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Suggest Treatment For Chronic Vomiting When Diagnosed With Gastroenteritis
Question: I previously lodged a question regarding my wife's presumed food poisoning from chicken about 3 weeks ago and the diagnosis was Gastroenteritis. My wife has been in hospital as she suffered Hypokalemia from chronic vomiting and diorreah. Her potassium levels while still unstable have been raised with the aid of syrup fed intravenously however she has now been left with Paralytic Ileus and her stomach is still as badly bloated as when first admitted. The problem here is she has a broken hip so is very immobile and this latest issue has made her considerably weaker. Whilst her fecie cultures have been negative ( I assume because of the antibiotics given prior to admission) her white blood cells are in the range of between 17,000 and 21,000 and she also has high Neutrophils and Monocytes . She has not vomited for several days and today commenced consuming clear soup however her diarreah is still watery and dark green. She has had ct scans and various blood tests however the hospital is unable to locate any infection. My concern is how to overcome the paralytic Ileus and also her elevated blood count. She is expected to be discharged in a couple of days provided she keeps her food down and her potassium level is stable. Any advice and possible diagnosis would be much appreciated .
Brief Answer:
It will take almost 2 weeks to fully recover.
Detailed Answer:
Hi again,
Thanks for choosing HealthcareMagic for your query again,
As per your query answers are-
1)Her leucocyte count is elevated due to residual inflammation of gastric mucosa.
Try to understand there are two part of infection-
First one is infection by organism and the second one is inflammation of gastric mucosa as a result of that infection.As per your history your wife had severe gastroenteritis.Now after treatment with antibiotics the causative agents(Bacteria's and protozoa's) are destroyed but the inflammation caused by toxins released by those agent will take time to settle.
Leucocte count right now is on higher side due to inflammation of intestinal mucosa and not due to infection.As the inflammation will settle down intestine would start to function normally again and stools will again become normal.Frankly speaking Severe gastroenteritis will take time to settle down and complete recovery may take about 2 more weeks.
Ileus is a temporary arrest of intestinal peristalsis.In your case it is due to severe infection causing inflammation of nerves and intestinal muscles resulting in malfunction of nerves and muscles,Hence impairing digestive movement.As the inflammation will settle down;Bowel moments will again be restored .Keep her on soft diet.In lay mans language her intestines are injured and inflammed and need rest,So by keeping her on soft and easily digestible food we are helping intestines to recover easily from their injury.
Give her a lots of probiotic and prebiotic to fasten her recovery.
Metamucil helps in increasing bulk of stool and should be given to her daily apart from medicines she is on.
In case you need any other professional advice feel free to question.
Regards.
It will take almost 2 weeks to fully recover.
Detailed Answer:
Hi again,
Thanks for choosing HealthcareMagic for your query again,
As per your query answers are-
1)Her leucocyte count is elevated due to residual inflammation of gastric mucosa.
Try to understand there are two part of infection-
First one is infection by organism and the second one is inflammation of gastric mucosa as a result of that infection.As per your history your wife had severe gastroenteritis.Now after treatment with antibiotics the causative agents(Bacteria's and protozoa's) are destroyed but the inflammation caused by toxins released by those agent will take time to settle.
Leucocte count right now is on higher side due to inflammation of intestinal mucosa and not due to infection.As the inflammation will settle down intestine would start to function normally again and stools will again become normal.Frankly speaking Severe gastroenteritis will take time to settle down and complete recovery may take about 2 more weeks.
Ileus is a temporary arrest of intestinal peristalsis.In your case it is due to severe infection causing inflammation of nerves and intestinal muscles resulting in malfunction of nerves and muscles,Hence impairing digestive movement.As the inflammation will settle down;Bowel moments will again be restored .Keep her on soft diet.In lay mans language her intestines are injured and inflammed and need rest,So by keeping her on soft and easily digestible food we are helping intestines to recover easily from their injury.
Give her a lots of probiotic and prebiotic to fasten her recovery.
Metamucil helps in increasing bulk of stool and should be given to her daily apart from medicines she is on.
In case you need any other professional advice feel free to question.
Regards.
Above answer was peer-reviewed by :
Dr. Prasad
Many thanks for your thorough answer Doctor, as far as I am aware the hospital is still giving my wife antibiotics and are not treating inflammation. Should the antibiotics cease and is there any medications they should be providing to reduce the inflammation.
Also how important is exercise in the recovery process as they are putting her on a gravity table once a day to assist with reducing the gas. At this stage my wife is unable to belch nor break wind.
