Hello and thank you for your question.
Stomach flu usually resolves within 24-72 hours and should not last a couple of weeks.
If you continue to experience abdominal pain, diarrhea, and/or nausea with vomiting, you might need to be further tested for gastointestinal infections. This is especially important if you have recently traveled somewhere or if you recently finished a dose of antibiotics.
I hope you find this information helpful. Please feel free to follow-up with any other questions you might have.
If I have answered your question, please click the green "Accept" button. Otherwise your deposit stays with JustAnswer and I do not get credit for my work.
Do you have any other questions I can answer for you? Anything I can clarify? I would be happy to assist you further.
If I answered your question, please click Accept button so that I may get credit for my work.
Well, the actual stomach flu usually lasts for about 24-72 hours, however, after effects of it can linger on. Depending on a bug which affected you and on your own age/immune system, symptoms can last longer, so in every individual it will be different.
You didn't mention your symptoms so I didn't know what was happening with you.
If you already had stool tests done and they were negative, then it is safe to assume that you (and your wife) are still recovering from a stomach flu.
I would encourage you to take a Probiotic, which is a medication that improves the flora in your gut and speeds up recovery. Probiotics are available over-the-counter, one that I personally recommend is called Florastor but there are other ones too. Also, avoid dairy products until you get better because they will increase diarrhea and cramping. If you like yogurt, you can eat that (it is healthy for your gut).
Please feel free to follow-up with any other questions you might have. I will be happy to assist you further.
Have you, by any chance, been on any antibiotics in the past 2 months?
Do you know if your stool was specifically checked for any bacteria (most important C. Diff)? Not that any stool has a nice smell, but do your stools smell worse then usual?
How many times per day do you have a bowel movement?
Thank you for your reply.
The first, and the foremost test that I would make sure you had is the stool culture for a bug called Clostridium difficile (C. diff). If this has not been checked, it is crucial that you are checked for it. Being on antibiotics for 3 weeks (even if you took probiotics at the same time), puts you at a great risk for developing this infection.
C. diff infection is extremely common (especially recently with increased use of antibiotics) and causes all the symptoms you are having. Even if your stool cultures were already checked for it in ER, I would still ask your doctor to be rechecked again (it is possible that because you brought your stool into the ER and the amount of time that passed between you having a bowel movement and them checking the stool is indeterminable, bacteria could have died and not shown up on the culture).
Until C. diff is ruled out, you have to be very careful with your baby and your wife because this infection is very contagious. If it is determined that you have it, it needs to be treated with another set of antibiotics (sounds ironic but that's the treatment).
Because you are not getting better at all in 8+ days, I am not sure if this is just a plain food poisoning virus that causes stomach flu. As I have mentioned prior, stomach flu usually does not last that long but some affects of it can linger, however, you should be noticing some kind of improvement (which you are not). I am not really surprised that you are not vomiting because not all viruses will cause vomiting in every individual.
So if you were sitting in my office, the first thing I would be doing is sending you to the lab to get another stool sample to rule out C. diff infection. If that test turns out negative again, I would suggest that you see a gastroenterologist and possibly have a colonoscopy to see if there is some kind of an inflammation going on in your colon which is causing you to have these symptoms.
I do want to say that whatever it is you are having, it is not life-threatening and you will be ok once the exact cause is found and treated.
By careful I mean make sure you wash your hands really well and often and use anti-bacterial wipes after washing your hands, do not share utensils or same towels.
Most people tolerate antibiotics for C. diff well. The most common antibiotic used is Flagyl (Metronidazole). The most common side effect is a metallic taste in the mouth, in some people abdominal pain (sorry). But it needs to be taken.
Please let me know what your stool results show.
You are very welcome. Update me on the results of your stool studies.
Thank you for updating me.
I think that endoscopy (stomach scope) is the right direction, however, I would be recommending that you do colonoscopy at the same time as endoscopy (since you have to be sedated for endoscopy anyway). Colonoscopy will look at your colon to see if there is any inflammation in your colon causing loose stools, endoscopy, as your doctor mentioned, will look at your stomach to check for gastritis and stomach ulcers.
Since your nausea and all other symptoms started with the beginning of stomach flu, it is most likely not gallbladder stones causing your symptoms, especially with normal ultrasounds last year.
Your flank pain might not be related to gastrointestinal issues but it might not be a bad idea to do an x-ray of your abdomen (called KUB) to look for kidney stones which can sometimes cause similar symptoms with abdominal/flank pain and nausea.
I hope this gives you some answer and direction. Please let me know if you have any other questions I can answer.
Yellowish stools are not very worrisome. They most likely are related to your diet and to the fact that you are trying to drink lots of fluids. If you stools were black or green, it would be more worrisome.
It sounds that your blood work was normal which, I am sure, checked your liver function. Sometimes liver inflammation can cause yellowish/clay colored stools but if that was the case, your liver enzymes would have been elevated and you would have been told that.
Let me know how your scope/scopes go.
For endoscopy there is actually no prep. You are being asked not to have anything solid or liquid to eat/drink after midnight.
For colonoscopy there is an actual prep...every doctor does their own preps but the usual prep is that you have to be on clear liquid diet before 2-3:00 pm and around 3:00 pm need to start drinking laxatives to empty out your bowel. Prep for colonoscopy is definitely annoying but if it needs to be done, you might as well get it done at the same time as endoscopy since you are most likely going to be sedated.
