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Bleeding from roof of mouth and rectum, abdominal pain and bloating after treatment for amoebic dysentry. Help?

Jan 2013
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Internal Medicine Specialist
Practicing since : 2003
Answered : 1658 Questions
Bright red blood is pouring from the roof of my mouth and rectum. Recently recovered from amoebic dsyentery. Abdominal discomfort and bloating started about 12 hours ago with occasional acute pain.
Posted Sun, 26 May 2013 in Digestion and Bowels
Answered by Dr. Mayank Bhargava 1 hour later
Welcome to XXXXXXX forum.

Let me know your other associated symptoms along with mentioned.
Do you have acidic belching/ abdominal discomfort/ gargling sound in abdomen/ abdominal bloating after taking meals?
Do you have fever/ spasmodic abdominal pain/ vomiting?
Do you have generalized weakness/ joint ache/ skin lesion along with mouth ulcers?

With the available described symptoms, there appears to be high possibility of Acute dysentery with drug/ infection induced mouth ulcers.
Acute dysentry could be due to amoebic or due ti bacterial infection (Salmonella and shigela).
Other possibility could be inflammatory bowel disease i.e crohn's disease which could also be associated with mouth ulcers with bleeding per rectum.

You should consult with XXXXXXX medicine specialist/ gastroenterologist and should go for thorough check up.
You should also go for complete blood count, blood sugar, serum electrolytes, widal test, amoebic antibodies and thyroid profile.
You should also go for colonoscopy for better clarification.
If ulcers has been found in large colon then biopsy is mandatory for exact diagnosis.

Treatment depends on exact diagnosis.
Meanwhile, you should take complete antibiotic therapy, antispasmodics, probiotics, hemostatic, antipyretics, if needed.
Take soft diet along with yogurt and banana.
Avoid milk and all milk related products.

Hope that helps.
Let me know your other query.
Take care,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
Follow-up: Bleeding from roof of mouth and rectum, abdominal pain and bloating after treatment for amoebic dysentry. Help? 21 minutes later

Yes there is acidity, belching, discomfort and bloating. Although eating seems to settle things.
Yes there is spasmodic abdominal pain and there was fever and vomiting a few weeks ago.
Yes there is general weakness and some joint pain but no skin lesions.

Recently finished a course of metronidazole. No other medication is available for amoebic dysentery in Thailand. Symptoms subsided completely about 3 days ago, bowel was almost constipated. Returned this morning from a 5 day trip to India. Is this a flare up of the old infection (experienced severe stress in India) or a new infection?

If the latter then it has not been cured by a wide range of antibiotic treatments, antispasmodics, probiotics and lastly metronidazole. Was hoping to try Auranofin but not been able to source it in Thailand or India.

I have medical insurance in the UK but not Thailand because this holiday trip has exceeded 3 months. The UK insurance will not treat a condition first treated overseas. What is your advice?
Answered by Dr. Mayank Bhargava 20 minutes later
There could also be possibility of presence of similar ulcers in upper gastrointestinal tract also.
You should also go for endoscopy to rule out possibility of these ulcers.
You should take cefixime along with ofloxacin & ornidazole on written prescription from a local doctor as metronidazole alone is not sufficient.
Possibility of amoebic dysentery should be suspected only when it is confirmed by stool examination.
Treatment is no expensive and you can treat it on OPD basis.
Best regards,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
Follow-up: Bleeding from roof of mouth and rectum, abdominal pain and bloating after treatment for amoebic dysentry. Help? 13 hours later
Hi Doctor

Some additional information:

1. In India, six weeks ago, a stool test confirmed amoebiosis.
2. There are no other amoebicides available in Thailand apart from metronidazole, hence the visit to India.
3. My friend's mother died from a botched endoscopy of the colon. I would prefer to avoid.

There is a something else: on arriving in Thailand yesterday morning, I took a generic taladafil pill from India. Could this have been the cause of the symptoms?
Answered by Dr. Mayank Bhargava 4 hours later
There could be possibility of untreated or partially treated amoebic colitis .
You should take complete course against amoebic colitis.
You are afraid regarding colonoscopy, as such there appears to be no risk with this procedure.
Taladafill is not associated with above mentioned symptoms.
Get well soon,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
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