Ages and Stages

When treating an adolescent, especially one who is female, for excessive GI fluid loss, assess for signs and symptoms of anorexia and bulimia. Teeth that appear yellow and worn away and a history of laxative or diet pill use are two obvious signs.

Also, assess the patient for use of alternative diet therapies, particularly pills containing ma huang or ephedrine, which speed the metabolism by mimicking the effects of adrenaline on the GI system. Other agents such as orlistat (Xenical) bind to gastric and pancreatic enzymes to prevent digestion of fats and may produce GI fluid loss as well as decreased absorption of vitamins.