Dr. XXXXXXX Reviewed My Last Few Questions. I Wanted To

Posted on Wed, 1 Jul 2020

Question: Dr. XXXXXXX reviewed my last few questions. I wanted to give an update as to Micah's situation. The chest xray came back clear. The antibiotic seemed to make a positive change after 2 days. However, he progressively started to become nausea beginning in the morning and lasting for 6-8 hours while taking it with food. He then reduced the dosage to 1/2 of the pill. The same symptoms remained. The past Sunday, he had intense abdominal pain and nausea for at least 12 hours along with constant diarrhea. This continued through Monday. He stopped taking the medicine on Tuesday and noticed a significant change in both the nausea and diarrhea. This morning, Wednesday, he feels even better than yesterday. Should he discontinue taking the antibiotic all together at this point? Would his blood panal that you reviewed show any results that would determine anything wrong in his pancreas or gallbladder?

Answered by Dr. Nishad BN (3 hours later)

Brief Answer:
Can change the antibiotic to alternative one.

Detailed Answer:
Hi Sir

Thank you for asking again.

I have gone through your query. Nausea and diarrhoea can be due to antibiotic (Amoxiclav) induced gastritis. Taking Proton pump inhibitors like Esomeprazole (Nexium) and domperidone will be helpful to control it. Instead of this antibiotic you can take alternatives like Azithromycin which won't make such gastric irritation.
Your blood works didn't shown any thing wrong with pancreas or Gall bladder. There were no relevant tests for this on the reports. Doing an ultrasound examination of abdomen will be helpful to rule out anything wrong with Gall bladder or pancreas. That is needed only if your symptoms are not improving.
Blood test for amylase can be done to rule out anything wrong with pancreas also.
Thanks.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Nishad BN (22 hours later)

Thank you for your response. This morning XXXXXXX woke with pains in his chest area/esophagus. Forced to eat a small amount of ativia yogurt and within 30 minutes he threw it back up. No nausea. Today is day 2 of not taking the antibiotic. He would like to rule out his heart first because of heart disease in his family and past life style. Would you suggest an echocardiogram? Also, do you suggest he start back taking the antibiotic?

Follow up: Dr. Nishad BN (1 minute later)

He has no strength as well. With the beginning symptoms this morning he also had mucus congestion in his lungs but that went away within 2 hours.

Answered by Dr. Nishad BN (1 hour later)

Brief Answer:
EKG (electrocardiogram) should be taken.

Detailed Answer:
Welcome again.

Thank you for your follow-up query.

As he is having chest pain EKG should be taken to rule out cardiac problems. Proton pump inhibitors like Esomeprazole (Nexium) and anti emetic like domperidone or Ondansetron will be helpful to control the discomfort and nausea.
If severe nausea is there then injections of proton pump inhibitors like Pantoperazole and ondansetron will be needed. Antibiotics I will prefer intravenous in such case.
Amoxiclav orally will worsen gastritis. Amoxiclav can be given as intravenous.
Hospitalization is better in such case.
Thanks.

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Above answer was peer-reviewed by : Dr. Prasad