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What Causes Persistent Diarrhea?

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Posted on Fri, 21 Oct 2016
Question: Hello there. I am from Indiana and my partner and I went to California on Sept 7th through the 10th. When I got back from my trip the following day, I had diarrhea for the next 4 days. I didn't have diarrhea again until a week later and it lasted for three days. It has now been 4 days with no diarrhea until today. I don't have any fever. sore throat, no vomiting, etc. I am only kind of sore all over. I went to the emergency room today and they ran some blood panels and said everything looked good on their end. They said my red and white blood cell count was normal, I don't have any UTI however I had a little blood in my urine but the Dr. said that was normal. They didn't do a stool culture as I did not initially have diarrhea when I went in today. I went in because I've just felt kind of sir for the post few days. Do you have any idea as to what might be the problem? This is the third week now that I have had some sort of diarrhea.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (1 hour later)
Brief Answer:
Recommendations

Detailed Answer:
Hello and welcome,

I read the history you posted today, and also the history you posted a day ago that mentioned that you were in water where there was an advisory not to swim due to high bacterial counts - is that right?

It's good that your blood white cell count was normal, but if the diarrhea is persisting, it's time to have stool studies done (culture, O & P, fecal fat). The person to order this would be your own physician.

In the meantime, foods that are helpful or at least usually tolerated with diarrhea are apple sauce, bananas, rice, and toast. Other foods such as non-spicy, non-greasy fish or chicken are ok too if you tolerate them. Eat small amounts at a time to decrease stress on your digestive system. And keep up with fluids (mostly water, some sports drinks ok too, avoid caffeine).

Usually in the US, people do not require antibiotics for diarrhea (compared with in non-industrialized countries with poor sanitation), but let's see what the stool studies show.

You can also try Pepto Bismol which can be used for some infectious types of diarrhea. Don't be alarmed if the bismuth in it makes your stools look grey/black.

I hope this information helps. Please let me know if I can provide further information.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh (4 minutes later)
Yes that is correct about the high bacterial counts. Do you think this could be some type of STD?
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (4 minutes later)
Brief Answer:
Not typical for STDs

Detailed Answer:
It's not a classic presentation for any STDs. May I ask, did you have receptive anal sex and was a condom used? Also, is this a new partner for you>
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh (3 minutes later)
I had anal sex with a new partner recently but he only had his penis in me a very short period of time not even a couple minutes and did not ejaculate at all. But I didn't think I would be at risk for that short period of time.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (22 minutes later)
Brief Answer:
Recommendations

Detailed Answer:
Ok - here is what I am thinking:

It would be unusual for HIV to present with these symptoms so quickly after an exposure (if there were an exposure) so I think your symptoms may be more related to the high coliform water you were in.

However, unprotected anal penetration, even if there wasn't ejaculation, still poses a risk. Not as high of a risk as if there was ejaculation, but still a risk. Given that there is a risk, and that you are achy and having diarrhea, I recommend having a 4th generation HIV test done 1 month from possible exposure. Given that you have an intact immune system (you have a normal white blood count), the test can be accurate as early as 2 weeks from possible exposure, but is increasingly accurate (i.e. for more people) the longer you wait. So testing at 4 weeks and again at 3 months should be adequate.

Again, I don't want to worry you, but best to cover all possibilities.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh (5 minutes later)
I really appreciate you. You have been a big help!!! I hope that's not the case, but will definitely do as you suggest.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (13 minutes later)
Brief Answer:
Glad if I can help!

Detailed Answer:
I'm glad if I can help. I welcome you to let me know how you are doing after you've had these tests. Hopefully your symptoms will resolve soon and you'll be done with it!
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3134 Questions

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What Causes Persistent Diarrhea?

Brief Answer: Recommendations Detailed Answer: Hello and welcome, I read the history you posted today, and also the history you posted a day ago that mentioned that you were in water where there was an advisory not to swim due to high bacterial counts - is that right? It's good that your blood white cell count was normal, but if the diarrhea is persisting, it's time to have stool studies done (culture, O & P, fecal fat). The person to order this would be your own physician. In the meantime, foods that are helpful or at least usually tolerated with diarrhea are apple sauce, bananas, rice, and toast. Other foods such as non-spicy, non-greasy fish or chicken are ok too if you tolerate them. Eat small amounts at a time to decrease stress on your digestive system. And keep up with fluids (mostly water, some sports drinks ok too, avoid caffeine). Usually in the US, people do not require antibiotics for diarrhea (compared with in non-industrialized countries with poor sanitation), but let's see what the stool studies show. You can also try Pepto Bismol which can be used for some infectious types of diarrhea. Don't be alarmed if the bismuth in it makes your stools look grey/black. I hope this information helps. Please let me know if I can provide further information.