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Thank you for the question. Answers given are for informational purposes only and are not meant to replace an exam by an in-person.
I am Dr. Sohaib, a Medical Internist (who deals with diseases of all the organ systems of body) and I will do my best to help you today.
You need to answer a few questions first which will help me assist you in a better way.
What is your friend's age?
What kind of doctors he has seen?
Any specific tests done?
Any concurrent medical illness like diabetes or hypertension he has?
no, they say he is ok and send him home.No one has questioned him about the water in his his home
he is a diabetic and he has been running in the 500 range and no one can say why. He follows his diet.
Thank you very much for the useful information.
Although the frequency of loose watery stools you mentioned is not very high, but persistence of these symptoms for such a long duration with out any improvement suggests "Chronic Diarrhoea", which should be evaluated.
If other members of the family get the same symptoms as he does, then it can be from the water source. Otherwise, this seems unlikely to be from the water. Moreover, there are number of other reasons which need to be considered here as well including;
1. Infections such as;
3. Bacterial Overgrowth
4. Other Malabsorption syndromes
5. Inflammatory bowel disease
6. Cancer (colon cancer or lymphoma)
7. Autonomic neuropathy (a complication of uncontrolled diabetes which can give a person diarrhoea, vomiting and stomach upset).
I think sufficient duration has passed and its time now to have this evaluated in detail by a Gastroenterologist for a comprehensive clinical examination aided by tests such as;
1. Stool examination (3 sets) to look for ova and cysts pf parasites. Also specialized staining can be ordered for parasites and to look for malabsorption.
2. Blood CBC/ESR, CRP and other inflammatory markers
3. Electrolytes, albumin, calcium levels
The above mentioned tests will be helpful to ascertain the exact underlying cause for her symptoms which will direct a specific and targeted management plan.
A consultation with a Diabetologist is also mandatory here to revise his diabetes treatment, and to bring down the blood sugars back to normal. He might be a candidate for combination drugs for diabetes including insulin. This is very important for general well being of any diabetic patient to keep the blood sugar levels under control. Sugars in the range of 500's is too high and should be treated promptly.
Finally, there is no harm in getting the water tested from the laboratory for possible infections/parasites which i mentioned earlier.
A gastroenterologist is the best person to help him in this situation.
Until then, following measures will be helpful;
Keep him well hydrated (plenty of water/juices)
Avoid large fatty and spicy meals
Toast ---- all will help.
Do ask his doctor to screen him for multiple deficiencies (which he might have developed due to chronic diarrhea and would be contributing to her symptoms) such as B-12, folate, calcium, iron etc. If found to be low, appropriate replacement will provide a symptomatic relief.
I hope this clarifies and answers your question.
I would have been worried too if I were at your place, but let me reassure you that this is a treatable condition and carries a good prognosis with appropriate management.
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