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Julia Kizhner
Julia Kizhner, Physician Assistant
Category: Health
Satisfied Customers: 1126
Experience:  7 years experience working in Primary Care as well as Gastroenterology, Sleep Medicine & Weight Loss
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Can stomach flu last for 2 weeks?

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Can the stomach flu last a couple of weeks?

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 travelled 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.

Julia Kizhner, Physician Assistant
Category: Health
Satisfied Customers: 1126
Experience: 7 years experience working in Primary Care as well as Gastroenterology, Sleep Medicine & Weight Loss
Julia Kizhner and other Health Specialists are ready to help you
Customer: replied 7 years ago.

I have been to the ER and my PCP in the last week. Have had blood work, stool and urine tests. All are fine. My PCP's nurse told me today that the stomach flu could last more than two weeks. My wife began vomiting a week ago Thursday. I developed diarrhea shortly thereafter and have struggled with occassional diarrhea, cramping, gurgling, upset stomach and an overall feeling of being unwell. Never had any digestive issues prior to this. My wife got better within about 3-4 days, but says she is still having loose stools.
The CDC website says it could last up to 10 days. Is it a case that it is really subjective?

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.

Customer: replied 7 years ago.

A week ago this past Thursday, my wife woke up at 2:00 am and vomited. Shortly thereafter, I began to feel a stomach ache and some gurgling. Later that morning, I had a lot of very foul diarrhea (sorry) and mild stomach cramps. Over the course of the next several days, my wife began to feel better, although, she still claims her BM's are not quite normal. During this period, I cut way back on what I was eating, because I felt some nausea and just didn't want to risk feeling worse. By last Sunday, the symptoms led me to the ER. I wasn't vomiting and actually hadn't had any diarrhea since the initial day, but the stomach cramps and nausea had gotten worse.
When I went to the ER, I brought a stool sample, which was forest green in color and quite hard. While there they tested my urine and CBC, and both were clear. I was told that the stool sample results would take a couple of days, and to follow-up with my PCP after the holiday weekend. Thus, this past Tuesday, I saw my PCP and went over my symptoms. For some reason, the stool results weren't available, so he ran two new stool tests (results not back yet). He told me that I was still in the window of time where it could be gastroenteritis of some kind, and to get back to him in a few days if I wasn't better.
Yesterday afternoon (day 8), I spoke to the nurse covering for my PCP's normal nurse, and she told me the ER stool results showed that nothing grew out. I told her that I have had a few more episodes of diarrhea with mucus, and that I continue to have cramping and gnawing pain, along with some occasional discomfort in my upper right quadrant. She indicated that it could certainly be the flu yet, because it's not uncommon for people to go two weeks with it. In fact, she said she just had a patient that had it 2-1/2 weeks.
The thing that puzzles me, is that I have never had any bowel or digestive issues in my life (41 years old). Moreover, it seems way too coincidental that my symptoms began on the same day as my wife's. On the other hand, she has mostly recovered, and I never vomited.
I have stuck to a very bland diet (BRAT, boiled chicken, crackers, water, Gatorade), and have limited my daily caloric intake to 700-1,000. Needless to say, I have lost about 10 lbs. in the last 8+ days. My stools vary in consistency and color, and seem to include some mucus. When I wipe, it usually is slightly yellowish in color. Pain waxes and wanes, and goes from cramps to a constant ache. Rarely over the last 8+ days have I been without mild to moderate pain. Often, my insides are making weird gurgling noises, and I can feel what seems like gas moving (like a boxing match).
The last week+ has been a nightmare. I haven't gone to work, and my poor wife is caring for our 22 month old son alone. I can't help but worry that I have some kind of serious issue going on.
I realize that offering medical advice to a stranger on the internet is a little difficult, but if I were sitting in your office and explained my story and symptoms, how would you respond? BTW, I'm 5'8" and 220 lbs., and otherwise healthy.
Your wisdom is greatly appreciated.

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?

Customer: replied 7 years ago.

Prior to my initial diarrhea event (8+ days ago), I was about 3 weeks post ABX for a sinus infection. My ENT first tried Keflex, but after a week without improvement, switched me to Augmentin for two weeks. Throughout both courses, I took probiotics and yogurt 2X daily. However, as has happened before on Augmentin, I began to have stomach cramps, diarrhea and heartburn both during and after the regimen. It took about a week after the ABX for my digestive system to return to normal, then about three weeks later, I started with this current mess.
I asked my PCP if it was possible that my system hadn't fully recovered prior to the possibility of getting some kind of stomach bug. He kind of shrugged his shoulders and said it's hard to say.

