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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for chronic diarrhea

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Dr. Rahul Tawde

General & Family Physician

Practicing since :1980

Answered : 1 Question

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Posted on Mon, 18 Aug 2014 in Digestion and Bowels
Question: I was diagnosed when I was about 15 with IBS. so I've dealt with and learned the triggers and symptoms very well. however, whatever I'm dealing with now is completely different. for about 3 months now, I can't eat ANYTHING with out having to go to the bathroom with horrible diarrhea within 15-20 minutes of eating. it no longer matters what the food is. a bowl of plain rice, a piece of bread, or more elaborate meals like pasta or chinese or mexican. even a regular salad. and what I just ate, is what is coming out. I only say this because I don't eat the same things because I've been trying to find something that won't trigger it. And when I eat mushrooms for the first time in a week and thats what comes out... so far two single slices of cheese, an apple, a banana, and a small order offries have been the only things not to trigger an episode. I'm not having any changes in appetite or weight, but I. constantly more tired and having dizzy spells which is assume are both from the fact that I doubt my body is able to absorb any nutrients from the things I eat. what bothers me though more than anything, is that about a month ago it changed from just a single bout of diarrhea. I go after I eat like I said, but then have to reutn within about 15 minutes to let out what I can only describe as bright yellow froth that kinda burns. I'm only nauseous in the morning for about 10 minutes after waking if I try to move immediately after waking up with hirrible pains that feel like someone squeezing my entire stomach area with a giant clamp. there have been a few instances where it was dark red before going to yellow and tonight I went on myself with not even realizing it until it happened because I didn't feel the need, or it happening... only the aftermath. I'm starting to really worry because this isn't the normal ibs pattern at ALL.
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Answered by Dr. Rahul Tawde 2 hours later
Brief Answer:
Enteritis or enterocolitis should be ruled out

Detailed Answer:
Hi XXXXXXX
Thanks for posting your concern in the HCM.
I think you have developed enteritis or enterocolitis. However, any other colonic pathology including IBD should also be ruled out.
My recommendations are-
1. Plenty of oral fluid and ORS- 3-4 l/day
2. Frequent small amount light diet. Avoid dairy products and refined carbohydrates for the time being.
3. For symptomatic relief from pain, Dicyclomine 10 mg may be taken, on SOS basis.
4. You should also have a PPI (Pantoprazole 20 mg/ Omeprazole 20 mg) and Domperidone10 mg 30 min. before breakfast.
5. I usually suggest my patient to have Mebeverine 200 mg extended release twice daily for 10 days in case of acute exacerbation of their IBS symptoms.
5. Investigations required- Blood for complete blood count, CRP, Urea, Creatinine, Electrolytes, Fasting Plasma Glucose, Fasting TSH, Fasting LFT and stool for routine examination (RE, ME, OBT)
6. Antibiotic treatment may be started depending upon the investigation reports.
7. You should also consult a local gastroenterologist for clinical evaluation.
8. In case you have dehydration, altered sensorium or blood in stool, you may need in patient treatment after hospitalization.
I need a few additional information too-
1. Did you have fever in last one month? If yes, what was the diagnosis? If not known, was the fever continuous or intermittent? Was the fever associated with chills, headache, joint pain?
2. Do you have any history of recent travel? If yes, please specify
3. Did you ever have blood in your stool or vomitus? If yes, was the blood fresh or altered?
4. Do you have any other concurrent acute or chronic illness?
5. Do you have any history any surgery or jaundice or any major illness in the past?
6. Are you allergic to any medication?
Please consult a gastroenterologist at the earliest.
You can reply back with above mentioned information and investigation reports for any further information or advice. You can attach scanned copy of your investigation reports in the follow up query.
Hope you are satisfied with my answer. If you think I have satisfactorily resolved your query, please rate my answer. If you have any further query related to this, please write back.
In case you have any new query in future, you can directly ask me questions @ http://www.HealthcareMagic.com/doctors/dr-kaushik-sarkar/68460. I will try my level best to help you.
Regards,
Dr. Kaushik

Above answer was peer-reviewed by : Dr. Yogesh D
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