, 3 months of outpatient follow-up
Treatment effect】Diarrhea relief, normal diet, physical strength recovery, good mental status
I. Initial consultation
The patient, Brother Li, came to the hospital in February 2022. The patient reported that he had diarrhea for nearly 2 months and had tried medications and injections at the clinic, but they were not effective, accompanied by abdominal distension, weakness, and wasting. After detailed medical history, we learned that the patient had intermittent dyspepsia and no history of other chronic diseases, but had a long history of alcohol abuse. Combining the patient’s symptoms and medical history, the patient was considered to have diarrhea due to absorption disorders caused by heavy alcohol consumption. Routine blood tests showed: leukocytes 7.25×10^9/L, neutrophil ratio 48.5%, hemoglobin 111g/L, platelets 127×10^9/L. The initial diagnosis was non-infectious diarrhea, and the patient was admitted to the hospital for treatment.
II. Treatment history
After admission, the patient was given Bifidobacterium tetradecanoides tablets to regulate the dysbiosis and montelukast to protect the gastrointestinal mucosa. In order to exclude organic lesions of the gastrointestinal tract, colonoscopy was performed, which suggested reflux esophagitis, chronic gastritis, duodenitis and colonic diverticulum. Enhanced CT abdomen suggested multiple weakly enhancing nodules in the left inner lobe of the liver and the right anterior lobe of the liver, considering hemangioma; calcified foci in the right lobe of the liver; multiple foci of lack of blood supply in the spleen, considering atypical hemangioma; cyst in the right kidney; small stone in the right renal calyx. The diagnosis of non-infectious diarrhea was confirmed by excluding the occupying lesions. The patient abstained from alcohol during treatment and was also given nutritional support therapy.
III. Treatment effect
The patient actively cooperated with the treatment by abstaining from alcohol and giving Bifidobacterium tetradecanoides tablets and montelukast for 9 days. The diarrhea symptoms were relieved, the diet returned to normal, the complexion gradually rosy, the weight did not drop significantly, the spirit and sleep were good, the physical strength returned to normal, and the patient reported that he felt better and met the discharge criteria, so he was discharged. Before discharge, the patient was advised to have regular review and 3-month outpatient follow-up.
IV. Precautions
The patient was a long-term alcoholic, and this time he had symptoms such as diarrhea, wasting, loss of appetite and weakness, and he was under stress. After discharge from the hospital, the following matters should be noted.
1, after discharge patients should continue to abstain from alcohol, can eat more fresh vegetables and fruits, avoid overeating, avoid eating spicy and irritating food, so as not to cause gastrointestinal discomfort.
2, the patient should maintain a good mood and optimistic and positive attitude, if the mood is not good, you can try to communicate with family members, so as to relieve the bad mood.
3. Patients can choose appropriate exercises according to their personal preferences to enhance their physical fitness.
V. Personal insight
Non-infectious diarrhea has a complex etiology and is difficult to treat. Common treatments include regulating dysbiosis and protecting the gastrointestinal mucosa. In addition, it is fundamental to actively search for the cause of the disease while treating it. In this case, the patient’s diarrhea was caused by long-term heavy alcohol consumption, so the patient was advised to stop drinking while symptomatic treatment was given, and nutritional support was also strengthened, which eventually achieved good results and no further symptoms such as diarrhea occurred in the follow-up period of 3 months.