Assuming she will be discharged in the next couple of days, other than soft foods is there any other management plan we should have in place and can she consume dairy products ie milk?
Also how important is exercise in the recovery process as they are putting her on a gravity table once a day to assist with reducing the gas. At this stage my wife is unable to belch nor break wind.
Assuming she will be discharged in the next couple of days, other than soft foods is there any other management plan we should have in place and can she consume dairy products ie milk?
Brief Answer:
Follow up answer.
Detailed Answer:
Hi again,
As per your question.No please follow the antibiotics as per the advice of primary Gastroenterologist.Stopping antibiotics can cause a repeat infection,So let your primary doctor decide how to taper them off.
Inflammation of intestines will take time to settle down,Use of anti inflammatory will worsen the situation as almost all anti inflammatory cause severe gastritis.So the safer and better option is;give her a lot of probiotics and prebiotics along with easily digestible soft food.The more the intestines will relax the faster the recovery will be.
Patient should resume normal activities as early as possible.As she would start walking and doing her regular routine chores gas problem would settle down.In hospital also if she is fine now then ask her to walk inside using a support.This will help her to recover earlier from ileus also.
No she should try to avoid dairy products however yoghurt should be taken as it contain lactobacillus which help improve digestion.
Diet to be taken at home should be simple,Non spicy and eaisly digestible.
Avoid meat for few days.
No alcohol or aerated beverages or processed food.
Apart from that she can take normal home cooked food.
Try to give her metamucil or fybrogel two tsf twice daily,They help intestines in forming bulky stools.
In case you have any other question,I would be happy to answer.
Regards
Follow up answer.
Detailed Answer:
Hi again,
As per your question.No please follow the antibiotics as per the advice of primary Gastroenterologist.Stopping antibiotics can cause a repeat infection,So let your primary doctor decide how to taper them off.
Inflammation of intestines will take time to settle down,Use of anti inflammatory will worsen the situation as almost all anti inflammatory cause severe gastritis.So the safer and better option is;give her a lot of probiotics and prebiotics along with easily digestible soft food.The more the intestines will relax the faster the recovery will be.
Patient should resume normal activities as early as possible.As she would start walking and doing her regular routine chores gas problem would settle down.In hospital also if she is fine now then ask her to walk inside using a support.This will help her to recover earlier from ileus also.
No she should try to avoid dairy products however yoghurt should be taken as it contain lactobacillus which help improve digestion.
Diet to be taken at home should be simple,Non spicy and eaisly digestible.
Avoid meat for few days.
No alcohol or aerated beverages or processed food.
Apart from that she can take normal home cooked food.
Try to give her metamucil or fybrogel two tsf twice daily,They help intestines in forming bulky stools.
In case you have any other question,I would be happy to answer.
Regards
Above answer was peer-reviewed by :
Dr. Kampana
Hi Doctor it looks like my wife is being transferred to the hospital head office tomorrow for more tests. She has a tube through her nose in to her stomach which is extracting bile. According to the gastro doctor if they took the tube out she would recommence vomiting and her bloating would worsen. Her stomach and both intestines are distended and badly inflamed. She is currently being drip fed Oliclinomel.
Have you any ideas what the cause may be, we are both very worried.
Have you any ideas what the cause may be, we are both very worried.
Brief Answer:
Folow up advice.
Detailed Answer:
Hi again,
The tube is called Ryle's tube and using it is a standard procedure in patient having paralytic ileus.It has two basic roles-
1)Gastric suction done by nasogastric tube help keep her stomach empty while she is healing. A low level of suction will be used by doctors to remove fluids,bile and acid.
2)Enteral nutrition can be given through it..Enteral feeding refers to the delivery of a nutritionally complete feed, containing protein, carbohydrate, fat, water, minerals and vitamins, directly into the stomach, duodenum or jejunum. For patients with vomiting and distention, use of a nasogastric tube provides symptomatic relief.As her intestines are severely inflamed and distended ,Giving food through oral route will increase burden on already injured digestive system.Therefore cabohydrates,Fats and protein in their simpler units are administered through tube so that they can be easily absorbed with burdening your intestines.
As she will recover she would be shifted from enteral to oral feeds.
In case you have any other query,I would be glad to help.
Regards.
Folow up advice.
Detailed Answer:
Hi again,
The tube is called Ryle's tube and using it is a standard procedure in patient having paralytic ileus.It has two basic roles-
1)Gastric suction done by nasogastric tube help keep her stomach empty while she is healing. A low level of suction will be used by doctors to remove fluids,bile and acid.
