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Suggest Treatment For Diarrhea, Abdominal Pain And Nausea

Posted on Wed, 8 Feb 2017

Question: our 20 year old son has been experiencing morning nausea without vomiting, feeling full after small amounts of food, diarrhea and pain in the stomach. He says his diarrhea is "sandy" . This has been going on for about 2 years and seemed to follow a case of mononucleosis in his freshman year of college. He has lost some weight and experiences these symptoms daily. He has been seen by his pediatrician who ran tests with negative results. He just saw a gastroenterologist last week who wants to do an endoscopy and colonoscopy. He also gets a mucocele on his soft palat that goes down but sometimes there are a few of them.

Answered by Dr. Dholariya Sagar Jayantilal (7 hours later)

Brief Answer:
Need complete clinical evaluation.

Detailed Answer:
Hello dear
Wecome to HCM and thanks for query
I understand your concern
I have undergone through yoir query

Nausea, bloating, stomach pain, diarrhea could be due to Irrotable bowel syndrome, Celiac disease, Malabsorption, microscopic colitis, inflammatory bowel disease (asspciated with blood in stool).

I would suggest to go for following investigation under advise of authorized Gastroenterologist to confirm possible cause:
Stool microscopy and culture, fecal calprotectin test, serology tests for celiac disease, routine blood tests like CBC,ESR.
Barium meal study, Colonoscopy with tissue biopsy.

Specific treatment will depend on cause and tests result. Please upload tests result afterwards for better management.

This is my personal opinion based on information available.
If you have further query then I will be happy to help you.
Best regards
Dr. Sagar

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dholariya Sagar Jayantilal (1 hour later)

Thank you for your answer. He will have the colonoscopy and endoscopy next week. The doctor also mentioned something about gastropyresis that could have started after the mononucleosis. Something odd that happened was that he had a confirmed mono test two years ago and then six months ago he was sick again and was tested again for mono and they said he had it again. Is that even possible? also I have been hearing radio commercials for EPI (exocrine pancreatic insufficiency) . Is that a possibility in a 20 year old male?

Answered by Dr. Dholariya Sagar Jayantilal (2 hours later)

Brief Answer:
Need complete clinical evaluation

Detailed Answer:
Hello dear XXXXXXX
Welcome and thanks for follow up
I understand your concern

Symptoms could be due to post mononucleosis gastroparesis.
It cause delay in empty of stomach and cause nausea, stomach pain and fullness. (but generally not associated with diarrhea).
Radioscintography or gastric emptying scan will help to confirm gastroparesis.

Clinical and laboratory sequelae has been reported in mononucleosis.
Chance of EPI is very less. (It is associated with watery diarrhea, bulky stool that floats, has an oily or greasy appearance, and smells foul)
It should be rule out in absence of all above mentioned causes.

This is my personal opinion based on information available.
If you have further query then I will be happy to help you.
Best regards
Dr. Sagar

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Above answer was peer-reviewed by : Dr. Nagamani Ng