HomeAnswersMedical Gastroenterologygreen stoolsMe and my son has bright green stools for the past few days. What is the problem?

What type of infection would cause bright green stools?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Vinodhini J.

Published At April 10, 2020
Reviewed AtAugust 10, 2023

Patient's Query

Hello doctor,

For the past two and a half months, my son 2 years old has had total bright green poop. Sometimes pasty. He is in daycare. For the past two months, I have also started to have total bright green stool inside and out with bright green mucus. 80 percent of the time without eating anything green significantly enough to cause consecutive green BM’s consistently in and throughout even while missing meals due to lack of appetite. I had lost 15 pounds in a month and a half. I have to force myself to eat. Due to all the complications I had been facing (I am a particularly healthy individual. Eat fairly healthy, have healthy habits. Never been to the hospital except to have pregnancy and delivery. But have been four times in the past two months for feelings of passing out, fast, and high heart rates. From out of no where very scary, feelings of extreme exhaustion, low energy, and tired quickly. Feeling dizzy with feeling off balance).

I forgot about the bright green BM of my son that had been ongoing and decided to tell his doctor. She said it could be an infection. I have had test on my heart from cardiology they ruled out everything cardio, test for vector like illness from my travel and ID ruled out those things like dengue fever. (I did not stress the BM at that time). And for the virus going around presently. All negative. I am feeling defeated. My job has started to suffer and I am a very hard worker. What type of infection causes bright green BM? And could this be the culprit of my all of the sudden odd symptoms?

Hello,

Welcome to icliniq.com.

I am very much concerned with all the problems you are facing. As both of you have the same problem and at the same time you are losing weight and also developing some vitamin deficiencies due to which you are feeling exhausted and having problems with your memory. You are also having some travel history. To me it looks like to be chronic giardiasis but needs to rule out other causes as well. I will like to suggest some tests and will advise some initial treatment. Hope that it will help with your and your baby's problem. If you still experience symptoms, please get back to me promptly. Try to use multivitamins and a lot of fluid intake. This you do not have to worry a lot, it all will settle with treatment. And I believe that all your symptoms are associated with these loose stools, which are leading to nutritional deficiencies. I will advise you to take multivitamins containing folic acid and vitamin B complex.

Hope this helps you. Feel free to ask if you have any further queries.

Thank you.

Investigations to be done

Recommended investigations include a complete blood count, electrolyte levels assessment, and a stool test for ova and cyst presence.

Probable diagnosis

A probable diagnosis could be giardiasis.

Treatment plan

The treatment plan involves taking a single dose of 2 grams of Tinidazole (Tindamax) for you, and a 50 mg single dose for your child.

Preventive measures

To prevent this condition, ensure the use of boiled water.

Regarding follow up

Get back to me with these lab workup.

Patient's Query

Hi doctor,

Thank you for the reply.

I wanted to follow up with you. As it has took some time to get all of these tests done. I was prescribed Flagyl 500 mg tid for seven days. Along with Levaquin 750 mg once daily for three days for campylobacter in my stool. I have been concerned about taking Levaquin due to the side effects. My stool has returned to green. I am still experiencing headaches, along with a feeling of being off balance. My child's stool test came back negative for giardiasis, as did mine. However, last week for the first time there was small clear balls in my stool along with small flat clear circular oval pieces. When I tried to compress this shape it did not. I figure food would change shape. After this bowel movement, I noticed increased blood flow to my extremities. As they were pale most of the time my fingers and eye lids. As I recall when my memory is good I get dark specks once a month lasting several days that are very small dots and squiggly pieces. My son also once a month lots of these specks I have also had a CT of my abdomen and pelvis I included it showed gallstones. Could this be something more than giardiasis? Could this be a parasitic worm from the specks once a month and clear circular pieces in stool? I appreciate your concern I am looking forward to returning to a normal routine hopefully.