2)Enteral nutrition can be given through it..Enteral feeding refers to the delivery of a nutritionally complete feed, containing protein, carbohydrate, fat, water, minerals and vitamins, directly into the stomach, duodenum or jejunum. For patients with vomiting and distention, use of a nasogastric tube provides symptomatic relief.As her intestines are severely inflamed and distended ,Giving food through oral route will increase burden on already injured digestive system.Therefore cabohydrates,Fats and protein in their simpler units are administered through tube so that they can be easily absorbed with burdening your intestines.
As she will recover she would be shifted from enteral to oral feeds.
In case you have any other query,I would be glad to help.
Regards.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
So why the need to transfer her, the hospital is obviously being thorough in case there maybe something more serious causing her issues. I spoke to them regarding the 2 week healing process and they stated my wife has a severe case of inflammation and distension and has no signs of improving as yet although her white cells had dropped from 21,000 to 13,000.
Do you agree she needs further diagnosis? I believe they are still trying to determine what type of bacteria they are dealing with.
Do you agree she needs further diagnosis? I believe they are still trying to determine what type of bacteria they are dealing with.
Brief Answer:
Please attach all test reports and medications copy.
Detailed Answer:
Hello again,
Shifting her to higher centre means that inflammation and ileus are not settling down.
Dropping of TLC is a good sign though it means that atleast infection is in control.
Yes definitely she needs further diagnosis and investigation.She is on Ryles tube and Enteric feed from many days and still not improving,She should be investigated thoroughly at a superspeciality centre with all facilities.
For any further professional advice please attach photos of all her treatment chart and blood and stool culture reports.As without going through her detailed reports,it's very difficult to provide further opinion about her prognosis and recovery.
I hope you can understand the intensity of situation.
Please attach a copy of all investigations and medication she is on.
Waiting,
Regards.
Please attach all test reports and medications copy.
Detailed Answer:
Hello again,
Shifting her to higher centre means that inflammation and ileus are not settling down.
Dropping of TLC is a good sign though it means that atleast infection is in control.
Yes definitely she needs further diagnosis and investigation.She is on Ryles tube and Enteric feed from many days and still not improving,She should be investigated thoroughly at a superspeciality centre with all facilities.
For any further professional advice please attach photos of all her treatment chart and blood and stool culture reports.As without going through her detailed reports,it's very difficult to provide further opinion about her prognosis and recovery.
I hope you can understand the intensity of situation.
Please attach a copy of all investigations and medication she is on.
Waiting,
Regards.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Hi doctor my wife has been diagnosed with intussuseption with one intestine inside another by 8 centimetres . This was picked up by a ct scan of the colon today. She is on her way to the headquarters now. The hospital still suspects infection as the cause of the inflammation however I have just googled and am concerned of the other possibilities . They could not see a mass however could not rule it out. I hope I have supplied you with enough information for you to give an opinion. As I mentioned in my original message she was fine when we went to bed and the next morning she vomited undigested food and was bloated. This was about 3 weeks ago.
Brief Answer:
Follow up
Detailed Answer:
Hi again,
Intussusception is very rare in adults and almost all the symptoms overlaps gastroenteritis,Therefore is often missed by doctors,Like in this case.
Firstly Don't panic; Intussusception is an emergency condition and should be treated immediately,But timely intervention has excellent results.
CT scan is a diagnostic test for Intussusception.Please mention detailed reports of CT was there any necrosis in intestines?
Treatment
Lapractomy will be performed(open the abdomen) through midline incision and the portion of the intestine that is trapped will be freed,In this way obstruction would be cleared However as three weks have already passed there are possibilty of necrosis of a part of intestine;In that scenario dead intestinal tissue would be removed.Emergency lapractomy is the only treatment available.
One thing which i can't get is that she is in a hospital from more then a week how come her CT scan was done so late and why was Intussusception not diagnosed in Ultra sound;which is usually the first test done on any patient presenting with gastric problem to a hospital.
Well i wish her a great luck,Feel free to ask any query.In which city of thailand are you right now,She requires a tertiary or quaternary care unit(Gastroenterologist).So please make sure that hospital has a full fledged working gastro unit as medical facilities in thailand are not that good(Just for your Information).
Regards.
Follow up
Detailed Answer:
Hi again,
Intussusception is very rare in adults and almost all the symptoms overlaps gastroenteritis,Therefore is often missed by doctors,Like in this case.
