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Gastroenterology (Expert Forum)
Chronic Diarrhea § Indigestion
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Chronic Diarrhea § Indigestion
by JohnE, Oct 24, 2004 12:00AM
I'm a 45 yr old male. Until the following I've had no health problems. Jan 02 begin frequent periods of diarrhea lasting a few days a month. Doctor tested kidney, thyroid, TB, heart, mono & Epstein-Barr virus (results normal). Nov 02: woke up with an asymmetrical swollen tonsil & 2 doses of antibiotics did nothing. March 03: night sweats nightly lasting 2–3 weeks. April 03: CT Scan of head & neck (normal), then tonsillectomy (biopsy: Actinomyces and Tonsillitis). July 03: sore throat continued & often heartburn & burning in side of neck. Diarrhea more frequent. ENT Dr tried 30 days Prevacid & heartburn went away. Nov 03: Abdominal CT Scan, Abdominal Sonograph, blood tests, Colonoscopy & Upper Endoscopy. Colonoscopy revealed Diverticulosis, Ultrasound showed Benign Cysts on Left Kidney and on Liver and the Endoscopy showed Esophagitis. Since then I've been on 30mg Previcid daily, other than a couple of times when I stopped for a few weeks to see if diarrhea would stop – it didn’t. Jan 04: one morning I woke up with swollen Uvula which went down later in day - this has happened a few times since. Esophagus PH probe and muscle test (while on Prevacid) showed normal PH levels and Hypotensive LES. Blood test for Angioneurotic Edema was negative. By now the diarrhea was (and still is) daily 2-3 times mornings. If there is any form to my stool, it's loose & narrow & sometimes light brown to yellowish color. Blood tests for Celiac & HIV (negative) & Stool Fat Test (normal). Urinary 5-HIAA & Serotonin tests (negative). April 04: Barium x-ray Upper GI Series and 72 hr Fecal Fat & Weight, Stool PH & Gastrin test (all normal). May 04: I went to ER because I had Black Stools. They pumped my stomach & found traces of blood. Also did some blood & urine tests & abdominal x-ray (results normal). June 04: Video Capsule found some dilated blood vessels which the Dr said could cause bleeding but not diarrhea, and also “Mild Nodularity at Terminal Ileum, likely representing Nodular Hyperplasia”. July 04: Blood Tests (normal except Creatinine at 1.4), Abdominal CT Scan to rule out Lymphoma (unremarkable), Stool Test (PH Level 5.5) Upper Endoscopy (Decrease in Duodenal Folds & Mild Gastritis. Biopsy revealed “Esophagushas numerous Eosinophils with focal clustering, their abundance suggests possibility of allergic esophagitis”) & Colonoscopy (A single Macule in Colon, mucus noted that was slightly stained with blood in the rectum, small Diverticulae in colon). Aug 04: GI Dr prescribed Ciprofloxacin to eliminate possibile bacterial infection in stomach & intestine. He says I have IBS. Did Promethius blood test for IBD (negative) & Food Allergy Profile / RAST (negative). Also had 3 consecutive nights of Night Sweats in Aug. Oct 04 I'm having right foot pain. Podiatrist ordered Bone Scan which showed symmetric Hot Spots in each foot and “Abnormal Bone Scan, No Focal Abnormalities”. Dr is not concerned with scan because Hot Spots are symmetrical. Is this really lBS?
Doctor's Answer
by Kevin Pho, MD, Oct 25, 2004 12:00AM
, Oct 25, 2004 12:00AM
Wow, that is one of the more comprehensive workups that I have read. On one hand, if there were a more serious diagnosis present, the many tests that were done would have found it. On the other, you are still having symptoms.
To be honest, I cannot think of any other testing that has been left out. IBS certainly remains a possibility - especially since other GI disease have been ruled out. Treatment should be optimized - possibly with anti-spasmodic agents and increasing the fiber intake.
You may want to inquire about a second GI opinion.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
To be honest, I cannot think of any other testing that has been left out. IBS certainly remains a possibility - especially since other GI disease have been ruled out. Treatment should be optimized - possibly with anti-spasmodic agents and increasing the fiber intake.
You may want to inquire about a second GI opinion.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
It sounds to me like you might be having a reaction to the antibiotics you have been taking....visit www.fqvictims.org
A website with information on fluoroquinolone antibiotics and side effects. (Cipro is a fluoroquinolone)
Have you been tested for clostridium difficile? or other types of bacteria? Also parasites? Overgrowth of yeast can also affect not only your digestive tract but your whole body.
Good luck!
Bev
did you test for hector pylori bacteria??
have you been overseas?eat,drink and swim in dirty water,restaurants?/
Bibsy - the symptoms were there before I took any antibiotics, so I don't think there is a relationship.
Yoshi - No parasites were found. Yes, they did test for hector pylori bacteria.
I have been overseas. We used to work often on cruise ships. The doctors are aware of this and I believe that they tested for parasites accordingly.