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Had vomiting, diarrhea, weakness, bed stricken. All reports normal. Why pain in abdomen still?

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Hi, I'm a 25-year female, 135lbs, generally healthy. I was in India last summer and got ridiculously ill - was vomiting/had diarrhea every 20-25mins or so for 30hours. And then couldn't keep food down for another 48. I was able to eat minimal amounts (and only light food like rice) after about 4 days. A few days after starting to eat again, I felt much better (this was on a Sunday) and was able to get back to normal life. But, started feeling weak on the Thursday evening, and by Friday afternoon was bed-stricken again. By Monday morning, I was fine. This continued for about 6 weeks. I did a bunch of tests in India (blood, stool) , and also when I got back to the USA. The doctors didn't find anything. It's been a year and a half, and I still get stomach problems on occasion - sharp pain, not wanting (or being able) to eat. I want to know what's wrong. Help, please?
Posted Sat, 28 Apr 2012 in Abdominal Pain
Answered by Dr. Poorna Chandra K.S 1 hour later
Hi and thanks for the query.

To suggest anything meaningful I need more information on-

1) The symptoms that you had on the second and third occasion.
2) The location, nature of the present pain, any radiation, precipitant and releiving factors, and it's effect on your apetite, weight and bowel habits.

It will also help if you can attatch the reports especially the stool examination reports.

Awaiting your response.

Above answer was peer-reviewed by
Follow-up: Had vomiting, diarrhea, weakness, bed stricken. All reports normal. Why pain in abdomen still? 44 minutes later
Re: second occasion:
- Thursday evening/night I'd feel very weak, and would have minimal appetite.
- Friday afternoon: very weak, fever, no appetite
- Friday night - Saturday afternoon: same symptoms as above + loose bowel movements
- Sunday: minimal appetite, ability to leave house, little weakness

Re: third occasion:
- Usually just loss of appetite + general weakness
- Sharp pain/heavyness in middle of stomach region. Usually lasts ~24-48 hours. - Bowel movements irregular during this time.

Re: stool examination reports: Don't have them but they were conducted in India every 2-3 days for about 2 weeks, to check for parasitic activity. Nothing was found.

Blood examination did standard blood test - all counts were normal.

General effect: appetite is definitely less than what it was pre-India trip. Effect on weight is minimal though.
Answered by Dr. Poorna Chandra K.S 23 hours later
Hi and thanks for the clarification,

The episode of illness that you had in India appears to be an infective Gastroenteritis only.

Some people develop some intestinal mucosal changes after a diarrhoeal episode while visiting tropical areas called Tropical enteropathy. This classically causes some abdominal discomfort, malabsorption and fatigue. There is no specific tests but for small bowel mucosal biopsies; which are difficult to obtain.

But it is wise to get a few tests like stool routine examination (atleast 2 days), serum folic acid and vit B12 levels, Serum CRP (quantitative) to rule out other causes.

Meanwhile i would advise you to stop intake of milk products(atleast for 2 weeks), take some zinc and probiotics. After giving the blood tests you can also take folic acid and Vit B complex.

Hope I have answered your query. Please do write back if you have any doubts.

Wishing you good health.

Above answer was peer-reviewed by
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