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Developed Abdominal Pain And Diarrhea. Abdominal Scan Showed Colitis And WBC In Stools. Had Gastritis. Have Mushy And Oily Stools. Cure?
Question: I was recently in Argentina and developed abdominal pain and diarrhea. An abdominal ultrasound showed that I had colitis and white blood cells in my stool. I was also told I had gastritis. They thought I had a parasitic infection from contaminated water or vegetables.. I was given cipro for 5 days and the problem resolved. They took stool cultures but we never got the results. Now I am back in the United States and a month has passed and now I have mushy, oily stools with occasional diarrhea. The first stool specimin came back negative for ova and parasites. Do they ever treat for giardia if cultures are negative.? Thank you.
Brief Answer:
Yes, if there is strong clinical evidence
Detailed Answer:
Hi and tank you so much for this query.
I am so sorry to hear about what you experienced while vacationing in Argentinia. From the information you have provided, you most likely had dysentery. The two most common causes of these in developing country are amoebiasis and shigellosis. Giardiasis does not cause blood in stool.
The treatment you received is classical for shigellosis. Amoebiasis or giardia is treated with tinidazole or metronidazole.
Though cultures provide excellent diagnostic aid, they are not 100% sensitive. So with a strong clinical evidence, treatment can still be pursued. Also, giardia is present in the united states and you could as well have contracted giardia upon return. I suspect this because you felt well after the treatment suggesting that the cause was treated unless it is a recurrence now. your symptoms are suggestive of giardia.
To me, it doesn't help giving you a one time treatment of giardia with 2g of tinidazole even if the results don't make that clear. At least, it would have taken it out of the picture.However, it is up to your treating physician to make this decision.
Hope this helps. Feel free to ask for clarification with related questions if need be.
I wish you well.
Dr. Ditah, MD
Yes, if there is strong clinical evidence
Detailed Answer:
Hi and tank you so much for this query.
I am so sorry to hear about what you experienced while vacationing in Argentinia. From the information you have provided, you most likely had dysentery. The two most common causes of these in developing country are amoebiasis and shigellosis. Giardiasis does not cause blood in stool.
The treatment you received is classical for shigellosis. Amoebiasis or giardia is treated with tinidazole or metronidazole.
Though cultures provide excellent diagnostic aid, they are not 100% sensitive. So with a strong clinical evidence, treatment can still be pursued. Also, giardia is present in the united states and you could as well have contracted giardia upon return. I suspect this because you felt well after the treatment suggesting that the cause was treated unless it is a recurrence now. your symptoms are suggestive of giardia.
To me, it doesn't help giving you a one time treatment of giardia with 2g of tinidazole even if the results don't make that clear. At least, it would have taken it out of the picture.However, it is up to your treating physician to make this decision.
Hope this helps. Feel free to ask for clarification with related questions if need be.
I wish you well.
Dr. Ditah, MD
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I did not have blood in my stool. It was white blood cells. Also, I am unclear are you saying it does make sense to be treated for giardia or not?
Is there any additional treatment for shigellosis?
Is there any additional treatment for shigellosis?
Brief Answer:
Sorry for the mix up
Detailed Answer:
Hi and thanks for this follow up.
Without blood in your stools, giardia is more plausible and ciprofloxacine does not treat it. Am sorry for having treated this as bloody diarrhea.
The treatment you received is classical and well adapted for shigellosis. No further treatment is needed.
Giardia treatment is simple with little or no side effects. With a strong clinical suspicion, it makes sense to treat even with negative laboratory findings because they are not 100% sensitive.
I wish you well and hope this addresses the concerns you raised. Feel free to keep the discussion going on if more clarifications are needed.
Thanks.
Dr. Ditah, MD
Sorry for the mix up
Detailed Answer:
Hi and thanks for this follow up.
Without blood in your stools, giardia is more plausible and ciprofloxacine does not treat it. Am sorry for having treated this as bloody diarrhea.
The treatment you received is classical and well adapted for shigellosis. No further treatment is needed.
Giardia treatment is simple with little or no side effects. With a strong clinical suspicion, it makes sense to treat even with negative laboratory findings because they are not 100% sensitive.
I wish you well and hope this addresses the concerns you raised. Feel free to keep the discussion going on if more clarifications are needed.
Thanks.
Dr. Ditah, MD
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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