I am feeling feverish due to abdominal pain, stomach burn and headache. Please help.

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It would have been great if you could have shared the report of CT (computed tomography) scan and blood tests to tell you about your problem.

The symptoms you mentioned can be due to various causes namely peptic ulcer disease, irritable bowel syndrome, small intestinal bacterial overgrowth, and many others.

For now, I suggest you to take capsule Esomeprazole 40 mg once daily before breakfast since you have pain, which seem to be secondary to peptic ulcer disease or acidity.

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Hello,

Welcome back to icliniq.com.

The reports were little blurred, somehow I managed to see the findings (attachment removed to protect patient identity).

So after all my understanding about you, considering your symptoms for the past two months, given raised level of fecal calprotectin in stools, and CT scan showing small bowel thickening makes me think it is an ulcerative jejunoileitis. In common words, it is inflammation of your small bowel. The underlying causes could by typhoid or any other bacterial infection (the most likely cause) and Crohn's disease. You have your typhi dot test which is negative. Nowadays we do not usually recommend this testing, instead, we do blood culture for confirmation of typhoid.

I would start by giving you an antibiotic course of a duration of 7 to 10 days and would see if you improve on that. For example, at the end of your antibiotic course, you do not have any improvement I would recommend other testing including a colonoscopy (endoscope of the large bowel) and/or enteroscopy (endoscopy of the small bowel) with biopsies. I strongly feel that you have an infection with possibly typhoid or with other bacterial infections. And this infection shall resolve with the medications I prescribe you.

The fever, abdominal pain, and pain over the stomach are part of this overall problem, and I expect that all symptoms will go away once you start the treatment and once underlying inflammation starts resolving. The antibiotic I prescribe would not trouble you in terms of side effects, however, Metronidazole can cause metallic taste in the mouth, with some nausea and loss of appetite. But these side effects are temporary and once the course of antibiotic is completed the side effects will go away by itself.

Lastly, I want you to understand that pain and fever will settle in the coming two to three days if not sooner because antibiotics will take time to show effects in terms of improvement of symptoms.