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History of ulcerative colitis. Taken Sulfasalazine. Diarrhea, nausea, bloating, vomiting

Born 15 Oct 1958. 5 foot 8 inches 196 lbs. Ulcerative Colitis since 1991. Starting early 2000’s more flareups began to occur Sulfasalizine and Prednisone to control it. Remicade 2010-2011 until expense barred. Ménière s disease 1998, loss of most of hearing in Left Ear. No other health problems. FIRST INSTANCE. Sunday March 17. Ate at 1500 (3 PM. Sirloin Burger and turkey sandwich with Welches Grape Juice. At Approx Midnight after 3 hours in bed woke up and had to go urgently. Felt bloated and nauseous. Over the next few hours went several times and vomited. Nausea did not come back but diarrhea remained. All through Monday till Tuesday evening. Tuesday took Pepto Bismol at 10 AM, 11, 12, 1:45, 2:15, 4:45. During this time I also took daily 2X 2 500MG Sulfasalazine and 20 MG Prednisone. Multi vitamin and folic acid . Gatorade and Water. Toast & Jelly, Bananas, Saltine Crackers, and one serving of Chicken and Rice Soup. Starting Tuesday afternoon condition improved steadily. First solid bowel movement 4:20 AM Wednesday. By Wednesday, 20 March returned to work. Bowel movements were normal. I was taking also Pro Biotics starting Tuesday night. 1 per day each for next 4 days. Diet was constricted next few days to Apples, Bananas, Concentrated Diet power shake. Chicken Noodle Soup and Turkey Sandwiches. Celery with Salt; Saltine Crackers. One Hamburger not fried with Lettuce and Tomato.Welches Grape juice. SECOND instance. Woke up Saturday. 23 March at 3:30. Normal Bowel Movement. Then began to have multiple movements and diarrhea returned. At least 10 movements next 60 minutes. At 5:00 called doctor who called back 5 minutes later and suggested 4 Sulfasalazine tablets and continue as during previous instance. Gatorade and Banana. 5:30. No nausea or vomiting or bloating or gas. Another movement at 6:15. Colored water basically. Laid down and dozed, slept from 6:30 -0820. Multiple movements upon getting up starting at 8:30-8:50 2 slices of toast and Jelly, Banana, Gatorade at 9:00 Movements 9:05, 9:10. Went to Walgreens to get things at 9:15.
Asked On : Tue, 26 Mar 2013
Answers:  1 Views:  96
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General & Family Physician 's  Response

Based on the information provided it seems as "INFECTIVE DIARRHEA" mostly an ingestion of some infected food.
It do not seem like another flare of Ulcerative Colitis because you are taking medication for long time and its working very good for long time.

Form the diet it seems may be "Hamburger" OR " Lettuce /Tomato " have campylobacter/ E.coli bacteria and that in turn is the cause of diarrhea. But still many other possibilities as follows.
Following bacterias can be the cause food poisoning

1)Campylobacter enteritis
2)E. coli enteritis
3)Staphylococcus aureus

1)Campylobacter enteritis mostly seen in the meat products which are not cooked well (e.g. hamburger)
2)E. coli enteritis will be seen in Raw fish or oysters, or raw vegetables/fruits not washed properly.
3)Staphylococcus aureus is present in poultry product like eggs
4)Salmonella is seen in poultry product,
5)Shigella is seen in poor hygiene mostly water bourn
6)cholera is seen in water
based no the location / food it can change the causative agent.

Sooner the better to see doctor.

Here is what they will do
1) physical exam
2) ask history of food/ water intake
3) collect stool sample and blood test for the culture
4) mean while will provide a broad spectrum antibiotic and ask you to keep hydrating yourself.
5) once the culture comes in they will check and may change the antibiotics if needed

Hope it helps.
Answered: Wed, 27 Mar 2013
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