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Please Help me

Doctor,
My name is Manjit Singh, i had a stomach infection in January,
My liver profile showed ggtp =332 and ALP=225. I was on Augmentin after that for 2 weeks. My liver enzyme were normal ( still Alp - 167) and abdominal pain was relieved. but during the course, i  had bleeding and diarrhea due to heavy antibiotics.
After 1 month that i started having diarrhea and immediate stool after breakfast lunch dinner = burning in rt side of abdomen. doctor gave pantaprozole, Now its June . i still have the burning sensation and i went for my CT scan and Ultrasound. CT was normal but USG showed fatty changes in Liver.

Now i went for my stool test. it showed Mucous present++ Blood occult present+ Excesssive Fat in stool

Now dotor has prescribed Udiliv + pantaprazole + OF + Entamizole Forte

what am i suffering from and should  i have all these medicines 3 times a day or not.. plz suggest

Is it anything serious or just some infection. i need more info about occult blood in stool and also Udiliv,
Alp in blood should be 130, why am i getting it as 167.

Age : 24
Sex : M
Smoking: Yes regularly
Drinking : Yes 2 quarters twice a week
Blood Press : Normal 110/80
Diabetes : No
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611999_tn?1298761891
I have been through it.  You will be ok :)  The probiotics take a while to help get rid of yeast.  Remember your stomach is still irritated from the infection you said you had earlier this year.  This will leave people with ibs for a while.


If you feel really bad then always go to er.  If this does not start to feel any better in a few weeks then remember to ask for hida scan and the cdiff tests.
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30 Comments Post a Comment
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1208572_tn?1276146143
It could be many things, but to me it sounds like Chrons, or even Ulcerative Colitis. The blood and diarrhea are the key factors, also throw in the pain in the right side.
You need to go to a GI and get a colonoscopy so they can properly diagnose you.
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611999_tn?1298761891
Have you been tested for C diff?  This is a bacteria that can come from antibiotic use.  It grows out of control when the antibiotics kill your good bacteria in the stomach.  3 Stool samples on different days need to be done since it can give false negatives.  The test also needs to be tested within the hour since it breaks down fast at room temp.
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1364835_tn?1278610242
Thanks Michel,
But Doc has already prescribed Entamizole Forte, Ornidazole which kill C.diff,
Hope it helps.

Also thanks, B_shel,
i think colonoscopy is risky and i dont have blood in stool, its blood occult which i think normally is present in every1.
i just wanna know why is Excess fats and mucous found in stool. i know that because of this fat only, i have Loose stools. is it becuase of gallbladder dysfunction or infection, CT and USG are normal, also my WBC were bit high. (Liver profile Normal. ALP-bit high)

I m a physiotherapist, so have little knowledge about Human body.. But need some expert advice

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Also let me know how much gap should be maintained between having antibiotics,
i m prescribed to have it 3 times, but worried about timings.

Is it better to have antibiotic after or before meals, (specify hours)

and when to have antacids, before or after meal. (specify hours)

any help would be useful
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611999_tn?1298761891
Metronidazole  is the standard treatment for Cdiff.  They give it for 7 days and if you are still having symptoms they give you another 7 - 14 days.  If you are then still symptomatic and test positive they will go to the potent antibiotic Vancomycin. If that does not work they try tapering you off vancomycin .  I am not sure why they prescribed the other drugs for you.

  Cdiff is becoming incredibly resistant to antibiotics.  There are lots of people who have been on Vancomycin and done may months of tapers to get rid of it.  Do not assume you are ok until you have been off of antibiotics for  a while and have tested negative 3 times. There is a high incidence of false negatives and the  test must be performed within 1-2 hours after you collect the sample.  The toxin breaks down fast.

The mucous and blood is possibly  from the Cdiff infection.  If you have bad symptoms and pain then the toxins from the Cdiff could have caused colitis.  This is usually diagnosed through a colonoscopy.  

Pantaprazole has actually contributed to causing Cdiff. It is a PPI which reduces acid in your stomach and this provides a better enviroment to Cdiff to flourish.