Firstly Don't panic; Intussusception is an emergency condition and should be treated immediately,But timely intervention has excellent results.
CT scan is a diagnostic test for Intussusception.Please mention detailed reports of CT was there any necrosis in intestines?
Treatment
Lapractomy will be performed(open the abdomen) through midline incision and the portion of the intestine that is trapped will be freed,In this way obstruction would be cleared However as three weks have already passed there are possibilty of necrosis of a part of intestine;In that scenario dead intestinal tissue would be removed.Emergency lapractomy is the only treatment available.
One thing which i can't get is that she is in a hospital from more then a week how come her CT scan was done so late and why was Intussusception not diagnosed in Ultra sound;which is usually the first test done on any patient presenting with gastric problem to a hospital.
Well i wish her a great luck,Feel free to ask any query.In which city of thailand are you right now,She requires a tertiary or quaternary care unit(Gastroenterologist).So please make sure that hospital has a full fledged working gastro unit as medical facilities in thailand are not that good(Just for your Information).
Regards.
Above answer was peer-reviewed by :
Dr. Prasad
Hi Doctor,
My wife is now in Bangkok which was a 3 hour ride in an Ambulance .
She had a ct scan this morning which revealed her colon has corrected itself which I find miraculous however the hospital are stating it was caused by all of the bumping and shaking in the ambulance ride. I find this hard to believe as she was degased yesterday (which she had done several times previously) however this time her stomach remained smaller and for the first time she became hungry. I suggested we wait 1 more day as her blood cell readings were improving but the doctors insisted she had to go to Bangkok. I mentioned the ultrasound and they dispute this would have found the problem.
They are now looking at giving my wife a colonoscopy to clear out all of the fecies and all being well take her off the tube and see if she can start eating and drinking.
I would value your opinion on their version of events and to date we have not been informed of the original cause.
Many thanks
My wife is now in Bangkok which was a 3 hour ride in an Ambulance .
She had a ct scan this morning which revealed her colon has corrected itself which I find miraculous however the hospital are stating it was caused by all of the bumping and shaking in the ambulance ride. I find this hard to believe as she was degased yesterday (which she had done several times previously) however this time her stomach remained smaller and for the first time she became hungry. I suggested we wait 1 more day as her blood cell readings were improving but the doctors insisted she had to go to Bangkok. I mentioned the ultrasound and they dispute this would have found the problem.
They are now looking at giving my wife a colonoscopy to clear out all of the fecies and all being well take her off the tube and see if she can start eating and drinking.
I would value your opinion on their version of events and to date we have not been informed of the original cause.
Many thanks
Brief Answer:
Follow up answer.
Detailed Answer:
Hi again,
This was really a pathetic explaination by Doctors.I think previous CT reports were not correct.Bumping and shaking in ambulance curing intussusception with ileus is really a miracle(Pun intended).
Most likely ileus was a result of Gastroenteritis.Now as infection and inflammation are settling down she would be on Ryles tube for few more day.Feeling hungry is a positive sign,It means that peristalsis has again started.
I think we should probably keep her on entral feed for a day or two more.Before weaning her off Ryle's.
Polyethylene glycol electrolyte enema will be good for her.It will clear her full bowel.You can discuss it with your treating gastroenterologist.
Why are they planning for colonoscopy?I mean what are they suspecting?
To sum up-
Most likely as suspected it was Severe gastroenteritis.Initial CT was faulty,Missing Intususeption in Ultrasound further supports that CT reports were wrongly interpreted.
As her TLC is settling down now and Her appetite is picking up.Most likely things will start getting better in a day or two.For Colonoscopy frankly speaking i am not sure what your treating Gastro is suspecting.
Regards.
Follow up answer.
Detailed Answer:
Hi again,
This was really a pathetic explaination by Doctors.I think previous CT reports were not correct.Bumping and shaking in ambulance curing intussusception with ileus is really a miracle(Pun intended).
Most likely ileus was a result of Gastroenteritis.Now as infection and inflammation are settling down she would be on Ryles tube for few more day.Feeling hungry is a positive sign,It means that peristalsis has again started.
I think we should probably keep her on entral feed for a day or two more.Before weaning her off Ryle's.
Polyethylene glycol electrolyte enema will be good for her.It will clear her full bowel.You can discuss it with your treating gastroenterologist.
Why are they planning for colonoscopy?I mean what are they suspecting?
To sum up-
Most likely as suspected it was Severe gastroenteritis.Initial CT was faulty,Missing Intususeption in Ultrasound further supports that CT reports were wrongly interpreted.
