Chronic diarrhea
When diarrhea lasts for more than four weeks a number of further tests may be recommended including:
Complete blood count and a ferritin if anemia is present
Thyroid stimulating hormone
Tissue transglutaminase for celiac disease
Fecal calprotectin to exclude inflammatory bowel disease
Stool tests for ova and parasites as well as for Clostridioides difficile
A colonoscopy or fecal immunochemical testing for cancer, including biopsies to detect microscopic colitis
Testing for bile acid diarrhea with SeHCAT, 7α-hydroxy-4-cholesten-3-one or fecal bile acids depending on availability
Hydrogen breath test looking for lactose intolerance
Further tests if immunodeficiency, pelvic radiation disease or small intestinal bacterial overgrowth suspected.A 2019 guideline recommended that testing for ova and parasites was only needed in people who are at high risk though they recommend routine testing for giardia. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were not recommended. Prevention
Sanitation
Numerous studies have shown that improvements in drinking water and sanitation (WASH) lead to decreased risks of diarrhoea. Such improvements might include for example use of water filters, provision of high-quality piped water and sewer connections.In institutions, communities, and households, interventions that promote hand washing with soap lead to significant reductions in the incidence of diarrhea. The same applies to preventing open defecation at a community-wide level and providing access to improved sanitation. This includes use of toilets and implementation of the entire sanitation chain connected to the toilets (collection, transport, disposal or reuse of human excreta). There is limited evidence that safe disposal of child or adult feces can prevent diarrheal disease.
Foster Kennedy syndrome is a constellation of findings associated with tumors of the frontal lobe.Although Foster Kennedy syndrome is sometimes called "Kennedy syndrome", it should not be confused with Kennedy disease, or spinal and bulbar muscular atrophy, which is named after William R. Kennedy. Pseudo-Foster Kennedy syndrome is defined as one-sided optic atrophy with papilledema in the other eye but with the absence of a mass. Presentation
The syndrome is defined as the following changes:
optic atrophy in the ipsilateral eye
disc edema in the contralateral eye
central scotoma (loss of vision in the middle of the visual fields) in the ipsilateral eye
anosmia (loss of smell) ipsilaterallyThis syndrome is due to optic nerve compression, olfactory nerve compression, and increased intracranial pressure (ICP) secondary to a mass (such as meningioma or plasmacytoma, usually an olfactory groove meningioma). There are other symptoms present in some cases such as nausea and vomiting, memory loss and emotional lability (i.e., frontal lobe signs). Diagnosis
Brain tumor can be visualized very well on CT scan, but MRI gives better detail and is the
preferred study. Clinical localization of brain tumors may be possible by virtue of specific neurologic deficits or
symptom patterns. Tumor at the base of the frontal lobe produces inappropriate behavior, optic nerve
atrophy on the side of the tumor, papilledema on the other side, and anosmia. Treatment
The treatment, and therefore prognosis, varies depending upon the underlying tumour. While awaiting surgical removal, treat any increased intracranial pressure
with high-dose steroids (i.e., dexamethasone).