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What causes nausea, diarrhea, lack of appetite, 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 (since Aug.2014) stomach and back pain with nausea, diarrhea, no appetite, and just plain feeling "run down". I haven't had ANY fever. She has ordered an ultra-sound and whatever it is called when they put the scope down the throat, along with a urine sample, which she said showed that I was well hydrated. She also prescribed Ciprofloxacin and Metronidazole. I am concerned about taking these antibiotics without first comfirming there is a bacterial infection. Should there have been bloodwork(CBC) done first before giving me these antibiotics? And, is it common practice to prescribe antibiotics for bacteria infection without evidence that a bacteria is present??
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Answered by Dr. Shoaib Khan (33 minutes later)
Brief Answer:
?? Suspect conditions like gastritis, ulcers, etc;

Detailed Answer:
Hello ma'am and welcome.

Thank you for writing to us.

I have gone through your query with diligence and would like you to know that I am here to help. The investigations with the scope put down the throat is called an endoscopy, just so you know. :)

Yes, there should have been blood work to confirm the infection, especially as it has been ongoing since almost or over 8 months now. If it were a stomach infection or the stomach flu, for which ciprofloxacin and metronidazole would have been most appropriate, then it shouldn't have lasted for this long.

But in my opinion, the more likely possibility could be an ongoing, and long lasting (without treatment that is) condition like peptic ulcer disease, gastritis (infective or autoimmune types), etc. These conditions can be easily diagnosed with the help of an endoscopy, so this is indeed one good thing your nurse did. :)

I hope you find my response both helpful and informative. Please feel free to write back to me for any further clarifications, I would be more than happy to help.

Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Shoaib Khan

General & Family Physician

Practicing since :2009

Answered : 9409 Questions

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

Brief Answer: ?? Suspect conditions like gastritis, ulcers, etc; Detailed Answer: Hello ma'am and welcome. Thank you for writing to us. I have gone through your query with diligence and would like you to know that I am here to help. The investigations with the scope put down the throat is called an endoscopy, just so you know. :) Yes, there should have been blood work to confirm the infection, especially as it has been ongoing since almost or over 8 months now. If it were a stomach infection or the stomach flu, for which ciprofloxacin and metronidazole would have been most appropriate, then it shouldn't have lasted for this long. But in my opinion, the more likely possibility could be an ongoing, and long lasting (without treatment that is) condition like peptic ulcer disease, gastritis (infective or autoimmune types), etc. These conditions can be easily diagnosed with the help of an endoscopy, so this is indeed one good thing your nurse did. :) I hope you find my response both helpful and informative. Please feel free to write back to me for any further clarifications, I would be more than happy to help. Best wishes.