Secure Message Visit
Narrative: SPRUCE MESSAGE VISIT Date: 2024-01-16 Encounter: Spruce text message CC: Persistent diarrhea and poor appetite following a GI illness. HPI: Jack had ongoing diarrhea since the GI illness in late December, with soft/loose stools occurring at least once daily (possibly more, as parent noted he seemed not to fully evacuate each time). His appetite was described as strange. Parent was simultaneously being evaluated for her own GI illness (stool studies and endoscopy ordered). No blood in stool, no fever reported. Assessment: Dr. Hobbs assessed Jack as likely having post-infectious lactose intolerance, which commonly follows diarrheal illness. No urgent red flags identified. Plan: Reduce dairy and berries in diet. Continue probiotic (multi-strain preferred). Monitor for blood in stool, fever, or worsening pain — escalate if any occur. Review parent's stool study results when available. Key clinical quotes: "He's probably dealing with some lactose intolerance too" "overall, I'd back off on as much dairy as you can with him and take it easy with berries. a probiotic can help. and let me know what your stool studies show when you get those results." Source: Spruce conversation t_226ST10QO3800