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Are Abdominal Pain, Severe Diarrhea And Loss Of Appetite Symptoms Of Intestinal Perforation?

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Posted on Tue, 6 Oct 2015
Question: 37 yr old Caucasian Female, has Rheumatoid Arthritis and Lupus. History of Ovarian Cysts, IBS. 12 months ago, Ovarian Cysts were gone after switching Birth Control Medication. Currently Off Birth Control (since April.) Abdominal discomfort for 3 days, no appetite, but not "painful." Approximately 48 hours after onset, began suffering from severe diarrhea. Approximately 30 BM's in 5 hour period, with abdominal muscles contracting hard. Stool was very green, and very liquid. Two doses Pepto Bismol - no effect. 1 full dose of Immodium AD plus one half-dose 1 hour later, and she was able to sleep last night. Before going to sleep, drank approximately 16 oz of Gatorade and water over 2 hour period. Temperature was 97.3. Pulse Oxidation was 99%, pulse was 85 BPM. This morning, 2 BM's within 1 hour of waking, remains green and liquid, but does not have the severe muscular contractions like yesterday. When lying down, there is a palpable "air pocket" located a few inches above the left pelvic bone. It is squishy, not particularly hard, and she states that touching it is "uncomfortable," but not particularly "painful." My concern is a perforated bowel, or something serious. Do we need to go to the ER, or is my current over-the-counter care sufficient? Any opinions would be very welcome. Thank you.
doctor
Answered by Dr. Amit Jain (58 minutes later)
Brief Answer:
No perforation, Take antibiotic and antispasmodic

Detailed Answer:
Hello! Thanks for putting your query in HCM. I am a Gastroenterologist (DM). Intestinal perforation is very painful, associted with fever, hypotension, may be shock due to infection. So It doesn't appears to be perforation. It appears to me that you are suffering from acute gastroenteritis. For which you may take a course of antibiotic of class quinolone and some antispasmodic. Keep your hydration level by taking lots of fluid.If no improvement with in 1-2 days, may go to ER for evaluation.
I hope I have answered your query and this will help you. If you have any further query I will be happy to answer that too. Remain in touch and get-well soon.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Amit Jain (44 hours later)
Thank you for your help. She seems to be doing better.
doctor
Answered by Dr. Amit Jain (8 minutes later)
Brief Answer:
Most welcome

Detailed Answer:
Most welcome ! If you don’t have further query then rate the answer and close the discussion
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Amit Jain

Gastroenterologist

Practicing since :2000

Answered : 1524 Questions

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Are Abdominal Pain, Severe Diarrhea And Loss Of Appetite Symptoms Of Intestinal Perforation?

Brief Answer: No perforation, Take antibiotic and antispasmodic Detailed Answer: Hello! Thanks for putting your query in HCM. I am a Gastroenterologist (DM). Intestinal perforation is very painful, associted with fever, hypotension, may be shock due to infection. So It doesn't appears to be perforation. It appears to me that you are suffering from acute gastroenteritis. For which you may take a course of antibiotic of class quinolone and some antispasmodic. Keep your hydration level by taking lots of fluid.If no improvement with in 1-2 days, may go to ER for evaluation. I hope I have answered your query and this will help you. If you have any further query I will be happy to answer that too. Remain in touch and get-well soon.