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Internist
Internist, Doctor (MD)
Category: Health
Satisfied Customers: 4761
Experience:  Board Certified in 2 Specialties, VERIFIED,American, trained and located in United States
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A few weeks ago I fell ill in the middle of the night

Resolved Question:

A few weeks ago I fell ill in the middle of the night with with intense vomiting and diarrhea,
followed by chills, fever, fatigue and body aches. The fever,
fatigue and body aches continued for about another week. I
wrote you a question then, because I had also been exposed
to raw clams. I had fully recovered from this. I was awakened
again yesterday, in the very early morning, with the exact same set
of symptoms; vomiting, diarrhea, chills, body aches and fever. This
time I had not eaten anything raw. I am still feeling very
weak, fatigued, fever and body aches. Can you help with
any suggestions as to what could be going on with me?
Thank you. Susan
Submitted: 2 years ago.
Category: Health
Expert:  Internist replied 2 years ago.
Hello
It is unlikely that you have had a viral gastroenteritis if you symptoms resolved for a while. I would now suggest you get a stool test for infection. I am concerned about possible c. difficult infection which becoming more common recently.


Press reply if you need more information.
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Customer: replied 2 years ago.
What is this c.difficult infection you
spoke of? Could you explain it to me?
Expert:  Internist replied 2 years ago.
Yes. C. difficile infection is seen in hospital patient's and in people who've been on certain antibiotics. However it can be seen in people not in the categories because it is extremely contagious. It is an infection of the bowel and can be treated but it must be first diagnosed by examining A. stool sample for the presents of any toxin. I would suggest at this point that you see a doctor to check your stool and exclude infection and possibly order other tests.


Press reply if you need more information.
This expert will not be paid for their time/efforts unless you click Accept. Funds are not automatically transferred to this expert. This response is for your information only and does not substitute for a visit to your doctor.
Customer: replied 2 years ago.
Can this infection go on for extended
periods of time if it is not treated? Can it go away on its own?
Expert:  Internist replied 2 years ago.
This infection can go on for extended period of time if it is not treated. The treatment in most cases is successful. It will usually not go away on its own. That would be uncommon. This is assuming that you have this infection. It is my suggestion that you get tested to exclude this and then your doctor may want to do other tests to diagnose your symptoms.


This expert will not be paid for their time/efforts unless you click Accept. Funds are not automatically transferred to this expert. This response is for your information only and does not substitute for a visit to your doctor.
Internist, Doctor (MD)
Category: Health
Satisfied Customers: 4761
Experience: Board Certified in 2 Specialties, VERIFIED,American, trained and located in United States
Internist and 6 other Health Specialists are ready to help you
Expert:  Internist replied 2 years ago.
Thanks, XXXXX XXXXX
Internist, Doctor (MD)
Category: Health
Satisfied Customers: 4761
Experience: Board Certified in 2 Specialties, VERIFIED,American, trained and located in United States
Internist and 6 other Health Specialists are ready to help you
Customer: replied 2 years ago.
I forgot to mention that I had started taking
Conjugated Linoleic Acid, 2,000 mg two times a day for belly fat
weight loss, sever months ago . Do you think this could be a factor
in my symptoms? Saw my Dr today and he is running tests you spoke
of as well as other labwork. I did forget to tell him about the CLA. I have
Been talking. Do you think this.could.be causing my problems
Expert:  Internist replied 2 years ago.
Hello

CLA can definitely cause change in bowel habits especially diarrhea. You should stop this until you get this resolved. Good luck.
Internist, Doctor (MD)
Category: Health
Satisfied Customers: 4761
Experience: Board Certified in 2 Specialties, VERIFIED,American, trained and located in United States
Internist and 6 other Health Specialists are ready to help you
Expert:  Internist replied 2 years ago.
Thanks again.
Customer: replied 2 years ago.
Thank you. I had stopped taking my CLA of 2,000
mg twice a day, about a week ago. Went to
my Dr on Mon. 9/10. He did a lot of bloodwork
and ustool samples to test for c.difficle,
giardia, and white blood cells in stool. So far
The bloodwork has returned normal. Won't know
results of stool until Monday 9-17. In the meantime,
I have had diarrhea for two more days . I awoke
out of a deep sleep last night to intense
vomiting and diarrhea. Another day in bed. Would
like to know what you think at this point. Also, if
effects from previous CLA use could cause severe
vomiting and diarrhea? Thank you
Expert:  Internist replied 2 years ago.
This is troubling as waking from sleep with vomiting and diarrhea indicates that there is something beyond CLA which would not cause this now that you have stopped it. This is also not consistent with irritable bowel. We must await stool results but if negative a colonoscoPy may be in order to exclude collagenous or lymphocytic colitis although this should not cause the vomiting. Also you symptoms are consistent with a viral infection but usually viral will not last this long.lets wait for test results and if there are white cells in stool.

Internist, Doctor (MD)
Category: Health
Satisfied Customers: 4761
Experience: Board Certified in 2 Specialties, VERIFIED,American, trained and located in United States
Internist and 6 other Health Specialists are ready to help you
Customer: replied 2 years ago.
I would like to follow up with you when I get my results back, or if I have additional question
about this, like what would white blood cells
In stools mean? Thank you. Susan
Customer: replied 2 years ago.
Hi- me again. I received results from stool
samples. Everything came back negative. I haven't
had any more severe attacks since 3 days ago.
I still just feel washed out, fatigue, low grade
fever and some nausea. What do you think
I should do? Susan
Expert:  Internist replied 2 years ago.
Hello,

White cells in stool may or may not indicate infection. Excessive leukocytes would suggest infection or non-specific inflammation.

Suggest to sit tight unless another attack of diarrhea. If so would need colonoscopy to check colon. May need upper endoscopy for nausea. Your symptoms are complex. Let me know what happens next.
Internist, Doctor (MD)
Category: Health
Satisfied Customers: 4761
Experience: Board Certified in 2 Specialties, VERIFIED,American, trained and located in United States
Internist and 6 other Health Specialists are ready to help you
Customer: replied 2 years ago.
Hi-Another thing I may have left out is that
I have RA and take 10 mg of Methexotrate a week. Was on this for 10 Years, then went into remission until this
past March-May 2012. Began Methx again after
6 years. Seemed to be doing well with it. I don't know if
this could possibly be a factor now. My
family Dr booked an appt. with a gastroenterologist
this FridaySept 21. Haven't decided if I'm going
to go yet. Really don't want to do anything
invasive right now, as I have been thru so much.
Would love your opinion again. Many thanks. Susan
Expert:  Internist replied 2 years ago.
It is difficult to pinpoint the cause of your sx. I would favor seeing GI as he may recommend several non-invasive test. If you want to hold off on colonoscopy you may. As you probably know MTX can increase susceptibility to infection and this remains a strong possibility especially in view of low grade fever. Not many single things will cause upper and lower GI sx. except for some of those we have discussed. Many times the cause of diarrhea is difficult to determine and multiple tests in sequence with thorough history and physical exam may be necessary. One other thought is to repeat stool for culture and parasites as may need 3 fresh warm stools done by very reliable lab to determine negativity. Still favor at least visit to GI as I can only make suggestions and hopefully explain things you may not understand. Keep me informed.
Internist, Doctor (MD)
Category: Health
Satisfied Customers: 4761
Experience: Board Certified in 2 Specialties, VERIFIED,American, trained and located in United States
Internist and 6 other Health Specialists are ready to help you

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