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IBS and viral infection - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: IBS(Irritable Bowel Syndrome)
Answered by

General & Family Physician
Practicing since : 2004
Answered : 40 Questions
User :   Hi, I've had mild cold symptoms (runny nose, congestion, occasional low grade fever) for about a week. Now I also have diarrhea and nausea, still with chills but no actual fever. I don't know if this is a virus or a complication of lupus (which I have) or something else entirely. I did see my doctor who advised rest and thought it was just viral, but I don't know. What do you think?
Doctor :   Hi...
User :   Hi, can you see my query on the screen?
Doctor :   Dr. here
Doctor :   yes
Doctor :   Let me read your query
Doctor :   May i know your age.?
User :   Yes, I'm 54.
Doctor :   When were you diagnosed positive for lupus ?
User :   In 2006. I have a mild case, thank goodness. But lately I have been very stressed at my new job (I have a daily 3 hour round trip commute), and I am running down. That is why I wonder if this is all a lupus flare.
Doctor :   I do not think the above symptoms are due to lupus flare
Doctor :   i too am in consideration of a viral illness
User :   Do you think I could actually have the flu, even the H1N1 flu?
Doctor :   H1N1 is a fast evolving type
User :   I know, and this year the flu shot is just a "combo shot" for all varieties. But I remember that H1N1 sufferers often had nausea and diarrhea along with the other respiratory symptoms. I am a little scared, I guess.
Doctor :   by a week you would have got LRTI ( lower respiratory tract infection )severe cough with sputum
User :   I definitely don't have that . . . one day I did cough up some mucus, but that was just one day. And I don't have any cough at all. And, like I said, my temperature has not been high (like 99.8 at the worst).
Doctor :   Almost of all viruses causing flu like symptoms ( influenza viral serotypes ) do produce the similar symptoms but the severity of them determines what to be suspected
User :   Right now I am too tired and fatigued to go to work, for instance, but I am not all that miserable. I just wish I could feel like myself so I could go back to work.
Doctor :   and yes , fever is one important symptom in H1N1
Doctor :   but rest is one which will help you lot now
Doctor :   anyway you can try working by taking some NSAIDS
User :   With the snow forecasted for NYC, I imagine I won't be going to work tomorrow . . . but I still work from home. I probably shouldn't even do that.
Doctor :   like Ibuprofen
User :   I try to avoid NSAIDs due to acid reflux issues . . . but tylenol helps me a lot.
Doctor :   yes, that too works well
Doctor :   and yes mental strain too adds to the fatigue and symptoms
User :   I have one other thought . . . part of the lupus, just recently determined, has been some vagus nerve dysfunction, swallowing difficulty, and also "vasovagal syncope." It's under control,mostly, but I wonder if the vagus nerve problem could be contributing to the GI symptoms.
Doctor :   yes, could be a chance
User :   But, mainly, you would say I should treat this as a virus, get rest, fluids, take tylenol, etc.?
Doctor :   nausea can be explained but not diarrhea
Doctor :   yes , very right
User :   I definitely have diarrhea; the nausea is very mild. Even the diarrhea is not too bad. I was told to switch to a lose residue diet, and that is helping. I even wonder if the diarrhea could be exacerbated by the fact that my gallbladder was removed two years ago.
Doctor :   no , thats not a problem , the liver will entirely substitute to gall bladder
Doctor :   post cholecystectomy do not pose any trouble and not at all after years
User :   I haven't had much trouble since the gb removal. I do think I have mild IBS, though it's never been formally diagnosed.
User :   I guess I am almost out of time, right?
Doctor :   a little left
Doctor :   please continue
Doctor :   IBS needs frequent episodes of such symptoms and to rule out all possible causes of the diarrhea
User :   I meet the criteria for IBS . . . abdominal bloating and discomfort, intermittent diarrhea, sometimes alternating with constipation
User :   I do have the diarrhea relatively frequently . . . at least once a week, but usually milder than what I have had these last few days.
Doctor :   yes, but the diagnosis can be considered only wen all the possible diagnosis like Acid peptic disease amoebic parasitic, bacterial viral are ruled out
Doctor :   you should have minimum of 3 stool cultures to consider IBS
Doctor :   3 stool cultures negative*
User :   I do have GERD or acid reflux disease, but no parasitic infections. I had a whole workup in the summer with colonoscopy, endoscopy, and three stool cultures.
Doctor :   oh , thats considerable then
Doctor :   yes, then IBS could be a chance
Doctor :   and aggrevated by viral infectuion
User :   Yes, my doctor and I have talked about it a lot, and since it has been relatively mild (compared to what else I have to deal with), it hasn't been a major topic of concern.
Doctor :   diet modification is the first line treatment for it
User :   So maybe I do just have a lingering cold and the IBS is acting up due to the virus. That sounds right to me. I know I have to sign off in 30 seconds so I think I have my answer.
Doctor :   takes so much to diagnose IBS but treatment is very silly
User :   Yes, I am always experimenting and being very careful and respectful about my diet!
Doctor :   Thanks for consulting me , kindly provide your feedback
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