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 effects 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.

Customer: replied 7 years ago.

When I went to the ER with the stool sample, probably 4 hours elapsed because of how busy they were. They did mention C. Diff. when I told them about the ABX. When I spoke to the PA-C several days after my visit, she told me that the lab didn't find C. Diff. I then asked her about whether the sample was still viable given the amount of time that elapsed, she said the lab didn't mention anything about the quality of the sample. My guess is the lab had no idea how old the specimen was.
This is why I pressed my PCP to run the other stool cultures. They were collected last Tuesday and I'm hoping the results will be available on Monday.
When you say be careful with my wife and son, what do you mean? No contact? I have been careful not to get too close, but that is really tough to do with a little one.
I have read that the ABX for C. Diff. are pretty nasty, is that true? Do they cause gastro problems?

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.

Julia Kizhner, Physician Assistant
Category: Health
Satisfied Customers: 1126
Experience: 7 years experience working in Primary Care as well as Gastroenterology, Sleep Medicine & Weight Loss
Julia Kizhner and other Health Specialists are ready to help you
Customer: replied 7 years ago.

Thanks so much for your time and expertise! I wish more health professionals were as helpful as you have been!

You are very welcome. Update me on the results of your stool studies.

Customer: replied 7 years ago.

The stool cultures came negative for C. diff. and everything else. Thus, with results from two different labs saying nothing is there, it's probably safe to assume that is the case. I did see a GI doc today, and she thinks it is possible that because this started about the same time as my wife got sick, I too may have been hit with a bug. However, because I was only a couple of weeks removed from ABX, the balance between good bacteria and bad may have been off. She indicated that if I happened to get a bug while my good bacteria was rebuilding, it could have upset my digestive system and more time may be needed to recover.
She wants to scope my stomach on Thursday, to check for the possibility of ulcers. She is wondering if the stomach pain and continued nausea may be related. Becuase I have been having loose yellowish stools, coupled with some right flank pain, I asked about the possibility of gall stones. She said it is certainly possible, but I had two US's last Summer and Fall for right flank pain, and both showed my GB was fine. However, she said, we have to start somewhere, and apparently she feels that the stomach scope is the best place.
My symptoms are: mild abdominal pain (no specific location), mild right flank discomfort (could be muscles?), light colored loose stools, nausea.
Any further thoughts/ideas/advice? Do you think I'm headed down the right path with the stomach scope?

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.

Customer: replied 7 years ago.

How normal are loose yellowish stools? Could it be from eating a REALLY bland diet?
I think I will call the Dr.'s office tomorrow and see about whether they sugggest a colonscopy at the same time.

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.

Customer: replied 7 years ago.

If I were to consider having the colonoscopy at the same time, would the prep be different? Don't you have to drink something for 24 hours or fast or something?
BTW, I never got a copy of the blood work, but I don't recall them mentioning liver enzymes...only WBC. Do you think I should have this checked? The GI doctor didn't mention the need for it, but maybe that isn't her domain, and she assumes the PCP will take care of that?

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.

Julia Kizhner, Physician Assistant
Category: Health
Satisfied Customers: 1126
Experience: 7 years experience working in Primary Care as well as Gastroenterology, Sleep Medicine & Weight Loss
Julia Kizhner and other Health Specialists are ready to help you
Customer: replied 7 years ago.

Thanks a bunch for your help and knowledge!

You are very welcome!

Let me know how your scopes go.

Customer: replied 7 years ago.

I spoke to my GI docs nurse this morning about getting a colonoscopy at the same time as the EGD, but apparently the doc told her that they would just start with the EGD. Seems a little odd to me, but whatever.
I'm thinking that the doc wants to do the scope to see if there is anything unusual. She mentioned wanting to rule out a peptic ulcer. Given that the majortiy of the persistent pain seems to be in my stomach, it sounds like a logical place to start. However, I'm wondering whether h. pylori could cause the diarrhea? From what I've gleaned on the web, it doesn't sound like it.
If the flora in my system was out of whack when I got a stomach bug, could it cause the stomach ache and loose stools I've been experiencing? I don't want to second guess the GI doc, but I also don't want to waste a bunch of time headed down the wrong path.

