Dr. Basuki Nath Bhagat
Family Physician
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi
I am looking after my father, and I am starting to get really worried about his condition. Since Sunday, he started with diarrhea, very bad, and vomiting. He assumed that it might be a case of food poisoning. This continued until Tuesday night when he started to have a black watery stool. He has not had any iron or Pepto Bismol. He continued this diarrhea and has not been able to eat anything since then. I have been giving him Hydralyte, Pedialyte, and ice cubes to keep him hydrated. His condition got worse, and I did take him to the hospital on Thursday early morning. They did a blood test and a COVID test. They gave him three bags of IV fluids and then told me to take him home and wait for the result of the COVID-19 test. They did not give him a stool test. I have taken him home and tried to provide him with some rice milk and bone broth as he has not eaten anything for five days now. The bleeding has not stopped, and his stool is still black. I am extremely worried about internal bleeding or complications. He is on Xarelto for over a year now for some blood clots in his leg. I am very worried that this internal bleeding is a big concern. I did talk to the doctor this afternoon, and he told him to stop taking it and come to the hospital on Monday for tests. But I do not feel like we have time to wait as he has become very weak tonight and does not have the energy even to get up to go to the bathroom. He is 280 lbs in weight and 6' 4" in height. He takes Terazosin and Finasteride for his prostate. I have taken his blood sugar, which is 12.9 mmol/L. On Thursday at the hospital, they took it, and it was at 11.9 mmol/L, and they said that was a concern. He has not been diagnosed as diabetic ever. I am getting really worried, wondering if I should take him back to the hospital immediately and not wait till Monday. Is there anything I can do now for him? Please advice.
Hi,
Welcome to icliniq.com.
I read your query and understand your concern.
I am sorry for such discomfort your father is having.
Diarrhea with black watery stool for five days is a sign of concern as it points toward possible lower GIT (gastrointestinal tract) bleeding.
You mentioned initially he had episodes of vomiting too. Is vomiting still continued?
At this age, such an amount of fluid loss needs active intervention.
How is your father hemodynamically? For example, what are his blood pressure and pulse rate?
You are giving him Hydralyte (glucose, Sodium, Potassium, Chloride, and Citrate), Pedialyte (Sodium Chloride, Sodium Citrate, Potassium Citrate, and Sodium Chloride), or rice water, but that is insufficient to replace the ongoing loss.
And now he is too weak to go to the bathroom alone.
His random blood sugar is 12.9 mmol/L which is high and in the diabetic range.
I suggest you go to the hospital and get him admitted.
He needs fluid replacement, IV (intravenous) antibiotics ( if the cause is infectious), to find the source of blood in the stool, and other tests.
His blood sugar needs to be addressed too.
Thanks.
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