As her TLC is settling down now and Her appetite is picking up.Most likely things will start getting better in a day or two.For Colonoscopy frankly speaking i am not sure what your treating Gastro is suspecting.
Regards.
Above answer was peer-reviewed by :
Dr. Kampana
Hi doctor,
My wife had a sigmoidoscopy last night and 5 litres of liquid fecies were removed. Her stomach is now flat, however she has limited peristalsis and insufficient for her to break wind. Her potassium level still requires some syrup top ups however her white blood cell count is now below 10,000. She recommenced eating clear soup today. If she continues to improve tomorrow they are looking at transferring her to a general ward and removing the Ryles tube.
What would you opinion of her present condition be?
My wife had a sigmoidoscopy last night and 5 litres of liquid fecies were removed. Her stomach is now flat, however she has limited peristalsis and insufficient for her to break wind. Her potassium level still requires some syrup top ups however her white blood cell count is now below 10,000. She recommenced eating clear soup today. If she continues to improve tomorrow they are looking at transferring her to a general ward and removing the Ryles tube.
What would you opinion of her present condition be?
Brief Answer:
She is getting better now.
Detailed Answer:
Hello,
As per your query things will take some time to get better.
It's a good sign that peristalsis has started, now as inflammation will start getting better; intestinal movements will improve. Remain calm, please don't panic. TLC is normal now and she has started taking things orally which is a good sign.
Food will stimulate intestinal moments. Yes, if every thing remains normal then she could be shifted to general ward and Ryle's tube could be removed.
My opinion is that, she is recovering and getting better day by day. Most probably she should be fine in 3-5 days(for discharge). Her condition seems stable now. Wait and watch is the best thing to do right now.
She should be asked to take light food orally and she should start ambulating. This will again stimulate intestinal movements and with in few days her bowel would be normal.
Instruction,
Don't over exert, just start things gradually.
Thanks.
She is getting better now.
Detailed Answer:
Hello,
As per your query things will take some time to get better.
It's a good sign that peristalsis has started, now as inflammation will start getting better; intestinal movements will improve. Remain calm, please don't panic. TLC is normal now and she has started taking things orally which is a good sign.
Food will stimulate intestinal moments. Yes, if every thing remains normal then she could be shifted to general ward and Ryle's tube could be removed.
My opinion is that, she is recovering and getting better day by day. Most probably she should be fine in 3-5 days(for discharge). Her condition seems stable now. Wait and watch is the best thing to do right now.
She should be asked to take light food orally and she should start ambulating. This will again stimulate intestinal movements and with in few days her bowel would be normal.
Instruction,
Don't over exert, just start things gradually.
Thanks.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Hi Doctor,
We discharged my wife yesterday against medical advice as she was becoming mentally frail and her anxiety levels were increasing. She is still suffering potassium loss through her urine and stools which are still very watery but are now brown. Amongst other medications she has to take potassium syrup which has completely taken away any appetite because of the unpleasant taste. She had another endoscopy to release gas the night prior to discharge but already she is heavily bloated and last night we had to change the bed twice due to bowel movements. The hospital have advised she has regained bowel movement although not fully and are hoping her fecies become firmer with regular ambulation. We sat her upright in a lounge chair for over 2 hours yesterday which was the most she could managed.
She is now being treated as an outpatient and has to go to hospital 3 times weekly for potassium and CBC tests as her white blood cells are also up and down.
We feel like we are going around in circles and she is still suffering from extreme anxiety which made her vomit last night.
Any advice you could offer would be greatly appreciated.
Kind regards XXXXXXX
We discharged my wife yesterday against medical advice as she was becoming mentally frail and her anxiety levels were increasing. She is still suffering potassium loss through her urine and stools which are still very watery but are now brown. Amongst other medications she has to take potassium syrup which has completely taken away any appetite because of the unpleasant taste. She had another endoscopy to release gas the night prior to discharge but already she is heavily bloated and last night we had to change the bed twice due to bowel movements. The hospital have advised she has regained bowel movement although not fully and are hoping her fecies become firmer with regular ambulation. We sat her upright in a lounge chair for over 2 hours yesterday which was the most she could managed.
She is now being treated as an outpatient and has to go to hospital 3 times weekly for potassium and CBC tests as her white blood cells are also up and down.
We feel like we are going around in circles and she is still suffering from extreme anxiety which made her vomit last night.
Any advice you could offer would be greatly appreciated.