If I was you.  I would ask for 3 tests on 3 separate days ( since it has high false negatives this is normal protocol)  for CDiff.and then if positive I would ask to be prescribed Metronidazole and if you feel better afterwards get tested again 3 times in a few weeks.  If negative then you will most likely be ok but have ibs for up to a yr or so until your insides are healed.  If positive try one more round and if that does not work then go to vancomycin.  You should also be on a probiotic such as florastor, culturelle or align.  These are available at the drug store.  It will help build up the good bacteria so C diff is not prominent.  

C diff is also very hard to kill.  You must bleach your toilet each time and let it stand 10 minutes and also flush with the lid closed.  Spores can get all over your bathroom by just flushing and they live for months.  Wash and scrub your hands very well and clean all clothes and surfaces with bleach and hot water.  Wash clothes separately from other household members clothing as well.  

The antibiotics are best with meals so it does not hurt your stomach.  Try to space them every 8 hours.  I would take any antacids in the morning with breakfast.
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1364835_tn?1278610242
Thanks again, Michell,

I had Ornidazole, Ofloxacin , and Pantoc today in morning after breakfast.
I will be having second dosage with lunch

Should i stop taking these medicines..
Can any of these killl C. diff.

Help help help
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611999_tn?1298761891
Ofloxacin is not used for Cdiff It is a fluoroquinolone and used to treat other type of infections such as respitory bladder etc....   Ornidazole is typically not used for Cdiff the drug Metronidazole ( flagyl ) is.  Also you do not want to take a fluoroquinolone at the same time as Metronidazole because it is one of the drugs that can cause c diff in the first place.  

Are they sure you have C diff?  

If it was me I would be asking for C diff tets 3 of them and if positive I would ask for Metronidazole and then if that did not work vancomycin.
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611999_tn?1298761891
Are you in the US?
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1364835_tn?1278610242
They are not sure about it that its C. diff..
I am from India right now,

Anyways i will complete my 5 days course and let u know my status after that.
Thanks for such a great Help.

Thanks a lot Ma'am
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611999_tn?1298761891
Well if it is C diff and you take the Ofloxacin you will be in much worse shape.  You need a stool culture 3  times for C diff before you take anything.
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1364835_tn?1278610242
Pray for me..


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1364835_tn?1278610242
my urgency for going to toilet after having food had stopped, but i am having mild pain over rt lower abdomen, tomorrow i am going for my stool test since my dose are over, will check for c. diff also.

will let u know the results ma'am.
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611999_tn?1298761891
Thank you for letting me know.  I am hoping that it may just be irritable bowel left over from an infection.  If it is then it should eventually go away
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1364835_tn?1278610242
Stool result showed
Mucous: absent
Blood occult : absent
Yeast: present ++
Excessive fats in stools

Doctor gave me DAROLAC Lactobacillus capsules ( for IBS)

I am not sure whether to have it on empty stomach or with meals and i am prescribed 1 cap. per day. so what should be the time..

Should i be concerned about Yeast ++

Plz Help Ma'am

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611999_tn?1298761891
lactobacillus is the same as yogurt.  It is good bacteria for your system.  It helps take over to get rid of yeast.   I take culturelle and align which is similar to that.  I take mine with a meal or alone.  It does not bother me either way .    I had yeast in my stool before and took the culturelle and  Nystatin and   it went away fairly quick.  I am not sure if they presribe nystatin over there .  Its fairly harmless to add .  Diflucan is another antiyeast drug but this is with more serious yeast infections since its a fairly strong drug.  You can see how you do with what he gave you.  I think You will be fine.    I am wondering why you have excessive fat in your stool.  Is he going to investigate that?
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1364835_tn?1278610242
I had the capsule y'day night with meals.

Still I am having the rt lower abdominal pain.
I am suffering from too much of gas also..

And i  searched whole internet for IBS diet..
They literally said to ovoid all foods.. what should i have???

