 [ Symptoms ] what health insurance plan is best for a pregnant woman  of course premiums go up or down but how does one decide if the 90 the insurance company pays 10 i pay the 8020 or 7030 is right for a first time pregnant woman [ Disease ] patient history diagnosis of colitis and its causes always begins with the taking of the patient is history the information the patient provides helps the physician guide the direction for diagnosis and treatment in patients with abdominal pain and diarrhea it is important to find out when the symptoms began how long they have lasted whether they come and go and what makes them better or worse questions may be asked about travel because infections may arise while traveling particularly in undeveloped countries patients often ask if the cause of symptoms is food poisoning but that is often a difficult question to answer immediately if the patient has blood with bowel movements which in general is not normal further questions may be explored to screen for colon cancer or polyps food poisoning not due to bacterial infections usually does not cause blood in the stool evaluation of the body is other systems cardiovascular neurological may be necesseary physical examination once the history is taken physical examination will be helpful in determining potential causes of the symptoms signs of more severe disease with dehydration may include orthostatic changes in blood pressure and pulse rate decreases in the former and increases in the latter upon standing in patients who are low on fluid or blood blood pressure and pulse may be normal when they lie flat but may change with standing the blood pressure falls and the pulse rate rises temperature often is checked for fever examination of the abdomen will disclose areas of tenderness and potentially abnormal masses if tumors or crohn is disease are present the exam also may include a rectal examination to test the stool for blood and to feel for abnormal rectal masses in patients where ischemic colitis is a consideration the health care practitioner may examine the heart and listen for sounds of abnormal restricted blood flow bruits in arteries located in the neck groin and abdomen as signs of coexisting vascular disease in patients where there is clinical suspicion of viral infection no further testing may be needed however in a patient who appears ill dehydrated or has significant pain fever or blood in the stool more evaluation may be required other tests blood tests may be useful to explore the possibility of anemia or low red blood cell count due to bleeding an elevated white blood cell count may be present as the body is response to infection however an elevated white blood cell count does not necessarily mean infection since the white cell count may be elevated as part of the body is general response to any type of inflammation blood chemistries may be measured looking for changes in electrolyte concentrations in the body especially abnormal sodium and potassium levels that would suggest serious diarrhea or loss of fluid kidney function may be checked by measuring the bun blood urea nitrogen and creatinine levels this may be an important clue that patients are dehydrated as well certain bacterial causes of diarrhea may also