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Suggest treatment for vomiting and diarrhea

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Posted on Sat, 30 Jul 2016
Question: I have been sick since XXXXXXX 20th. I woke up vomiting and having diarrhea from 3 am to 6 am every 10 minutes or so, went to ER. They took CT, showed 2 cm mass on pancreas neck. Dr put me on 2 antibiotics, for diverticulitis, which I am know to have before. I have pain all across lower abdomen, middle, lower back, abdomen feels bloated, crampy, moderate pain, all the times does not go away. Back pain is moderate, to severe, hurts to touch. Left stomach hurts to touch. Now on prednisone for 7 days twice a day. Don't think it is doing any good..
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Answered by Dr. Grzegorz Stanko (7 hours later)
Brief Answer:
Please give some details.

Detailed Answer:
Hello.

Thank you for the query.

Do you have any recent blood work? Have you been told that the mass in the pancreas can be a cancer? Can you please attach the CT report? Have you discussed the treatment with a surgeon?
I need to have this informations to give valuable answer.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Grzegorz Stanko (4 hours later)
I have provided 2 ct scans, 1 without XXXXXXX and 1 with XXXXXXX plus MRI rolling out the mass. I have also provided blood work from hospital visit and blood work from 3 months ago. I will also have blood work done again on Friday morning, normal blood work for diabetes and high cholesterol.

I have been naused since XXXXXXX 20th stopped vomiting after they provided the meds but threw up again this Monday. Every time I pee, I also pass stool, this has been only since XXXXXXX 20th. I would call it loss but not diarrhea. Like this morning, I have problems breathing, it is heavy. I have to breathe with my mouth open, I feel I get more air that way. I still have pain in abdomen and back.
doctor
Answered by Dr. Grzegorz Stanko (6 hours later)
Brief Answer:
Colonoscopy and ERCP should be done.

Detailed Answer:
Generally it seems that you may have two conditios. First is a diverticulitis which could cause a fistula between the large intestine and the bladder. This may cause stool and urine passing together. This may be a reason of chronic kidney infection and give back pain along with other symptoms.
Secondly you may have a narrowing of the pancreatic duct. This can be the reason of vomiting and abdominal pain.
In my opinion you should have colonoscopy done to see diverticles and fistula.
For pancreas diagnostic a test called ERCP should be done and EUS considered (both are done during endoscopy). You should consult good gastrologist.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Grzegorz Stanko (1 hour later)
Thank you. My primary care was thinking kidney problem only with my diabetes. Now I was put on 2 weeks of two different antibiotics (Metronidazole 500mg Tablets, and Ciprofloxacin 500mg Tablets) for the diverticulitis shouldn't that have cleared it up? In the MRI they didn't mention anything about seeing, they said it was clear. I had a colonoscopy less then a year ago and had a mild case then. I do still have pain on the mid section upper left, which my primary said something about the junction where diverticulitis starts...

I don't mind doing another colonoscopy if it will clear everything up, I'm tired of the pain, that is for sure.

I do like the idea about the ERCP should be done and EUS.

doctor
Answered by Dr. Grzegorz Stanko (11 hours later)
Brief Answer:
Try Rifaximine for diverticulitis.

Detailed Answer:
Both diverticulitis and kidney infection should be gone after such treatment. However if there is a connection between large intestine and bladder the infection will be present no matter what treatment you will get. Surgical removal of the fistula is the right treatment.
If you do not feel like having colonoscopy, cystoscopy should also diagnose the problem.
For sure you should try Rifaximine treatment for recurent diverticulitis.

In the MRI there was no tumor in tge pancreas but there might be some impression on the pancreatic duct. That is why ERCP and EUS are necessary.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Grzegorz Stanko

General Surgeon

Practicing since :2008

Answered : 5769 Questions

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Suggest treatment for vomiting and diarrhea

Brief Answer: Please give some details. Detailed Answer: Hello. Thank you for the query. Do you have any recent blood work? Have you been told that the mass in the pancreas can be a cancer? Can you please attach the CT report? Have you discussed the treatment with a surgeon? I need to have this informations to give valuable answer. Regards.