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 don't 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.

Julia Kizhner, Physician Assistant
Category: Health
Satisfied Customers: 1126
Experience: 7 years experience working in Primary Care as well as Gastroenterology, Sleep Medicine & Weight Loss
Julia Kizhner and other Health Specialists are ready to help you
Customer: replied 7 years ago.

I had the endoscopy and colonoscopy today. The endoscopy showed:

  1. LA Grade A reflux esophagitis (biopsied)
  2. Hiatus hernia
  3. Gastric ulcer with clear base
  4. Non-bleeding erosive gastrophy (biopsied)
  5. Normal duodenum (biopsied)

The colonoscopy showed:

  1. Entire examined colon was normal (biopsied)

Because there were things that were biopsied, I don't get to speak to the Dr. for almost two weeks. The nurse talked with me briefly about the findings, but to be honest I was too out of it to remember anything. I think I recall her saying that the colon was clear and that the problems with diarrhea could be due to a viral or food thing that just hasn't worked itself out yet. I also thought she said that if the ulcer gets better, it could alleviate the other symptoms I have.
Again, because I wasn't very coherent at the time, and certainly wasn't able to ask questions, I need some help interpreting these initial findings. They did give me some Prilosec and said to take twice a day. Isn't an ulcer from the h pylori bacteria? If so, I wonder why they wouldn't just start the ABX now, instead of waiting for my return appointment. They said the labs would be back with 4-5 days, and I would be notified.

So to start with colonoscopy - it was normal so no problems in the colon.

Endoscopy showed several different things:

  • LA Grade A reflux esophagitis (biopsied) - means that you have acid reflux which escapes from the stomach into esophagus and causes inflammation in the esophagus (esophagitis)
  • Hiatus hernia - its a hernia located between the stomach and esophagus through which acid in the stomach can escape and cause irritation in the esophagus and symptoms of indigestion; hiatal hernias are common and unless they are huge, we do not do anything with them other than treat symptoms of reflux if they are present
  • Gastric ulcer with clear base - you have an ulcer right in the stomach
  • Non-bleeding erosive gastrophy (biopsied) - means inflammation in the stomach from acid
  • Normal duodenum (biopsied) - normal first part of your small intestine

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 than 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.

Customer: replied 7 years ago.

Thanks for helping me understand all of this. I guess the biggest mystery is the cause of the occasional gurgling and cramping, coupled with the yellow diarrhea. I assume with the colon being clear, that we can rule out things like IBS, colitis, etc. However, what are the odds that those symptoms could be from something related to my gall bladder, liver or pancreas? Would it be wise to pursue further testing for these possibilities?
The only other explanation I can think of, is that those symptoms are somehow related to my anxiety about this situation. I really hate to make that assumption, because blaming things on anxiety seems too easy. Yet, I know that I have certainly been anxious about this, thinking that it could be something really serious.
With the findings from the procedures, what would be your advice if I continue to have issues with gurgling, cramping, gas and yellow, water stools? Also, the nurse sent me home with a packet that details things I should and shouldn't eat. It looks like a copy of something created fifty years ago. Any suggestions about finding food/diet ideas for an ulcer?

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 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 bottom line 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.

Customer: replied 7 years ago.

I can't thank you enough for all of your time, expertise and assistance! It seems so difficult to find people in the healthcare field that have the compassion or interest to educate their patients. In my experience, you get all of five minutes with your doctor, which often isn't nearly enough.
The nurse suggested taking Immodium if the diarrhea continues. Is Metamucil similar to Benefiber, and, if so, will either cause more gas or cramping? They also suggested a probiotic called Align. Any experience with it? I got some of the Florastor you suggested, but isn't that a yeast? Is the yeast or bacteria type better?
I did find out that when I was in the ER and had the bloodwork done, they only looked at the white count and electrolytes. They didn't look at liver enzymes. Thus, I suppose I could have that checked at some point if the yellow diarrhea/loose stools don't resolve.
You are right...I need to work on being less anxious about this

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.

Julia Kizhner, Physician Assistant
Category: Health
Satisfied Customers: 1126
Experience: 7 years experience working in Primary Care as well as Gastroenterology, Sleep Medicine & Weight Loss
Julia Kizhner and other Health Specialists are ready to help you
Customer: replied 7 years ago.