HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

What Causes Abdominal Bloating, Belching And Diarrhea?

Posted on Mon, 13 Nov 2017

Question: After travelling this summer in early August and eating steak tartar (kibbeh nayeh if you're familiar with Lebanese foods) plus a variety of fresh vegetable salads, I suffered approx 5 weeks of severe watery diarrhoea, bad taste in mouth or reduced taste, reduced appetite, difficulty swallowing, EXTREME gas with belching and bloating or fullness. Tests so far including barium swallow and endoscopic exam have shown no apparent cause. The diarrhoea have somewhat subsided but the other symptoms are on-going.

Answered by Dr. Ramesh Kumar (1 hour later)

Brief Answer:
Travellers diarrhoea and indigestion.

Detailed Answer:
Hi,
Thanks for query.

Have seen your detaills.

Traveler's diarrhea is a digestive tract disorder that commonly causes loose stools and abdominal cramps. It's caused by eating contaminated food or drinking contaminated water especially seen in persons with history of long travel and change in food.
The most common signs and symptoms of traveler's diarrhea are:
Abrupt onset of passage of three or more loose stools a day
An urgent need to defecate
Abdominal cramps
Nausea
Vomiting
Fever

All these symptoms are there in your case.

One thing which i can't understand is that you were neither given antibacterial nor aniprotozoal therapy and why was endoscopy and barium swallow done?

My suggestion to you is go for a Stool microscopy test to rule out amoebic or parasitic infection.
A fecal calproctin test can be done to rule out inflammation in gut.

If stool test is positive for bacterial or protozoal infection.Start taking Zithromax(Azithromycin 500 mg once daily) and secnidazole 1 gram daily for 5 days.However my suggestion is that you should take a 5 days course even if stool tests are clear.

Secondly start taking a probiotic like VSL#3 twice daily.When gut flora is disturbed proper digestion of food does not take place.Probiotics replete the level of good bacterias in gut hence would aid in proper digestion of food.
Take Omeprazole 20 mg for gas.
Take home made easily digestible vegetarian food for few days with proper medication.

Follow up after 5 days.
You would feel much better.

Regards!

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

Follow up: Dr. Ramesh Kumar (21 hours later)

Dr. Kumar: Thanks for detailed response. The endoscopy and barium swallow were done because of my complaint about difficulty swallowing, hoarse voice, that my PCM diagnosed as possible esophogiatis. Symptoms started at same time as traveller's diarrhoea in early August and have continued since. Gas is so Excessive that it pushes my diaphragm up and causes chest pain and inability to eat. BTW, today I just completed stool collection and the lab is testing per Gastrointestinal physician's order for 1. Fecal leukocytes
2. Ova and Parasites
3. Giardia Antigen
4. Cryptosporidium
5. Stool culture
6. Stool H.pylori Antigen
7. C.diff PCR
Diagnoses: Diarrhea: 564.5 - K59.1
In your opinion should there be testing for anything else?
Thanks,
EGN

Answered by Dr. Ramesh Kumar (2 hours later)

Brief Answer:
follow up.

Detailed Answer:
Hello my dear friend,
Thanks for follow up.

I feel that these tests are Ok for baseline investigation,If any thing would come up to be abnormal we can proceed with other tests.

The endoscopy.......gas is so excessive-
See basically you are having Dyspepsia.Its not a disease but is an umbrella term which covers entrritis with gastritis and severe bloating.

Once your test results are there we could proceed with proper management.Its fully managable so don't worry.

Follow up wth reports.
Thanks!

Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Kampana