I am sure that your liver enzymes were checked. Its a routine work up for diarrhea and abdominal pain, especially if gallbladder is considered as one of the possibilities (even if its a remote possibility). However, it would not be a bad idea to double check on it.
You are very welcome!
Let me know how your scopes go.
Sorry for not getting back to you sooner. I have been away from the computer for the entire day.
Given your symptoms of loose stools along with abdominal pain and nausea, doing colonoscopy at the same time as endoscopy is not unreasonable. I am not sure why your GI doc doesn't want to do both at the same time. Maybe she believes that she will find her answer in doing endoscopy only. Endoscopy, due to its lack of prep, is an easier procedure.
Diarrhea is not a symptom of H. pylori. Usually H. pylori causes bloating, nausea, indigestion/heartburn, and abdominal pain. Some of your symptoms are suggestive of H. pylori but not all of them. H. pylori is diagnosed with a biopsy on endoscopy. Stomach ulcers also do not cause loose stools.
I am not sure what all she has been explaining to you about flora in the gut being out of whack. To tell you the truth it is not very medical and does not make much sense to me. Antibiotics can cause C. diff infection, which in your case, has been ruled out twice. Besides C. diff, I dont know what else is meant by out of whack flora.
I dont think you are going down the wrong path. Endoscopy is the right step to take but, as I mentioned before, given your loose stools, I would check colonoscopy as well. Maybe, if endoscopy is normal, she will then have you do a colonoscopy.
So to start with colonoscopy - it was normal so no problems in the colon.
Endoscopy showed several different things:
So this is what all these results mean.
In terms of H. pylori...H. pylori is diagnosed with a biopsy which is why you did not get antibiotics right away. It needs to be confirmed first before more antibiotics are given to you. Prilosec is the right medication to take. You will need to have a follow-up endoscopy in 3 months (I am sure gastroenterologist will inform you) to make sure gastric ulcer has healed.
The good news is that you do not have any colon inflammation causing you diarrhea which means your symptoms are still lingering on from whatever food poisoning you have. It is quite rare that we see gastroenteritis lasting for 2+ weeks now but in your case there is no other explanation (which is probably good, because anything other then lingering stomach flu would be more dangerous).
Hope this helps. Let me know if you got other questions. I am at work so may not get back to your right away.
Ok, lets talk about all your questions.
Normal colonoscopy rules out colitis and diverticulitis. IBS cannot be ruled out by any testing. IBS is a diagnosis of exclusion which means its a condition which is ruled in (diagnosed) once all the other conditions are ruled out.
Your liver and pancreas are extremely unlikely cause of any of your symptoms especially if you had normal blood work. Liver problems are detected on a simple blood test which I wrote to you previously about. I am pretty sure your liver enzymes were checked as it is a normal blood work looking for causes of abdominal pain and diarrhea.
Right now it seems to me that the cause for most of your symptoms have been found - it is a gastric ulcer causing you pain. You need to wait for H. pylori test to come back which can explain the reason for your ulcer and the reason for the upper abdominal pain.
Gallbladder pain causes quite severe pain in the right upper quadrant about an hour after you eat. If your symptoms do not resolve with use of Prilosec, you can ask for an ultrasound of your gallbladder, however, at this point I would not be doing it.
Gurgling and cramping is caused by the faster movement of stool through the bowel which also causes loose stools. So I think gurgling and cramping is more related to diarrhea. Anxiety can easily increase the transit of stool through the bowel and cause loose stools. You do seem to be a bit anxious about your health right now but I can assure you that you do not have anything serious.
In terms of diet...at this point we know that you have a lot of acid in your stomach which is causing irritation in your stomach and in your esophagus. If we find out that H. pylori is the cause of your symptoms, you will need antibiotic treatment along with Prilosec and no specific diet. If there is no H. pylori, then your symptoms are due to just plain acid reflux and there are many things that can be modified in your diet - avoid/limit the following: tomato products, coffee, spicy, citrus, and chocolate. In terms of diarrhea diet - avoid dairy.
So the botXXXXX XXXXXne I would tell you is take Prilosec twice daily, await results of pathology for H. pylori, avoid dairy. You also might want to take Metamucil to bind your stool and hopefully decrease loose stools. You need to work on being less anxious about what is going on because there is nothing serious going on. Further testing can be considered once the results of current testing is available.
I know I have said a lot but I hope I answered all your concerns and questions. Please let me know if you have other questions.
I will be away from the computer for about 2 hours but will get back to you later this evening if you do have other questions.
Thank you for your compliment. I really do enjoy making sure that my patients understand their treatment plan and their diagnosis. I have been spoiled by working at the VA because we have 30 minutes to spend for any follow-up appointment which is far more then any private sector can offer.
You can use Imodium to slow down your stool frequency. Dont be surprised if it even makes you a bit constipated.
Metamucil and Benefiber are both fiber supplements so their purpose and use is the same. They are bulking agents and can help in people with diarrhea to firm up their stool. In some people either can cause bloating, however, there is no way to predict if it would do it to you so I think it is worth a shot. But Imodium is also a good choice.
In terms of probiotics...really the purpose of all probiotics is the same. They are just made by different companies so any probiotic would work. I always recommend Florastor but for no specific reason. At the VA we use Lactobacillus probiotic. Since you already bought Florastor, stick with it.
About liver enzymes...if your symptoms continue following Prilosec treatment and you need further work up, liver enzymes should be checked.
I will wait to hear from you about the pathology results. In the meantime write if you have other questions.