What causes loose motions with gas and appetite loss?
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My 16 mo daughter has had what I feel is a stomach bug for 2 weeks. Her bowel movements are loose (like splats) & have a foul smell. She def has gas production & some loss of appetite. No fever. She had c. Diff in nov, 2 colon X-rays and a barium enema in the last 2 weeks. Stool samples are neg for blood, we currently have one sent off to test for everything. Dr feels its Hirshsprung's disease. I don't agree- we may be getting a referral to a GI dr 6 hrs away if no answers from her stool cultures. Any thoughts???
Posted Fri, 7 Feb 2014 in Digestion and Bowels
Answered by Dr. Enrique Molina 28 minutes later
Brief Answer: more testing needed Detailed Answer: hello, i will try to help you. i am a gastroenterologist. Fist of all C.Diff can recur after treatment so obviously that would be the first thing to rule out, and stool should be tested not only for the c.diff toxin (most common and cheap test), but also the c.diff PCR (better test, more expensive). For a doctor to tell you she has Hirshsprung's disease something must have been abnormal on that barium enema, however this is a disease people is born with. She would have a history of longstanding constipation or difficulty going to the bathroom to defecate. Any viral gastroenteritis can produce loose stools, bloating, gas, etc. These symptoms usually last <1-2 weeks, however after any infection you can remain with what we call post infectious IBS (irritable bowel syndrome). I would recommend checking the stool for all infectious agents possible. She can take some probiotics and simethicone (over the counter) in the meantime for her gas, loose stools. Celiac sprue is always in the back of our mind with these symptoms, and this can be checked with a simple blood test. Thyroid studies evaluation is also recommended (blood test), as hyperthyroidism can cause chronic gastrointestinal symptoms. If still no answer with above, and she continues with symptoms, then she should get an endoscopy and colonoscopy with biopsies. hope that helped.
Follow-up: What causes loose motions with gas and appetite loss? 3 minutes later
Thank u for ur advice!
Answered by Dr. Enrique Molina 9 minutes later
Brief Answer: you are welcome Detailed Answer: you are welcome!
Follow-up: What causes loose motions with gas and appetite loss? 25 hours later
Hello again, we got the results for the stool. Negative: parasites, viruses, no blood Postive: c diff TOXIN & yeast She is gonna get an antibiotic for c diff and yeast med We are still going to be referred to Dallas GI specialist What is difference b/w c diff toxin positive vs c diff with blood in stool??? Can she account for her loose foul smelling stool???
Answered by Dr. Enrique Molina 7 hours later
Brief Answer: see below Detailed Answer: She needs antibiotic for her C Diff. This seems to be a recurrent infection, and she should get strong antibiotics by mouth, such as vancomycin or fidaxomicin. Blood in the stool is commonly seen with any infectious colitis, and it does not change the treatment options. Her C diff is the cause of her loose and foul smelling stool. Yeast in the stool does not necessarily need to be treated. I would start by treating the C Diff first.
Follow-up: What causes loose motions with gas and appetite loss? 8 minutes later
She is getting Vancomycin. I just don't understand what is the difference between testing positive for c diff toxin vs c diff with blood? Isn't it the same thing? My doctor acts like its separate thing and that some drs don't treat c diff toxin. I appreciate u taking the time to respond and help me understand.
Answered by Dr. Enrique Molina 3 hours later
Brief Answer: see below Detailed Answer: the "toxin" is the substance that produces diarrhea. therefore if a patient has diarrhea and tests positive for the c diff toxin, he/she should be treated. Toxin without diarrhea, shouldn't be treated, however i don't see why somebody would check for the toxin without symptoms. When you say "c diff with blood", i understand it's blood in the stool. There is no thing such as a blood test itself (taken from the vein) to check for c diff. We can check for blood in the stool, and c diff can cause diarrhea with blood in stool or without blood in stool. hope that makes sense.
Follow-up: What causes loose motions with gas and appetite loss? 40 hours later
It does!! Thank u again for ur patience and knowledge! God bless :)
Answered by Dr. Enrique Molina 3 days later
Brief Answer: You are very welcome! Detailed Answer: You are very welcome!