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Suggest Treatment For Chronic Dysentery
Question: Hello.
I think that you remember my history.
2 months ago I went to an asian restaurant (not too much higienic) and I eat a lot of food: chicken, pork and beef.
3 hours after I ate this meal I suddenly felt a hot and pain in my stomach, and I had suddenly diarrhea with green stools.
Since then I have a lot of pain in my stomach and stomach upset specially in the mornings.
I have done an ecography and a blood analysis and Pancreas, Liver, kidneys and Gallblader are ok.
I have done gastroscopy and colonoscopy , both ok
The doctor told me that I have Irritable Bowel Syndrome, but I think that my symptoms are not as an Irritable Bowel Syndrome because I pass hours and hours in bed because I feel too ill due to my upset stomach, and my pain. Do you think is Irritable Bowel Syndrome with this symptoms?.
My current medication is:
spasmoctyl 40: 3 caps everyday
omeprazol 20: 1 cap everyday
orfidal 10: 1 cap everyday
Another question: In emergency room they prescribe me tramadol 50mg for the pain, can I use tramadol with spasmoctyl?
Brief Answer:
Specific medications necessary.
Detailed Answer:
Hi,
From your description it appears to b case of chronic dysentery.
I would suggest that you take a full course of antibiotics for 10 days comprising of ciprofloxacin and metronidazole.
You can continue with antispasmodic medications only if you have pain otherwise it is not advisable.
The nature of pain will decide the type of drug to be given. If it is spasmodic then antispasmodic medications are required.
If the pain is upper abdominal and burning in nature then omeprazole is necessary.
tramadol would not be required for both these situations.
I hope this answers your doubt.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
One question: if I had cronic disentery, it would be visible in the colonoscopy, isn´t it?. Because in my colonoscopy the doctor said that mucose was ok.
Brief Answer:
Early infection does not lead to ulceration
Detailed Answer:
Hi,
Persistent pain and discomfort is suggestive of disorderly intestinal function. In your case its could be due to the fall out of the previous infection.
There is alteration of the existing intestinal flora which gives rise to malabsorption and persistent symptoms.
i would therefore suggest that a course of antibiotics to followed by a course of pro biotic preparations would help in normalizing your flora. This could possibly lead to normalization of function.
For the colonoscopy to be positive the infection needs to be very severe accompanied by passage of blood and mucus in stools. Just pain is an early feature of residual infection.
I hope this answers your doubt.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello.
Thank you very much for your answer.
First of all I think that I agree that a course of antibiotics probably is the best, but my doctor is very conservative if he does not view signs of alarm: blood in stool, an significative increase in the number of bowel movements, blood anemia, etc...he does not prescribe antibiotics for me, but I will try to going to convince him.
Another question: do you think that is it possible to make a Conservative treatment?, this is: not taking any medicine and wait to a slow reduction of the pain and discomfort because the body is fighting against the infection?, if this not occurs (I bet it not) then consider the antibiotic treatment.
Brief Answer:
Medications are preferred option.
Detailed Answer:
Hi,
Not taking any treatment or the wait and watch policy can be resorted to. But as you have symptoms it is always advisable to get treated till the symtoms completely disappear. Waiting for the body defenses to fight the infection may at times take time and may not always be complete. I hope this answers your doubt.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Another question about the pain: neither of this medicines alleviates my pain:
paracetamol , ibuprofen, Algozone (metamizol)
neither omeprazol, spasmoctyl does alleviate my pain.
This is why in ER they gave me tramadol, do you think that there is something better?, can you suggest something for the bowel pain?.I have another question to you:
I have made breath test and it was negative for HP, If I have a duodenal ulcer is it posible to produce a false negative in breath test?.
In the gastroscopy the doctor didn´t see nothing remarkable, again: is it possible to produce a false negative because the ulcer is placed very low in the duodenum?
Brief Answer:
Antispasmodics treatment of choice
Detailed Answer:
Hi,
Thanks for writing in.
Tramadol is last pain killer on the ladder of pain killers. There are no medications for pain left. However the medications of choice for such problems are antispasmodics which you are already taking.
All duodenal ulcers do not test positive for H pylori. As a result your breath test will be negative. Presence of duodenal ulcer does not interfere with H pylori tests.
Endoscopy will reveal any lesion only up to the second part of the duodenum. Any lesion below that may therefore not be picked up on endoscopy. That may necessitate capsule endoscopy.
I hope this answers all your questions.
Regards
Above answer was peer-reviewed by :
Dr. Prasad
Thank you very much for your answer.
Another question, please.
Apart from dysentery, Is it possible that my symptoms are due to an small bowel ulcer?.
Brief Answer:
Unlikely
Detailed Answer:
Hi,
Thanks for the feedback.
It is unlikely to be intestinal ulceration except in those patients who are taking aspirin for a long time say approximately over a year.
I hope this answers your doubt.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello.
Thank you very much for your answer.
I don´t understand why I am taking spasmoctyl because I don't feel bowel spasm, I only feel a pain that comes in waves, that lasts about 2 hours and pain gradually decreasing, but still leaves a little pain.
I want to ask you why spasmoctyl doesn´t alleviate my pain, perhaps because it is not due to an spastic colon? or is because my colon is very spastic?.
Another question: can spasmoctyl could stop my stomach movement?, I ask this because I have take it for one month and perhaps is too much time, isn´t it?.
Brief Answer:
Answers to your questions
Detailed Answer:
Hi,
Thanks for writing in.
If the pain is not spasmodic then you can stop the antispasmodic medication. The medication is not giving relief for various reasons. The commonest cause would be insensitivity of the gut to the drug due to prolonged use. The other cause could be a altogether different origin of pain which could either be stress induced or organic.
If taken in large doses it could.
I hope this answers your question.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you very much for your answer.
Last question: I have noticed this days that I have restless legs syndrome , do you think could be due to my stomach discomfort?.
Thank you very much.
Brief Answer:
IT is a stress related problem
Detailed Answer:
Hi,
If unlikely that restless leg syndrome has nothing to do with stomach issue. It is a stress related issue.
Regards
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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