Cólicas Intestinais com Diarreia e Vômitos: Avaliação Médica Urgente Necessária

Recurrent abdominal cramps + diarrhea + vomiting suggest significant GI pathology requiring professional assessment.

Red Flags for Immediate Care

• Hematochezia or melena
• High fever (>38.5°C / 101.3°F)
• Signs of dehydration (dry mucosa, ↓ skin turgor, oliguria, orthostasis)
• Severe unremitting pain
• Weight loss >5% unintentional
• Nocturnal symptoms awakening from sleep
• Age >50 new onset (colorectal cancer screen)
• Immunocompromised

Differential Diagnosis

• Infectious gastroenteritis (viral, bacterial, parasitic)
• IBD flare (Crohn's, ulcerative colitis)
• Celiac disease, food intolerances
• Medication adverse effect (metformin, antibiotics, PPIs)
• Functional: IBS-D (diagnosis of exclusion)
• SIBO, pancreatic insufficiency
• Ischemic colitis (elderly, vascular disease)

Workup

Stool studies (culture, O&P, C. difficile, calprotectin), bloods (CBC, CMP, CRP, celiac serology), imaging (CT enterography), endoscopy/colonoscopy with biopsy.

Self-Care Risks

Antidiarrheals (loperamide) contraindicated in bloody/febrile diarrhea. Delayed diagnosis → complications.

Seek care promptly; do not self-manage persistent symptoms.