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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest remedy for persistent diarrhea in a diabetic

Answered by
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Dr. Ajit Naniksingh Kukreja

Gastroenterologist, Surgical

Practicing since :1984

Answered : 923 Questions

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Posted on Sat, 24 Oct 2015 in Liver and Gall Bladder
Question: Hi sir. I am diabetic since 2000 and htn since 2008 . Presently diagnosed with Ckd stage 2/3 . Suffering from chronic diahrrea for last 18 months for no apparent cause. Endoscopy and colonoscopy done in Dec 2014 are normal . Taking Imodium 2 mg almost daily and more sometimes when the symptoms are severe. On bland diet . Small bowel biopsy is insignificant . Kindly suggest action and advise. Taking probiotics daily
doctor
Answered by Dr. Ajit Naniksingh Kukreja 4 hours later
Brief Answer:
Need some information

Detailed Answer:
Hi

Thanks for writing in

What is your age and gender ?

Can you give a detailed history of your CKD diagnosis ?

What is the frequency of stool and the consistency of stool ?

Did you ever go for a stool culture ?

Please give details of your renal function and any other test that you have undergone

Do revert back with the information and I will help you out

Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Ajit Naniksingh Kukreja 2 hours later
Stool culture negative latest. Stool formed with imodium cap 2 mg . Cr 1.7 bun 19 uric acid 7 hb 12.9 hba1c 6.6 fasting bs 110-120 plbs 170-185, usg normal , liver profile normal , stool frequency 3-4 times with imodium. Always sounds in stommach like water and gas. Male 38, ckd stable for last 2 years. Pl help me . Had taken a course of cifran 500 and orni o last year and was better off for the next one month or so, but the symptoms keep coming back. Unable to eat fibre food. Only having carbs which elevates my blood sugar. Have visited lot of docs but no relief. They say its IBS. Pl suggest if i can take something for sibo which is not absorbed in the blood like xifaxan. Presently take imodium 2 mg every morn . Also extra dose when aggravates.
doctor
Answered by Dr. Ajit Naniksingh Kukreja 31 minutes later
Brief Answer:
It is IBS

Detailed Answer:
Hi

Thanks for the detailed information

Cifran and Ornidazole will surely work if it is infective in origin

I would suggest take Rifaximin 400 and a good probiotic twice a day for two weeks,
stop taking imodium and get a stool culture done before starting any antibiotic

Manage your stress levels with yoga and meditation

Take gluten free diet, it will help you

Hope this helps
Do write back in case of concern
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ajit Naniksingh Kukreja 12 minutes later
Rifaximin would not affect kidneys?
doctor
Answered by Dr. Ajit Naniksingh Kukreja 28 minutes later
Brief Answer:
Unfortunately no documented studies

Detailed Answer:
Hi

Thanks for a very intelligent question

Unfortunately there are no studies on effect of Rifaximin in patients with renal disease

Though we get occasional patient who have safely consumed the medicine with impaired renal function without deteriorating, I would not prefer taking a chance

Instead wait for the culture and decide on the antibiotics accordingly

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ajit Naniksingh Kukreja 17 minutes later
Sir can i safely take imodium 2 mg per day if that helps with my symptoms? That is metabolised through the liver i guess? Imodium has helped me over the past few months with the minimum dose and the occaisional triple dose . Pl suggest as the culture is always negative for me with the bacteria ++. Is imodium safe in the long run ?
doctor
Answered by Dr. Ajit Naniksingh Kukreja 30 minutes later
Brief Answer:
Any medicine in long run is not advisable

Detailed Answer:
Hi

Thanks for your followup

You may take Imodium intermittently as and when need be

Any formulation taken for long term is not advised

Imodium has it's own side effects but if you are not affected do take it cautiously

With the awareness that you have I am sure you will care for yourself

If stool culture are negative on frequent occasions take a ten day course of Ofloxacillin and ornidazole

Hope this clears your doubts
Do not hesitate to write back in case you have any query
Above answer was peer-reviewed by : Dr. Prasad
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