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Epigastric abdominal cramps, diarrhea, body ache, chills, fever. Taken pepto bismol. What can be the cause for this?

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Internal Medicine Specialist
Practicing since : 1998
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2 days severe epigastric abdominal cramping, at times with an intermittent bulge just under the xyphoid. zero nausea or fever at this point. diarrhea, but not obviously tied closely to eating. Didn't feel sick at this point so kept eating. Maybe two hours later would have diarrhea stool. Day 3 I stopped eating thinking it might be a gi bug. cramps got lighter - diarrhea seemed to resolve. day 4 light cramping - no stool - still no nausea or fever. Cramping primarily in morning when leaving for work - 2 hours after eating and in later afternoon - again about 2 hours after eating. Ate a bit on returning home, no real cramping noted. Day 5 - felt pretty good until mid afternoon - felt really tired. Very light body aches as leaving work. Took hot bath when I got home. Did not seem to help. Increasing body aches, chills, and now low grade fever. 99.5 is the high so far. Feel worst so far still no n/v. Have not noticed any cramping today. Dark black / XXXXXXX normally formed stools today ( I did take pepto bismol twice total on days 3 & 4). Sooo.. what's up doc?
Posted Tue, 22 May 2012 in Abdominal Pain
Answered by Dr. Jasvinder Singh 41 minutes later
Thanks for posting your query.

I can understand your concern for these symptoms and from your symptoms three possibilities need to be ruled out. These include:

1)     Acute cholecystitis and gall bladder disease which can cause severe epigastric and right upper abdominal pain along with XXXXXXX colored stools.

2)     Peptic ulcer disease which can cause epigastric pain, diarrhea, abdominal cramping along with black colored stools which may be due to upper gastrointestinal (GI) bleed.

3)     Third possibility is of enteric fever or typhoid.

The incubation period of typhoid is 10-20 days and is divided in two phases. In the first phase, temperature rises gradually to 40ºC and is accompanied by sweating, no appetite, coughing and headache. This phase lasts for a week. Then the second phase starts in which the fever remains very high and the pulse becomes weak and rapid. In this phase the constipation is replaced by severe pea-soup-like diarrhea and fever may be present for 1 week to 10 days. It's not until the fourth or fifth week that the fever drops and the general condition slowly improves.

You need to consult a physician and get ultrasound upper abdomen and blood tests for typhoid done. You may need antibiotics and antipyretic drugs for fever.

Also take plenty of fluids to avoid any dehydration and take a light easy to digest diet. Also clean toilets, door handles, telephone receivers and water taps with a household cleaner to avoid any spread. Wash your hands and the other family member’s hands frequently.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

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