Gastrointestinal and Hepatobiliary Disorders Case Study Paper
The Diagnosis of the Patient
The patient is experiencing acute viral gastroenteritis, most likely caused by hepatitis C. The patient may have been more susceptible to this disease due to their history of drug usage and the medications they are currently taking. Absorption issues with lipids are a common feature of gastrointestinal and hepatobiliary illnesses, and these issues might arise from a lack of biliary secretion, a decrease in the number of enterocytes, or impaired enterocyte activity (Orenstein, 2022). Diarrhea that is loose or watery and occurs at least three times a day is diagnostic of acute gastroenteritis. Other possible symptoms include nausea, vomiting, fever, and stomach pain.
The usage of medications over an extended period of time can also lead to this disease. The most typical method of contracting viral gastroenteritis is the ingestion of contaminated food or water (Stuempfig & Seroy, 2022). Sharing eating utensils, towels, or food with someone infected with the virus that causes gastroenteritis increases the likelihood that one will also become infected. To cite just one example, noroviruses are one type of virus that can set off an episode of stomach issues (Wilber et al., 2021). In this case, I diagnosed the patient with acute viral gastroenteritis because the patient presented with nausea, vomiting, and diarrhea symptoms. Besides this, the patient history of drug abuse would have also led to the occurrence of the disease. Gastrointestinal and Hepatobiliary Disorders Case Study Paper
An Appropriate Drug Therapy
The patient would require drugs to manage the presenting symptoms. The pharmacological maintenance therapy for HL will consist of 100 mcg of Synthroid, 30 mg of Nifedipine, and 10 mg of Prednisone daily. These medications should be continued to manage the client’s underlying condition, which may include allergies, thyroid disorders, and issues with blood pressure. These are the reasons why the client would be taking prednisolone, Synthroid, and Nifedipine, respectively. Antiemetics, such as 4 mg of ondansetron every 8 hours as needed for nausea and vomiting. Patients with gastroenteritis can be managed by the use of antiemetics. The antiemetic medication belongs to the serotonin antagonist class. Inhibiting serotonin (5-hydroxytryptamine) type 3 receptors is the mechanism of action of these medications (Wielgos et al., 2019). The central nervous system is stimulated to induce vomiting by 5-HT produced from the gastrointestinal tract after triggers.
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In addition to that, a prescription for loperamide, in the amount of 2 mg every 8 hours as needed for diarrhea, would be added to the mix. On the other hand, the conventional therapy for this sickness consists of bed rest, hydration replacement, and reassuring words. Loperamide binds to the opiate receptor that is located in the wall of the intestinal tract. As a result, it lengthens the amount of time it takes for food to pass through the intestines by reducing the amount of propulsive peristalsis and by suppressing the release of acetylcholine and prostaglandins (Leung & Hon, 2021). Because it strengthens the tone of the anal sphincter, loperamide can help reduce symptoms of urgency and incontinence when taken regularly.
Reasons for Recommending this Drug Therapy Plan
The patient’s history of drug abuse and suspected Hepatitis C infection, both of which produce nausea, vomiting, and diarrhea, necessitate the utilization of the above medication therapy regimen. The medications Synthroid, Nifedipine, and Prednisone all alleviate the signs and symptoms of the disease. The use of antiemetics is necessary to prevent nausea and vomiting in the patient following viral gastroenteritis and the side effects of other drugs taken by the patient. Extreme vomiting results in rapid fluid loss. Patients with severe dehydration due to excessive vomiting will require hydration therapy and medications to balance the lost electrolytes (Stuempfig & Seroy, 2022). In addition, the acid from the stomach that is expelled during vomiting can erode the esophagus resulting in additional pain. Gastrointestinal and Hepatobiliary Disorders Case Study Paper
Diarrhea in the patient is another factor that contributes to an excessive loss of fluid. As a result of this, loperamide is going to have to serve as the antidiarrheal medication of choice. Because it prevents or lessens the absorption of fluids and electrolytes into the intestines, it lessens the number of times a person passes loose stool (Iturriza-Gomara & Cunliffe, 2020). If treatment is not received, severe dehydration brought on by diarrhea can be fatal. Dehydration can cause life-threatening health issues, especially in young children, adults, and immunocompromised people who are at high risk.
Conclusion
Patient HL, in this case, presents with acute viral gastroenteritis, which may result from drug abuse and Hepatitis C. The presenting symptoms validate the diagnosis because the patient presents with nausea, vomiting, and diarrhea. The management therapy for this patient would involve the use of medications to prevent nausea, vomiting, and diarrhea. Loperamide and ondansetron are the medications of choice. The patient also requires fluid therapy to prevent dehydration. Lastly, the patient has to continue with the present medications to achieve a better health status. Gastrointestinal and Hepatobiliary Disorders Case Study Paper
References
Iturriza-Gómara, M., & Cunliffe, N. A. (2020). Viral gastroenteritis. In Hunter’s Tropical Medicine and Emerging Infectious Diseases (pp. 289-307). Elsevier. https://doi.org/10.1016/B978-0-323-55512-8.00034-X
Leung, A. K., & Hon, K. L. (2021). Paediatrics: how to manage viral gastroenteritis. Drugs in Context, 10. https://doi.org/10.7573/dic.2020-11-7
Orenstein, R. (2022). Select Gastrointestinal and Hepatobiliary Infections. In A Rational Approach to Clinical Infectious Diseases (pp. 132-145). Elsevier. https://doi.org/10.1016/B978-0-323-69578-7.00010-7
Stuempfig, N. D., & Seroy, J. (2022). Viral gastroenteritis. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK518995/
Wielgos, K., Setkowicz, W., Pasternak, G., & Lewandowicz-Uszyńska, A. (2019). Management of acute gastroenteritis in children. Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego, 47(278), 76-79. https://doi.org/10.1056/NEJMoa1802598
Wilber, E., Baker, J. M., & Rebolledo, P. A. (2021). Clinical implications of multiplex pathogen panels for the diagnosis of acute viral gastroenteritis. Journal of Clinical Microbiology, 59(8), e01513-19. https://doi.org/10.1128/JCM.01513-19 Gastrointestinal and Hepatobiliary Disorders Case Study Paper
