Approach to diarrhea (chronic) Quiz: Ace Your Exams
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A previously healthy 19-year-old man presents to the primary care office due to recurrent bloating, abdominal pain, and flatulence for the past several months. His stools have mostly been a watery liquid consistency, and his symptoms are worse after meals. He recently started training to become a competitive bodybuilder and has been on a diet consisting of milk and whey protein shakes, yogurt, and red meat at every meal. He has not had recent illnesses, nocturnal diarrheal symptoms, or recent weight loss. The patient has no significant past medical history and takes only multivitamins. Vital signs are within normal limits. Cardiopulmonary examination is normal. Abdominal examination reveals normoactive bowel sounds without tenderness to palpation. Stool osmotic gap is 110 mOsm/kg. Which of the following tests is most likely to confirm the diagnosis?
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