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Stomach cramps, back pain, diarrhea, blood stools. Emergency?

I woke up around 2 am with stomach cramps and back pain . I had diarrhea for several hour. Stomach cramps and back pain is worse but instead of a stool when I have the urge to have a bowel movement it is only blood. My stomach cramps and back hurt worse when I have the feeling that I need to have a bowel movement. I have had the blood instead of stool for about 5 hours. It has occured about 4 times during this time. Is it something I should go to er for?
Asked On : Thu, 13 Dec 2012
Answers:  2 Views:  140
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Pathologist and Microbiologist 's  Response
hi there, definitely you need to visit the ER as you are suffering from a case of dysentry and you will need antibiotic cover for it ,in the meanwhile you continue to consume plenty of fluids and electoral powder to combat any dehydration that you might be having. You could take an antispasmodic to relieve you of the cramps but you will need to be started on a coursr of antibiotics to get rid of the infection,.Take care.
Answered: Sat, 15 Dec 2012
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General & Family Physician Dr. Lt Cdr ASN Bhushan's  Response
Dear Concerned.,

Thanks for writing to us.

As the history is only available with us we shall discuss few probabalities/Investigations/treatment/prevention.

In all probabalities the Differential Diagnosis falls into these categories.,

a)Protozoal infection;Amoebiasis and Giardiasis along with mixed bacterial infection.The right lower abdominal quadrant/Caecum acts as a storehouse for parasite and flask shaped ulcers are formed through which blood /altered blood may pass mixed with stools.when a vein ruptures even frank blood/clots are passed through stools.

Investigation;In a Stool Microscopy ,Demonstration of trophozoites and flagellated Giardia are diagnostic.

Untreated cases may remain dormant and the parasite may spread through Portal Veinous system to Liver causing Liver Abscess.

please take proper anti protozoal such as Metronidazole/Tinidazole/Secnidazole for total no of days as decided by your MD.Proper Hydration/Nutrition and Bed Rest are equally important.

b)Bacillary Dysentery;Usually caused by Salmonella/Shigella/E.coli and other species .Contaminated eggs, poultry, meat, unpasteurized milk or juice, cheese, contaminated raw fruits and vegetables (alfalfa sprouts, melons), spices, and nuts. This appears after 12 to 24 hours of taking contaminated food.

This is the commonest cause for Diarrhea, fever, abdominal cramps, vomiting.

Complete Bedrest/Oral or IV Rehydration/Oral or IV antibiotics are to be taken.

Prevention of Bacterial And Mixed Infections;-

1)Avoid eating street food/high risk food/partially cooked/uncooked food/unboiled milk..

2)Properly Refrigerate the food after cooking and preheat the same before consumption thereby destroying bacteria.

3)Maintain Cold Chain ;Transporting meat and meat products ,pls maintain cold chain so that bacterial multiplication does not occur.

4)Wash your hands properly with disinfectant soap and water before and after all types of food handling.

The back pain is all due to muscular cramps and also due to any intestinal (produced now)or stomach ulcers already existing due to Acid Peptic Disorder(APD).

You will have to reach ER for preliminary investigations/admission/hydration/antibiotics and further management as per the merits of the case.

Wishing you a speedy recovery.,

Best Regards.,

Dr Lt Cdr ASN Bhushan.,

Answered: Sat, 15 Dec 2012
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