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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for persistent diarrhea with abdominal cramps

Answered by
Dr. Prasad

General & Family Physician

Practicing since :2005

Answered : 3345 Questions

Posted on Mon, 29 Aug 2016 in Liver and Gall Bladder
Question: I have been suffering with acute colitis since August 1; I am in the middle of a VERY stressful, complicated house move and my elderly husband is having significant vascular ulcers on his feet (this is a month long problem and he stubbed his big toe on Wed) and we've been back and forth treating him during the leadup period for the move. I'm doing virtually of his wound care. I have a history of colitis episodes in response to extreme stress, tho' I haven't had an attack like this in many years - truly can't remember when. I was reasonably careful of my diet (homemade chicken rice soup, homemade applesauce, white toast) and took OTC Immodium for a couple of days.

Then I saw an MD - NOT my regular physician and one for whom I confess I don't have much regard. He prescribed 2.5 mg of generic for lomotil four times a day (no other advice or suggestions) and I began taking them religiously in the afternoon of August 3. I had a very but too much fiber breakfast and lunch that day (I had felt better) but since then have restricted my diet to applesauce, apple juice, chicken broth and VERY soft rice, some lightly buttered white toast and as much water as I can drink. Last night I had about half of a soft medium burger, no bun; about 4 bites of baked potato and about 6 very well cooked green beans - I even removed the seeds! My sister did some research for me on WEBMD and told me MINIMUM therapy was TWICE the lomotil (to a maximum of 20 mg per day) I was taking so I began taking double the prescribed dose yesterday evening. I continue to have TOTALLY watery stool about every 2 hours; sometimes 2-3 times in an hour. I was able to sleep last night (got up to take Rx) and slept most of the day today, following a week of substantial physical effort packing and organizing and supervising move - have to go back to house to continue packing for storage and toclean tomorrow and Monday! Closing is Tuesday.

The cramps are MUCH better/eased off but the diarrhea continues unabated. I am 68 years old, blood pressure well controlled on AstavanHCT, take a statin, thyroid med, generic for Nexium, gabepentin (for muralgia) and meloxicam. OTC calcium, baby asprin, Allertec and arthritis strength acetominiphen. JUST has physical and except for being substantially overweight (5'2, 210) have no major health problems. I'm going to eat some chicken rice soup and applejuice now and plan to up the dosage of lomotil in desperation at next dosing time of about midnight. MANY thanks for whatever advice or assurances you can give. YYYY@YYYY
Answered by Dr. Prasad 15 hours later
Brief Answer:
I'd prefer treating with probiotics instead of round the clock lomotil.

Detailed Answer:
First I apologize for the late response. Your query wasn't attended for long time due to reasons unknown. It is not typical on this site.

Coming back to your problem, as I understand you been suffering from persistent diarrhea with cramps for more than a week. The cramps have got better and that's positive news. It also seems like you have had colitis / irritable bowels in the past; but this episode is bothering a lot especially at a time when you have to attend other concerns.

Well, sometimes an acute diarrheal episodes lasts for a week to 10 days. And in acute diarrhea, the best line of management is hydration, proper hygeine and probiotic supplements. Though lomotil is helpful, I wouldn't prefer to use it round the clock.

Therefore my suggestion to you are:
1. Consider starting probiotics (supplements). These are commensal bacterial flora such as lactobacillus, bifidobacterium, enterococci, sacromycetes and so on. As I practice far away from your locality, I am unaware of brands containing probiotic. But you should find them over the counter easily at chemist stores.
2. Your diet seems good. I would also add yogurts, curds and buttermilk for more benefits.
3. Continue drinking fluids for hydration.
4. If you don't get better soon, say in the next 3-4 days, I would plan stool examination and other tests.
5. Hyperthyroid state also results in diarrhea. I am not sure this is an associated factor in your case. But I would like to check thyroid status if the episode persists.

I hope this is helpful.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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