Very sick mother

[kerriw]

On April 8, my mother, who is 74, suddenly started having severe vomiting and diarrhea episodes, but she never ran a fever.  Before this day she was fine.  However, she has had problems ever since.  She can't really keep solid food down.  Eventually we found out about Ensure, and she has been drinking that (she tries for 3 a day), but the vomiting and diarrhea episodes continue, around every 5 days or so.  She has lost a ton of weight (over 20 pounds in the first 5 weeks) and appears very bony, and she is weak.  It has been 8 weeks today, and I am at the end of my rope.  So far, she has had stool tests, blood tests, colonoscopy, endoscopy, X-rays, a scan with barium, and they haven't found anything.  She is scheduled for some sort of radioactive gall bladder scan on Tuesday.  This doesn't make sense to me because although she has gall stones, she hasn't had any pain from them.  So, why the scan?  What could the gall bladder contribute to these symptoms?  And assuming that the gall bladder scan shows nothing (which at this point seems rather likely), what on earth could account for these symptoms, that came on so suddenly?  I myself have a lot of health anxiety (she is handling this better than I would in her position), and this is freaking me out.  My dad has born the brunt of it, though.  On Thursday she had a severe neck  spasm, we think, and she was given a muscle relaxant, which made her sleep all day.  Not sure if the spasm is related to  the other issue.  She is on a lot of medications, but there weren't any new ones at the time all this started.  At one point a few weeks ago she was given Aciphex to cut down on stomach acid, but she broke out in a rash, which could be an allergic reaction.  I don't know what to do or what can be done.  This is a very helpless feeling.  I think maybe she should be in the hospital, seriously.  Is there a way she can be fed intraveneously/feeding tube/etc.??  I just don't see how she can continue like this.

[Kevin Pho, MD]

She has had a pretty comprehensive evaluation thus far.  The gallbladder scan will be able to evaluate the gallbladder ejection fraction.  A low ejection fraction may contribute to the symptoms.  

If the vomiting continues, delayed gastric emptying can be considered.  A specialized test such as a gastric emptying scan would evaluate this.

The colonoscopy would rule out many of the major GI disorders leading to the diarrhea.  The stool can be sent off for evaluation of malabsorption disorders.  Blood tests can be done to evaluate for celiac disease.

These options can be discussed with her personal physician.

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.
kevinmd_

[jeepmo]

This may be WAY off base, but my Mom had some similar issues 3 years ago and it was that the veins leading to her bowels were clogged, causing at first vomiting and loose stools, then constipation and no eating, unfortunately they ran other tests, but never found out about the bowels and she passed away after 16 days in the hospital. It seems that ischemic bowel disease was listed as her cause of death but they just kept treating her for a minor infection that she seemed to have, she had MRIs CT scans, blood tests, etc. She was 64 and in good health prior to that. So mention to the doctors if they've tested her arteries for a blockage, and specifically for those leading to the bowels. Likely it's not that, but just in case.

[yoshi]

would colonscopy reveal the blockage??

[kerriw]

Oh, and I forgot to say, she says everything tastes weird and 'off' to her, like her taste buds aren't working.  The only thing that tastes somewhat normal seems to  be fruit.