Kind regards XXXXXXX
Brief Answer:
follow up answer.
Detailed Answer:
-Hi again,
Sorry for a bit late reply.
Potassium syrup(potklor) is the only way to correct her potassium levels.
However alternate day monitoring of her serum potassium level should be done as even slight elevation of potassium can be toxic.
For her stool start giving her Econorm XXXXXXX thrice daily(probiotic) along with 15 grams Metamucil or Fybrogel(three times a day).Dissolve metamucil granules in water for 10 minutes and take it after that.
As she has regained her bowel moments,It will take 3-4 weeks for her to be normal again.Paralytic ileus will take its time.So have a practical approach,As there is no magical formula body will take it's time.
Try to ambulate her as much as possible.Ambulation will cause intestines to stretch and relax and will make recovery fast.
For any further suggestions ,Please attach her current treatment chart.
I have to go through her treatment before giving any further advice.
I hope you can understand the intensity of problem.
Waiting.
Thanks.
follow up answer.
Detailed Answer:
-Hi again,
Sorry for a bit late reply.
Potassium syrup(potklor) is the only way to correct her potassium levels.
However alternate day monitoring of her serum potassium level should be done as even slight elevation of potassium can be toxic.
For her stool start giving her Econorm XXXXXXX thrice daily(probiotic) along with 15 grams Metamucil or Fybrogel(three times a day).Dissolve metamucil granules in water for 10 minutes and take it after that.
As she has regained her bowel moments,It will take 3-4 weeks for her to be normal again.Paralytic ileus will take its time.So have a practical approach,As there is no magical formula body will take it's time.
Try to ambulate her as much as possible.Ambulation will cause intestines to stretch and relax and will make recovery fast.
For any further suggestions ,Please attach her current treatment chart.
I have to go through her treatment before giving any further advice.
I hope you can understand the intensity of problem.
Waiting.
Thanks.
Above answer was peer-reviewed by :
Dr. Remy Koshy
Hi Doctor, the following are her test results from yesterday ; Blood urea nitrogen specimen type serum, blood urea nitrogen 12.86 mg/dl Electrolytes - sodium 136 potassium 5.19 chloride 107 TCO2 17.9. ( low) anion gap 11.1 all mol/L. Creatinine specimen type serum, creatinine 0.52 eGFR 116.58 ml/min/1.73 m2. Complete blood count - only abnormal readings are Total WBC 13.77H, RBC distribution width 16.5H & Neutrophils 69% normal and 9501H. Platelet count is 436 and mean platelet count is 8.2. Red blood cells 5.02. RBC Morphology - Normochromic Normocytic RBC.
Her abdomen is continually making noises like a drain and her fecies are basically brown water. We are going to try and start using a commode today and increase ambulation.
Her abdomen is continually making noises like a drain and her fecies are basically brown water. We are going to try and start using a commode today and increase ambulation.
Brief Answer:
follow up advice.
Detailed Answer:
Hi,
Have gone through your details,
Potassium is almost normal now and is a bit on higher side.So you can ask your doctor to reduce the frequency of potklor.
TLC is 13k jus bit higher then normal values.
Recovery from paralytic ileus is a bit slow and will take its time.Severe gas and bloating is because of paralytic intestines(Still in recovery phase).
Wait and watch is best policy.
Along with antibiotic and anti inflammatory therapy prescribed by doctor,Start giving her econorm thrice daily.
Metamucil 15 gram twice daily with water will help increasing bulk of stool.
Ask her to take regular walks intially in room then extend it to garden gradually.
Proper ambulation with medication will fasten up the recovery process earlier.
Her reports are almost normal in a settling trend.
There is no magical formula,It will take its time.
Thanks.
follow up advice.
Detailed Answer:
Hi,
Have gone through your details,
Potassium is almost normal now and is a bit on higher side.So you can ask your doctor to reduce the frequency of potklor.
TLC is 13k jus bit higher then normal values.
Recovery from paralytic ileus is a bit slow and will take its time.Severe gas and bloating is because of paralytic intestines(Still in recovery phase).
Wait and watch is best policy.
Along with antibiotic and anti inflammatory therapy prescribed by doctor,Start giving her econorm thrice daily.
Metamucil 15 gram twice daily with water will help increasing bulk of stool.
Ask her to take regular walks intially in room then extend it to garden gradually.
Proper ambulation with medication will fasten up the recovery process earlier.
Her reports are almost normal in a settling trend.
There is no magical formula,It will take its time.
Thanks.
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Remy Koshy
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