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What causes nausea, diarrhea, lack of appetite, persistent stomach and back pain?

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Posted on Thu, 14 May 2015
Question: Yesterday I was seen by a Nurse Practitioner at a local clinic for ongoing pain in my stomach and back, along with nausea, diarrhea, no appetite, and just plain feeling "rundown". I have had NO fever. She took a urine sample, which she only commented on it showing that I was well hydrated.
She ordered an ulra-sound and whatever you call it when they put the scope down your stomach. She also prescribed Metronidazole and Ciprofloxacin. I am really concerned about taking these antibiotics without any evidence that there is a bacteria infection. Is it common practice to prescribe an antibiotic for such without any bloodwork (CBC)?
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Answered by Dr. Grzegorz Stanko (11 minutes later)
Brief Answer:
Your symptoms are quite characteristic for gallstones.

Detailed Answer:
Hello!

Thank you for the query.

Giving this two antibiotics without proper diagnosis is not a good idea. Its easy to give a prescription, because not the Nurse will have awful side effects of this antibiotics which can make you feel even worse. Even if she thought it is gastrointestinal infection, plenty of such infections are caused by viruses. And antibiotics are completely ineffective against viruses.
Your symptoms indicate that you might have gallstones. Upper abdominal pain radiating to back is a vary characteristic symptom of this problem. Nausea very common appears with this issue. Diarrhea is also possible. And usually there is no fever.
Peptic ulcer (which she wants to diagnose with gastroscopy) does not give pain which radiates to back.

In my opinion you should follow this steps:
- have abdominal ultrasound and blood work done, amylase level and liver tests should be done as well, amylase should be checked in urine as well
- avoid any solid foods for next 12 hours and drink plenty of liquids
- until you wont get an ultrasound result, avoid fatty foods, spicy foods, fried foods, coffee, alcohol
- if ultrasound will be negative, than gastroscopy is a correct next step

Hope this will help. Feel free to ask further questions.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Grzegorz Stanko

General Surgeon

Practicing since :2008

Answered : 5769 Questions

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What causes nausea, diarrhea, lack of appetite, persistent stomach and back pain?

Brief Answer: Your symptoms are quite characteristic for gallstones. Detailed Answer: Hello! Thank you for the query. Giving this two antibiotics without proper diagnosis is not a good idea. Its easy to give a prescription, because not the Nurse will have awful side effects of this antibiotics which can make you feel even worse. Even if she thought it is gastrointestinal infection, plenty of such infections are caused by viruses. And antibiotics are completely ineffective against viruses. Your symptoms indicate that you might have gallstones. Upper abdominal pain radiating to back is a vary characteristic symptom of this problem. Nausea very common appears with this issue. Diarrhea is also possible. And usually there is no fever. Peptic ulcer (which she wants to diagnose with gastroscopy) does not give pain which radiates to back. In my opinion you should follow this steps: - have abdominal ultrasound and blood work done, amylase level and liver tests should be done as well, amylase should be checked in urine as well - avoid any solid foods for next 12 hours and drink plenty of liquids - until you wont get an ultrasound result, avoid fatty foods, spicy foods, fried foods, coffee, alcohol - if ultrasound will be negative, than gastroscopy is a correct next step Hope this will help. Feel free to ask further questions. Regards.