Differential Diagnosis for 58 year old male with floating reddish brown clay color stool and normal liver and gall bladder labs
- Single most likely diagnosis
- Gastrointestinal bleeding (likely from the upper GI tract): The presence of reddish-brown, clay-colored stool suggests that the blood has been partially digested, which is consistent with an upper GI source. The fact that liver and gallbladder labs are normal makes a hepatobiliary source less likely.
- Other Likely diagnoses
- Inflammatory bowel disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause changes in stool color and consistency due to inflammation and bleeding in the GI tract.
- Infectious colitis: Certain infections, such as those caused by Salmonella or E. coli, can lead to bloody stools.
- Diverticulitis: Inflammation of a diverticulum in the colon can cause bleeding, leading to changes in stool appearance.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Intestinal ischemia: Reduced blood flow to the intestines can cause ischemic injury, leading to bleeding and potentially life-threatening complications if not promptly addressed.
- Colon cancer: Although less likely given the acute presentation, colon cancer can cause bleeding and changes in stool appearance, and is a critical diagnosis not to miss due to its potential for serious morbidity and mortality.
- Rare diagnoses
- Hemobilia: Bleeding from the liver or bile ducts into the GI tract, which could cause clay-colored stools, although this would be expected to affect liver and gallbladder labs.
- Angiodysplasia: A condition characterized by abnormal blood vessels in the GI tract, which can cause bleeding and changes in stool appearance.
- Intussusception: A condition where a part of the intestine telescopes into another part, potentially causing bleeding and changes in stool, although this is more common in children.