Diarrhea sick

[michell221]

I have bad diarrhea for over 1 1/2 month fever99- 101 nightsweat nausea vomiting, aggravated gerd, abdominal pain in upper right quad shoulder and diffuse lower and side abdominal pain as well, cramping  weight loss15lbs and weak  constant heart rate of 95 -100 and hearlt palps. I had the same thing happen last year but less severe
WBC has ranged  from 9.3-17 Now at 15.  Neutrophils at 8.92 ( 1.4 - 6.5) Lymph  4.81 ( .5 - 3.5 range) Lipase 20.0 ( 22-51) Bun 6 ( 8-26)  My tsh is low again .3 with normal T3 and T4  Endo diagnosed as mild hyperthyroid today and asked I start 5mg tapazole.  Cortisol, catecholamine, metanephrine, all ok.  

started after taking a few cipro and discontinued beause diarrheah then took zpack.  Diarrheah continued.  Had nuclear stress test done woke up sweating nausea with diarrheah 20 times. Went to ER and WBC 17.  Told gastroenteritis.
GP doc  suspected c diff.  Took flagyl 500 mg 2 times a day and stools were a little better for 4 days 5th day were bad again. I  could not tolerate . Started Vanco 250 x 3 .  On it 4 days still had Dirrheah. Admitted for 2 days antibiotics stopped Did sigmoid 1 cdiff test gallbladder ultrasound neg,  WBC was 9.3 when I went in 12 when I left. ER week later cat scan of abdomen was ok WBC 15   Colonoscopy normal. Passed a huge cotton ball sized thing in stool that was completely chalk white.  Went back to family doc. New tests neg for c diff toxins ova &P neg . Said I have heavy growth of Hafnia Alvei  and a test from hospital heavy candida albicans. Gave me nystatin for mouth throat thrush and rt lymph  swelling that developed after the flagyl.    GI told me he does not know much about this but what he has read suggests it can be nonpathnogenic and there have not been many reoprts of it causing problems. He said he  is afraid to give me more antibiotics since I react to most meds and my gut seems so out of whack.  He advised to start probiotics.  Can this be coming from the hafnia what should I do?

[michell221]

thank you I asked about the growth of hafnia alvei and candida albicans and can this be causing this?  Thanks.

[Kevin Pho, MD]

You clearly have had a comprehensive evaluation for your symptoms, which would rule out many of the major causes.  

A negative colonoscopy will make inflammatory bowel disease or anatomical causes, like polyps or cancer, less likely.

At this time, more specialized tests can be considered.  This can include stool tests to look for fat malabsorption.

If the tests remain negative, I cannot think of anything else that hasn't already been thought of.  Irritable bowel syndrome would be the remaining diagnosis to treat.  Treatment for this can include tricyclic antidepressants as well as the antibiotic Rifaximin.

These options can be discussed with your GI physician.

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 Pho, M.D.

KevinMD.com
Twitter.com/kevinmd

[michell221]

when similar symptoms  happened last year for 6 months I was also tested for celiac through biopsy, hida scan had endoscopy, addisons, cushings, sed rate, ana, lyme and all ok.  only thing found last year was tsh .5 and nonfunctioning adrenal adenoma sinusitis and 13 WBC.  HIV syphillis, gonorrhea clamydia neg .  HSV2 positive.  

This  new episode is 10 times worse. I am thinking whatever it was just calmed down since I never felt 100% after last year and is now coming back worse.  I often am crying and shaking from the pain in my stomach upper right abdomen and sides and back when it is really bad. It sometimes happens after I eat anything.  I am so weak from the upset stomach constant pains and not being able to eat normally I cannot do anything anymore .  I just wish I could be ok.