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Suggest Remedies For Stomach Pain And Diarrhea

Posted on Wed, 1 Jun 2016

Question: Hi, My mother is 70 years old. She has been complaining of mild stomach since 2-3 days. She also has loose motions but only 2-3 times jn the morning. She has been taking Nor-TZ. Tonight, she went to bathroom 2-3 times, vomited and also experiencing pain. I gave her ROKO and Spasmonil. Kindly suggest, what further can be done

Answered by Dr. Tushar Kanti Biswas (6 hours later)

Brief Answer:
Acute Gastro-enteritis

Detailed Answer:
Hi,

Thank you for your query to HCM. I can understand your concerns.

It seems your mother is suffering from acute Gastro-enteritis -most likely infective in etiology. You have already started a combination of antibiotic (Fluoroquinolone group-Norfloxacin) and antiamoebic (Tinidazole).

You can continue 1 tablet of fixed dose combination twice daily for 3 days. Fluid and electrolyte replacement are of central importance to all forms of acute diarrhea. You can add Oral Rehydration Solution (WHO-ORS) 2 tablespoon in a glass of water every 6 hourly and on each loose motion to replace concurrent loss.

However you have to restrict antimotility agent like loperamide (ROKO) as it may exacerbate or prolong infective enteritis. You can give spasmonil (Acetaminophen, Dicyclomine Hydrochloride) as and when required basis.

For vomiting, one can add Domperidone 10 mg orally (maximum three times a day).

Let me if anything's not clear yet....

Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Tushar Kanti Biswas (1 hour later)

Thank you doctor. I was reading somewhere that Nor-Tz is not a good combination drug. It has mild to severe side effects. My mother has been taking this since last one week, wheneever she had 2-3 times loose motions in the morning. She also had econonorm fir three days as advised by a doctor.

I think she has been given enough medicines, however her loose motion and mild pain has not subside.

In this regard, do you still wang me to give Nor-Tz? Kindly suggest

Answered by Dr. Tushar Kanti Biswas (7 hours later)

Brief Answer:
Diarrhea

Detailed Answer:
Nor-Tz contains Norfloxacin 400 mg and Tinidazole 600 mg.Norfloxacin should be given 400 mg per day in case of renal impairment which is not uncommon at 70 years of age.Check her serum creatinine.
Since combination of Norfloxacin and Tinidazole has not worked well even after 7 days,you may as well discontinue it and investigate her further for altered bowel habit.
You may continue her probiotic (Econorm). Meanwhile a course of Rifixamin (poorly absorbed rifampin derivative & highly effective against noninvasive bacterial pathogens such as enterotoxigenic and enteroaggregative E. coli) in standard doses won't be out of place.
Discuss with your doctor.

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Prasad