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Suggest Treatment For Constipation

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Posted on Tue, 21 Jun 2016
Question: my 19 yo severely handicapped son has been having a lot of issues this past year with chronic and acute constipation. In the last 10 daysVS his stools began showing a lot of mucus with little solids. He has a G-tube (with Nissen) and is usually fed Fibersource HN. Beginning Friday at noon he received only Pedialyte with added sugar (for calories). Saturday evening he had the only BM since Friday - it showed less mucus and more substance. There were no stools after then until this morning about 3 hours after we began feeding him 1/2 Pedialyte and 1/2 formula. This first stool had a consistency of cottage cheese. His only GI doc (who cannot see him now because they don't contract with his insurance) placed him (a month ago) on Linzess 290 qd; Miralax 17g bid, VSL#3 probiotic qd with a cup of senna tea qod. We are currently searching for a new GI doc. Meanwhile we continue to try and treat symptoms. Any thoughts
doctor
Answered by Dr. Neel Kudchadkar (27 minutes later)
Brief Answer:
Increase fluids. Possibility of amoebic infection? Try Tinidazole tablets.

Detailed Answer:
Hi!

I have carefully examined your question and I would ask you to give him more fluids, as he is already taking Fibresource and Miralax. The other thought foremost on my mind was the possibility of an infection. If so this would probably be of amoebic origin, given the descriptions of the mucus that you mention. Given these facts, you might wish to do a stool test, and if required give him Tinidazole tablets to clear the infection if any. However, the chances are remote, given that he is fed at home.

Regards,
Dr. Neel Kudchadkar
Above answer was peer-reviewed by : Dr. Naveen Kumar
doctor
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Follow up: Dr. Neel Kudchadkar (1 hour later)
I doubt that it's amoebic since he's totally NPO however I agree that it could be an infection except that he just finished a course of Keflex (10 days), although this is perhaps not specific for what's going on. In addition to the 900 ml of pedialyte a day he's been getting an additional 500 free water. Of course the free water he gets comes from our well and/or treated city water, wherever we happen to be. Have to find a doc who will order the stool sample. We live in a small town with no docs who have the faintest idea how to treat a person so medically involved. Our nearest specialists and his PCP are 80+ miles away. Will keep on. Thank you.
doctor
Answered by Dr. Neel Kudchadkar (15 hours later)
Brief Answer:
You're welcome.

Detailed Answer:
Hi again!

I agree with you that the amoebic infection scenario is quite doubtful at this time, however it would be prudent to do a stool test nevertheless. You do not need a PCP sometimes. You can check for clinics with RNP and PA's who can do a small assessment. Keflex is a good antibiotics works on most gut infections.

I welcome any further doubts or musings.

Thanks for using healthcaremagic.

Regards,
Dr. Neel Kudchadkar

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Neel Kudchadkar

General & Family Physician

Practicing since :2004

Answered : 532 Questions

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Suggest Treatment For Constipation

Brief Answer: Increase fluids. Possibility of amoebic infection? Try Tinidazole tablets. Detailed Answer: Hi! I have carefully examined your question and I would ask you to give him more fluids, as he is already taking Fibresource and Miralax. The other thought foremost on my mind was the possibility of an infection. If so this would probably be of amoebic origin, given the descriptions of the mucus that you mention. Given these facts, you might wish to do a stool test, and if required give him Tinidazole tablets to clear the infection if any. However, the chances are remote, given that he is fed at home. Regards, Dr. Neel Kudchadkar