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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 33094
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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My boyfriend has been throwing up and horrible for the pas

Customer Question

my boyfriend has been throwing up and horrible BM for the pas two weeks. He went to doctor a week ago and they said stomach bug, I took him to Outpatient clinic tuesday and they gave him IV, he has been given stool samples this week but they have not come back so the doctor would not give him and antibiotic. he is getting worse each day--we got from mexico three weeks ago, so he got sick a week after mexico. shouldn't he be on an antibiotic and is there anything that would help.
JA: How long has this been bothering you? Are you experiencing any vomiting or nausea?
Customer: checking to see if you received my question
JA: Anything else in your medical history you think the doctor should know?
Customer: my boyfriend has been throwing up and horrible BM for the pas two weeks. He went to doctor a week ago and they said stomach bug, I took him to Outpatient clinic tuesday and they gave him IV, he has been given stool samples this week but they have not come back so the doctor would not give him and antibiotic. he is getting worse each day--we got from mexico three weeks ago, so he got sick a week after mexico. shouldn't he be on an antibiotic and is there anything that would help.
Submitted: 8 months ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 8 months ago.

Hello,
I am Dr. Arun and will be helping you today.

I agree that this is likely to be either an infection or worm issue.

The stool exam and stool culture, give following information:

a) Confirm the infection or worm infestation.

b) Also tells the best antibiotic.

So let the stool report come, which will tell about the optimum medicine.

The initial evaluation of diarrhea is on these characteristic;

a) stool volume,

b) frequency,

c) consistency, and

d) gross appearance.

Stool volume can give an idea of disease location and underlying mechanism.

a) Large-volume stools (more than one liter per day) would point to small bowel disease and secretory diarrhea.

b) Small-volume stools (less than 300 ml per day) suggest large intestine diseases and functional gastrointestinal disorders like IBS.

Stool consistency can be varied ranging from formed to watery, and correlates with the rate of intestinal transit.

a) Secretory diarrheas are liquid.

b) Functional diarrheas are soft or semi-solid.

c) Stool floating will be indicative of if being filled with gas from fermentation of mal absorbed carbohydrates.

d) Mucus can point to both inflammatory and noninflammatory diarrheas, such as ulcerative colitis and IBS.

Stool appearance helps to classify diarrhea as;

a) Watery diarrhea is caused by carbohydrate malabsorption, medications, bile acid malabsorption, Crohn's disease, microscopic colitis, chronic mesenteric ischemia, post surgical diarrhea, hyperthyroidism, colonic adenomas and carcinomas, alcohol induced diarrhea, laxative abuse, and hormone-secreting tumors.

b) Steatorrhea or fatty diarrhea is greasy, oily, foul smelling, bulky, or voluminous stools that are often difficult to flush, might contain undigested food particles, and sometimes leaves an oily stain in the toilet bowl. These characteristics suggest pancreatic disease, short bowel syndrome, celiac disease, giardiasis, and small bowel bacterial overgrowth (SBBO).

c) Bloody diarrhea suggests Ulcerative colitis, Crohn's colitis, cancer and chronic infections.

He may also need blood work like complete blood counts, comprehensive metabolic panel etc. An ultrasound of the abdomen and CT scan too would be necessary for the complete evaluation.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

Expert:  Dr. Arun Phophalia replied 8 months ago.

Some persisting infections (C. difficile, Aeromonas, Plesiomonas, Camyplobacter, Giardia, Amebae, etc.) can be associated with chronic diarrhea.

Microscopic colitis may also be the other possibility of the diagnosis; Microscopic colitis is characterized by chronic watery (secretory) diarrhea without bleeding. It usually occurs in middle-aged patients. Two different types of microscopic colitis have been generally recognized:

a) Lymphocytic colitis

b) Collagenous colitis without lymphocytic infiltration of the surface epithelium

Collagenous and lymphocytic colitis produce a similar clinical picture characterized by non bloody chronic watery (secretory) diarrhea of up to two liters daily. So total amount of stools per day has to ascertained.

It is privilege assisting you.

Please let me know if you have further queries or unanswered questions.

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Thank you.

Wishing you all the very best in life.

Expert:  Dr. Arun Phophalia replied 8 months ago.

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Thank you.

Expert:  Dr. Arun Phophalia replied 7 months ago.

Best wishes,
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