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What causes constipation and diarrhea while on Zpack?

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General & Family Physician
Practicing since : 2004
Answered : 580 Questions
I have IBS from stress at work a lot of stress. Recently I got strep and urgent care gave me a Zpack which cleared it up. However shortly after my IBS started to act up between Constipation and diarrhea. Last week I ate a late meal and went to bed and woke in the middle of the night with cramps throughout my abdomen and stomach. First movement the next day was normal, then it began diarrhea, cramps, gas, some bouts of nauseas/gagging with a fever around 101.5 that at times went up to 102.5, and in the morning would be down to 100.1. Over the course of the last 7 days, the tenderness and cramps seemed to heal, however my digestive system is still very rambunctious. Ive been eatings small amounts and drinking lots of water, but I get worried that it sets off the digestive track and causes crampy movement through my system that at times is painful. I still have liquid diarrhea and a mild fever, but it seems to be working its way out. Any idea what this was? Was it food poisoning exacerbated by my spastic IBS?
Posted Mon, 27 Nov 2017 in Digestion and Bowels
Answered by Dr. Zotaj Antoneta 2 hours later
Brief Answer:
It does not seem food poisoning, possible causes explained and advises give

Detailed Answer:
Thank you for asking at healthcaremagic.

I carefully read your question and understand your concern.

The fact that you had fever with the bowel change it means it is very likely something infectious might have been a cause of the symptoms. As long as you don't have blood with stools or mucus than viral infections of the bowel are more likely.
Bacterial infections of the bowel may be considered if fever is longer than 3 days and sometimes especially because you had the bowel change after a course of antibiotics a postantibiotic colitis might be considered.

Food poisoning generally causes diarrhea and vomiting but no fever and settles within a few days so does not seem to be your case.

To conclude i would say:
1. if you have the diarrhea for longer than a week or fever for more than 3-4 full days than you will need to talk with your doctor and consider colitis after antibiotics or other bacterial infections of the bowel and consider if specific treatment related to them is needed.
2. it does not seem to be a food poisoning the way it has appeared and developed
3. make sure you do go on to drink well and frequent small amounts as you are already doing and if still diarrhea the best substitution of fluids is oral re-hydration solutions that you can get in the pharmacy.
4. take some enterogermina (probiotics) daily to help with the bowel flora. Yogurt is helpful also.

I hope this is helpful and answers to your questions but please feel free to reply in case more clarification is needed on this.

Kind regards,

Antoneta Zotaj, MD
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