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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Diverticulitis In An Elderly Person

I am a 50 year old female. I have a history of colitis with mucus from 2001-2008 and took Asacol during that time. I honestly don t remember much about symptoms from back then. A colonoscopy check in 2010 showed no sign of colitis. Had to go to ER 09/2011 due to micro-tear in bowel (experienced severe pain in right shoulder and it turns out I had the tear and gas was getting trapped in my shoulder). Diagnosed with Diverticulitis, was in the hospital for 7 days with no food & then liquid diet and recommended colonectomy when bowel completely healed. Had my Sigmoid colon (doc said 1 foot) removed 12/2011. I cannot remember if I suffered from bowel issues in 2012 or 2013...but I know I wass very bloated the whole time. Beginning 01/2014, diarrhea, bloating, cramps & urgency. Internal medicine doc thought it might be gallbladder issues. Had a complete abdominal scan 12/2014. Nothing abnormal found. Colonoscopy performed 12/2014 and showed I had C Diff but nothing wrong with colon or intestines. Took Flagyl...did not tolerate it well at all, but finished the 2 week course. Diarrhea stopped for a few weeks but came back full force. Doc prescribed another course of Flagyl for 30 days, this time a lower dose and I tolerated it better. Had an endoscopy and another colonoscopy 12/2015. Showed ulcers in base of esophagus but nothing in colon. Suffered with same bad diarrhea all through 2016. Landed in the hospital 06/2016 with severe pancreatitis (Lipase was at 7500 in the ER. Had CT scan with contrast...gallbladder functions normal. Had Nuclear test on pancreas...normal. Said it was idiopathic...I do have type 2 diabetes since 2011 but it is controlled with Metformin. A1C taken in 06/2016 at 6.1 and 12/2016 was 6.1 again. Lipase 12/2016 was 28. I do not drink alcohol). My GP prescribed Welchol and Hyocyamine (for cramping). Got very bad constipation from Welchol. Saw my 4th gastro doc in 3 years 12/2016 and she recommended an endoscopic ultrasound procedure (thinking there might be structural issue with pancreas) along with blood work and stool samples. She also told me to take a 2 week course of Xifaxan. I took the full course and diarrhea is worse than ever. The only test that came back positive was the fecal leukacytes said positive by lactoferrin. I had the endoscopic ultrasound 1/10/2017 with nothing abnormal found and biopsy was negative for anything. I am still taking Hyocyamine due to very bad cramping and I have horrible achiness in wrists and ankles after diarrhea bouts. I take a lot of anti-diarrheal medicine. A lot of mucus is present (looks like egg whites and is very foul smelling) and feeling like bowel is not emptying and look like I am 9 months pregnant. Super tired ALL the time. I have not received a call regarding stool sample/blood work results and that was 2 weeks ago. I am at my wits end! Thank you for your time!
Fri, 3 Feb 2017
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General & Family Physician 's  Response
Hi,
Thanks for your question.
I do understand your pain and discomfort.
As per your history is concerned please follow :-
1)Take [ GALAZYME-PRO tablet] a digestive enzyme after food 3 times per day and it contains alpha-galactosidase 150 mg, lactase 7 mg, protease 25 mg, amylase 50 mg, lipase 3 mg.
2)Take [ECONORM powd for oral] it contains [Saccharomyces boulardii] two times per day
3)Take Vitamin B-12 in injection In IM 4 times per weekly upto one month then once a month & Correct Iron deficit by taking [iron sucrose twice weekly in IV line with 100 ml saline]
4)Take [gluten free]diet ,tell your nutritional expert to make a chart for it.
5)Take [metronidazole 500mg] 3 times per day along with [Mepacrine-100] mg 3 times per day up to 10 days and repeat monthly.
6)Add a full course of [DUOCLOX caps 3 times per day]it contains ampicillin+ cloxacillin for 10 days
7)Do your CBC ,Blood culture,Stool culture &Urine culture
8)Check your blood sugar and try to control it below 90mg/dl if required take Insulin.
I hope I was able to address your query. If you have any further questions, please do not hesitate to write to me.
Wishing you all the best.
Thanks
Dr U N Sahoo
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Suggest Treatment For Diverticulitis In An Elderly Person

Hi, Thanks for your question. I do understand your pain and discomfort. As per your history is concerned please follow :- 1)Take [ GALAZYME-PRO tablet] a digestive enzyme after food 3 times per day and it contains alpha-galactosidase 150 mg, lactase 7 mg, protease 25 mg, amylase 50 mg, lipase 3 mg. 2)Take [ECONORM powd for oral] it contains [Saccharomyces boulardii] two times per day 3)Take Vitamin B-12 in injection In IM 4 times per weekly upto one month then once a month & Correct Iron deficit by taking [iron sucrose twice weekly in IV line with 100 ml saline] 4)Take [gluten free]diet ,tell your nutritional expert to make a chart for it. 5)Take [metronidazole 500mg] 3 times per day along with [Mepacrine-100] mg 3 times per day up to 10 days and repeat monthly. 6)Add a full course of [DUOCLOX caps 3 times per day]it contains ampicillin+ cloxacillin for 10 days 7)Do your CBC ,Blood culture,Stool culture &Urine culture 8)Check your blood sugar and try to control it below 90mg/dl if required take Insulin. I hope I was able to address your query. If you have any further questions, please do not hesitate to write to me. Wishing you all the best. Thanks Dr U N Sahoo