I am also worried about excessive fats in stools..
The doctor said my reports were fine, nothing to worry.

can i have metrogyl with probiotics
or should i complete  my 1 month course


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1364835_tn?1278610242
I again started having soft loose stools after having food . . .
why is that so

I m getting mad

I will take nystatin..Is it safe with probiotics
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1364835_tn?1278610242
nyastatin is unavailable in my country.. can i take fluconazole 150 mg with probiotics.

what dosage should i have and for how long
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611999_tn?1298761891
Probiotics can be taken with anything.  It is not really a medicine .  It is only  good bacteria like eating yogurt.  The probiotics will cause some gas for a while until you get used to them.  Did your dr precibe the fluconazole pills?  These can be taken with probiotics also.  Your dr would need to determine dosage but the nystatin is easier on your system so this is the one I would try first.  
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611999_tn?1298761891
I am wondering if they have checked your GB with a hida scan?  Sometimes the rt sided pain is associated with that as well.   Is the pain under the ribs?
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1364835_tn?1278610242
sometimes after having food or smoking, i get burning pain below sternum more towards rt. side..

I am suffering from rt sided pain below my ribs as well often..
My liver profile states everything normal except high ALP in blood..
USG and CT are normal.. Should i talk with my doc for HIDA scan

Can yeast cause fats in stools..

The lower abdominal pain is getting worst after having probiotics, I searched everywhere, it states yeast die off symptoms.. is it anything serious
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611999_tn?1298761891
The probiotics can cause a little cramping since it produces gas.  It should be helping you kill off the yeast.   I do not think yeast can cause fat in stools.  If the pain is below the right ribs then yes I would ask about a hida scan.  This can tell if your GB is functioning normally.  If it is not then you would get fat in your stools.  
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1364835_tn?1278610242
Actually i was having a gall bladder infection in January, usg showed some sludge which went away within 10 days.

Recent USG showed GB is normal..
I also have Fatty Liver

I think you are right, but is there any other way to find out Gall bladder disorder..
People say HIDA is painful..

I think i need to get my GB removed.. Its the main culprit..

Thanks Ma'am for the information

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611999_tn?1298761891
The hida scan is one of the best tests.   The Ultrasound can not tell you as much.   When they inject the cck during the hida scan it will reproduce your symptoms in most people.   When I had mine I felt the same cramping and nauseous feeling that I usually had with my attacks.  It was worth it to know what was wrong.     The hida scan will show them the percentage that your gallbladder is functioning.  No other test will do that.  If it is low then usually surgery is recommended.    If it is not functioning normally then you will get fat in your stools as well.  Since you had sludge you may get that again along with another infection.  I would suggest the hida scan .  Its is really not that bad.  I have had 2 of them.
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1364835_tn?1278610242
Am i going to be alright someday or i will die with this uncomfort..

when i got up today, i get constipated.. then i have breakfast and i get diarrhea with mucous,
I am feeling very very bad, what and why is this happening to me,

Waiting till Tuesday to see whether probiotics will work.. but i don't think that they are working..

I am too much scared ..

Sorry Ma'am, Just shared my views.. you might be also thinking whats going on, but i think i am gonna die
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611999_tn?1298761891
I have been through it.  You will be ok :)  The probiotics take a while to help get rid of yeast.  Remember your stomach is still irritated from the infection you said you had earlier this year.  This will leave people with ibs for a while.


If you feel really bad then always go to er.  If this does not start to feel any better in a few weeks then remember to ask for hida scan and the cdiff tests.
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1364835_tn?1278610242
Thank you Ma'am . .

Antacids are helping against burning in the epigastric area ..

Should i stop taking diflucan  . . .

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611999_tn?1298761891
I would stay on it for the course of treatment presribed along with the probiotic to eliminate the yeast and then if your pain persists after a while then get your gallbladder checked and cdiff cultures .
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1364835_tn?1278610242
I gave the sample for testing C. Diff.

It will take 10 days for reports..
Waiting

Also checked for H pylori to rule out Ulcers..

Will inform you Shortly Ma'am
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1364835_tn?1278610242
My RECENT Reports states :

Stool: All Normal
Urine: All Normal
HIV: Negative
ESR: 20 (13 is upper normal Limit)
CBC: All normal but WBC is 13400 (Upper normal limit is 10000)

Doctor says Everything is normal,

I am getting Abdominal Pain and Diarrhea after 1st meal, Epigastric Burning ..

What it can be
Any Idea Ma'am
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