Suggest Treatment For Acute Diarrhea With Vomiting And Abdominal Cramps

Brief Answer:
Acute Giardiasis with Dysentery with incomplete treatment

Detailed Answer:
Hi,thanks for the query to HCM virtual clinic.
I studied your query and all the details of your last visit .
I understood your health concerns.
Don't worry about the ulcerative colitis because your son has it.
As the current problem seems to be food and water born acute illness,caused from Acute Giardiasis which is complicated by Dysentery due to incomplete and uncovered treatment from your doctor.
In my opinion I would advise you to Consult your Er Physician,as you had emergency acute problem.

Treatment Suggested-
Consult Er Physician-
Get USG and Xray abdomen with Stool by concentration method to find and confirm cyst and protozoal Giardia
Continue Ciplox and Flagyl under his cover for 10 days
Bland Diet
Plenty of fluids/
Banana milk shake 2 times per day
Tab Loperamide
Anovite locally to control false stool frequency due to proctitis.
Sos Surgeons proctoscopic examination,if need be.
Hope this would help you for time being .
Welcome for any further query in this regard to Me.
Have a good day.
Dr.Savaskar M.N.
M.S.Genl-CVTS XXXXXXX Surgical Specialist

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Brief Answer:
Acute Recurring Dysentery with Proctitis due to Giardiasis

Detailed Answer:
Hi Dear, thanks for the last reply and update on the concerns about the recurrent attacks (almost 3-4 times after the first recovery)of the stool upsets.

Thanks for your updates on the gallstones you have.
I reviewed your main query and reviewed it with last doctors consultation 2 days ago at HCM and processed all this data with your last reply.
I understood concerns and the trouble you are undergoing due to the painful frequent stools with excruciating and painful burning.

*Cause of the excruciating Burning with very high and annoying stool frequency-

-This acute problem of yours,is not in any way related with the your updated facts of gallstones and hence should not be your immediate concern.
-What I want to make you understand is the fact that, all these 2nd or 3rd or 4th flare ups are mostly, the result of the uncontrolled dietary intakes of spicy normal diets which has reloaded the attacks of infection on the already inflamed small and large bowels,as you shifted to a new place.
As a result of these repeated infective insults with bacterial and Giardiasis infection ,which have occurred due to improper diet schedules you had during the early recovery periods of your disease,the bowel condition complicated from controlled disease to recurrent 3-4 flare up attacks of lower bowel dysentery with mucus and blood.

* Critical-Treatment Plan-
With this background, I have already advised the above(last reply) treatment-which needs to be-updated with ER Physician's cover as follows-
-Check your stool by Concentration method for ova and Protozoa /cysts of Giardia.
-Strictly Controlled bland Liquid-diets for initial recovery period(4-5 days) to stabilise the healing of the upper and lower bowels.You would have lot of benefits from this dietary schedules supplemented with Butter milk / and Banana Milk Shakes.
-tab Loperamide x 2-3 times a day with guidance from your Er Physician to reduce the motility and increase the binding of the stools
-Anovate / Proctosedyl oint-Control of false frequency of stools is on my top Priority for which you have to understand and implement these suggestions meticulously,
for control of Proctitis-by Anovate /Proctosedyl cream locally in the anal part under instructions from Er Surgeon,the steroid contents in it would help reduce the acute inflammation causing Proctitis,which is causing excruciating burning pain along with acute giardial colitis.
-Control recurring Acute Giardial Colitis - with multiple colonic ulcers,is causing flare ups and mucus and blood,due to the food load of spicy normal diets which you are taking during the recovery periods and this is adding more pain and frequent mucus /blood foul stool you suffer from.
-So for this reason -Fresh Course of Antibiotics-like Ofloxaxin with Ornidazole combination (instead of Cipro and Flagyl,which is not working as you feel)-which are advanced and more effective medicines,which hence I would suggest in your case-for 10 days time,to be taken under guidance of ER Physician.

If you follow this treatment meticulously with patience(which is very important,as you are quiet pained by the illness you had),you would recover soon from this acute stage.

-Plan of Treatment After the initial recovery after the above treatment-
Once the acute disease cools down I would suggest to go for-
Colonoscopic studies with ER Colonoscopist- with Swabs taken from the colonic ulcers for Bacterial / and Giardial protozoal/cyst microscopic studies,which would confirm the cause of this acute illness you have.
-and this would rule out any diverticulitis or Ulcerative Colitis, which you fear.

You have to Understand the Importance of-
- Bland Liquid non spicy diet and
-Importance of Treatment of Proctitis by Anovate / or Procotsedyl and changed Fresh Antibiotic treatment, to reduce the burning pain associated with frequent painful stools for fast recovery from this illness.

I hope this reply would help you to understand the importance of Bland diet and patience with fluid diet in coming out of the recurring flare ups ,
and would help you to understand importance of Fresh course of Ofloxacin with Ornidazole therapy,for early and fast recovery of this complex,annoying dysentery problem of yours.

Welcome for any further query in this regard to ME.

If you are satisfied with this reply don't forget to strike thanks and to write excellent review with your nice comments, which would improve my rating for new needy visitors to HCM.

Wishing you fast recovery from this complex annoying health problem.
Don't hesitate to asks any doubts,which I would love to clear and reply, till you are relieved of this health issue.

Have a good day.

Dr.Savaskar M.N.
M.S.Genl-CVTS XXXXXXX Surgical Specialist

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