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Suggest Remedies For Low Grade Fever In An Elderly Person

Posted on Fri, 7 Apr 2017

Question: I am 74 years old. I have always had a sensitive stomach. In December, I took a z pack. My stomach has been off since then. with in the last week I have had a low grade fever. The symptom I am most concerned is indigestion after eating and the about 12 hours into the night. I have violent pain and diarrhea or soft stools. I have had the violent pain for about 5 or 6 nights. I have tried the brat diet and am not sure it is helping. I have even wondered if I could have a virus. My blood tests are normal.

Answered by Dr. Ramesh Kumar (55 minutes later)

Brief Answer:
Gastroenteritis!

Detailed Answer:
Hello,Thank you for choosing HealthcareMagic for your query,
Have gone through all your details and appreciate your concern.
Any thing presenting with fever is an indicator of infection inside the body.
The infection you are suffering from is called Gastroenteritis or stomach flu.In gastroenteritis the mucosa of the intestine is severely inflamed causing symptoms like loose stools,indigestion and vomiting.

Tests suggested-
Ultrasound abdomen to rule out inflammation of abdomen.
Stool test for bacterial or protozoal infection
Fecal calproctin to rule out intestinal inflammation.

Most likely stomach flu is viral and is self limiting.However antibiotic therapy can be given in case its bacterial or protozoal.

Treatment suggested-
Start taking Fybrogel or metamucil. It increases bulk of stool and improves digestion.
Start taking a good over counter probiotic daily.It will gradually improve digestion.They are rich in good bacteria which assists digestion.
Take lots of banana,Apple and peaches.
Drink lots of fibrous juices.
Take light and easily digestible food.
Antibiotic therapy could be given as per the reports of investigation.
Imodium 4 mg stat dose can be taken to stop loose stools.
Dicyclomine can be taken fir spasmodic pains along with Nexium 40mg.

Thanks.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Ramesh Kumar (15 hours later)

I did take a probiotic yesterday. I ate very little yesterday. Probiotics have always made my stomach burn as my stomach does this morning. I did have the same cramping pains this morning with a small bowel movement that was thiner than usual. It;however, was not diarrhea. Do you think my condition has anything to do with the Z pack I took in December. And maybe a virus on top of that. I read on line that you could have complications from this drug 2 to 3 months after taking it.
What do you think? My temperature is normal today.I went to a PA and got the tests ordered that you suggested. They were very insistent that I have a colonoscopy. I have lost a lot of weight and feel very weak. Do you suggest that I have that? I have never had a colonoscopy, but don't think I could do it now. How would I know when the time is right or if I should do it at all. I don't do well with procedures. I had serious hives after having an appendectomy.

Answered by Dr. Ramesh Kumar (4 hours later)

Brief Answer:
Follow up answer.

Detailed Answer:
Hi again,
I appreciate your concern very well but please specify how much weight have you lost in how many months. Sudden drop of weight can be an indicator of any malignancy (carcinoma). So, I would request you to be a bit specific with these datas as they are very important while considering possibility of carcinomas.

Sudden weakness can also be indicator of an ongoing pathology.
If you could give me a approximate idea of weight lost, i could give you a better professional advice in regards to colonoscopy.

However, it's always good to be on a safer side. Rule of medicine is that if you suspect something, just rule it out.

Please mention some additional details--
- Why was Azithromycin taken ?
- For how long was it taken ?
- How much weight is lost in last 3 months ?
- Do you have family history of colon cancer ?
- Any history of smoking/alcohloism ?
- Food habits ?

Awaiting..
Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Ramesh Kumar (20 hours later)

z pack taken for 5 days for Bronchitis
lost 5 lbs in the last month mostly the last 2 weeks because of not eating
No colon cancer in my family
No smoke/alcohol
I eat a very healthy diet. I haven't eaten red meat for over 20 years. I eat salad, vegetables and a little fish and chicken.
I weigh 122 lbs. now and am 5'5"
My stomach has really hurt on the right side since I took the probiotic two days ago.I wonder if I could have ulcers? It is a hurting, burning feeling. It is so much worse since taking the probiotic. They really push everyone around here to have a colonoscopy. I haven't done it before because I had a very severe case of hive 9 years age and my dermatologist thought I shouldn't take the chance since the cause of the hives was never found.got stool test back and there was blood and inflammation. I can never talk to a real doctor here so I am very concerned as to what this could mean. C-Dif was neg

Answered by Dr. Ramesh Kumar (12 hours later)

Brief Answer:
follow up answer.

Detailed Answer:
Hello again,
As per your query no weight loss in your case is too small to be a symptom of ongoing malignacy.
If Probiotics are causing problem don't take them.Our body is a complex system.Different persons are allergric to different things and this is decide decided by their genes.
Usually probiotic's are safe but in your case they are irritating your gastric mucosa most likely.Try to take natural food containing lactobacillus.
5 days Azithromycin therapy three months back has no relation to present events.
As your stool test is positive for occult blood here comes two possibility-
Either the source of bleed is in upper G. tract-Endoscopy to be done.
Second is that the source of bleed is in lower G.I tract colonoscopy is to be done.

As of now as C-dif is negative its not bacterial gastroenteritis.

So if stool is positive for blood then further tests should be done.
You have not mentioned why were doctors insisting for colonoscopy in the past,What were doctors suspecting at that time and do you have history of
Hemorrhoids?
And how are your lose stools and weakness now.

I am sorry but all details are required before giving a good advice,Missing small details can lead to wrong suggestions.

Waiting.

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Ramesh Kumar (9 hours later)

There was no specific suggestion for me to have a colonoscopy before now. It is suggested that anyone over 50 have one every 10 years. My husband has had 3. I do have hemorrhoids. In the stool sample, there was very little blood. Also, there were white cells. I guess that accounted for the inflammation. I still have stomach pains in the early morning before having a loose bowl movement. Pain was not as severe today.

Answered by Dr. Ramesh Kumar (1 hour later)

Brief Answer:
Follow up answer.

Detailed Answer:
Hi again,
Follow every thing i advised for atleast a week,I don't feel that urgent colonoscopy is required at present.
Most likely its inflammed intestinal mucosa due to viral infection overlaped with depleted intestinal flora.
Things will take atleast a week to settle down,If things remain the same after a week we can proceed for further investigations.

Regards.

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Above answer was peer-reviewed by : Dr. Raju A.T