I have remained calm and hopeful, but now it has been going on for four months. The dizziness has reduced but is still lingering, along with headaches and minor body aches. My stool is still green. I have included three pages that so you can see which laboratory tests were ordered. My 2-year-old son's doctor did not find anything in his stool and did not recommend any treatment. However, he did mention that he would follow the same treatment as mine. My son did have a TSH level of 5.4 and Hb level of 10.4. My TSH was high but has since returned to normal. I would appreciate your thoughts on this. If you zoom in on the pictures, you can see the specks. Our stool consistency is also soft. I have attached pictures of the stool, showing the transition from brown to green. The same applies to my son's stool. The lab results are also included for your reference. Thank you for your time.

Hello,

Welcome back to icliniq.com.

I reviewed your history and all the 20 files attached with it (attachment removed to protect the patient’s identity). All your tests came out to be normal and gall stones has no association with these symptoms. Still I believe that it is due to giardiasis which may be resistant to Flagyl (Metronidazole). But as the symptoms now persists for almost four months, I will recommend to do an endoscopy with duodenal biopsies and take a trial of Tinidazole as well and the above dose. As far as Levaquin (Levofloxacin) is concerned you should use it. It is safe medication.

I hope this has helped you.

Thank you.

Patient's Query

Hi doctor,

Thank you for the reply.

So, I wanted to get your opinion once again. My gastro doctor ordered an MRI, which came back negative, although I didn't physically see the results. My abdominal ultrasound also yielded negative results. When I mentioned the issue with the balls previously, my doctor prescribed Albendazole 400 mg, one dose now and another in two weeks. All my symptoms stopped a few hours after taking it, and my symptoms list was quite extensive. This surprised me. However, within a day or two, the symptoms returned, slightly worse, and then leveled back to their previous state. I informed my GI about this, but he declined extending the treatment, insisting it is related to anxiety. I am desperately seeking relief. I even tried raw goat milk, which led to multiple stools with abundant content.

At the end of week one, I experienced a similar symptom, akin to the third day of taking Albendazole, but it was milder. Subsequently, my headache and dizziness significantly reduced for a span of two weeks or more. However, I am still dealing with lingering light dizziness and a headache. My son's doctor stated he would treat him according to my treatment plan. However, when I mentioned it, he asked me if I was sure, as it seemed like a light dose for my complaints. He prescribed Albendazole 400 mg for my son, to be taken twice daily for five days, based on his weight. I picked up the prescription today, so he will start tomorrow, and I will observe any changes. A few weeks ago, my son and I passed some very peculiar pieces in our stool that I ended up washing off. After reporting the presence of worms in the stool to my doctor, he requested results from a worm identification test. I have attached the pictures I sent. One of them appears to have a tail, measuring 7 mm in width with a firm outer shell. The multiple identical pieces, resembling pulp and also firm, are 4 to 5 mm in length. I believe this should provide sufficient evidence for a longer course of medication to be prescribed. Have you encountered anything similar before? What are your thoughts?

Hi,

Welcome back to icliniq.com.

I am deeply concerned that both you and your child are still experiencing symptoms. It appears to be a tapeworm infestation. But, I would still recommend undergoing stool testing for worms and their eggs. Also, I suggest considering a course of Praziquantel (antihelminthic medication). You can inquire about this option with your GI (gastrointestinal) doctor. I am inclined towards the idea of performing an endoscopy with duodenal biopsies to fully address and resolve this prolonged issue. I hope I have addressed your questions. Please know that I am available at all times to provide assistance and guidance.

Thank you.

Patient's Query

Hi doctor,

Thank you again for your time; I greatly appreciate it.

My son's doctor will be referring him to an infectious disease specialist. His doctor mentioned that sometimes surgery and six months of medication might be necessary. He characterized it as a uncommon complicated infection. Having this information concerns me, especially given my doctor's uncertainty about the treatment approach for me as well. My GI doctor has not treated a patient with tapeworm before and is unsure about how to proceed. He asked me about the dose and duration of Albendazole treatment. Currently, I will be taking 400 mg daily for 21 days. If that does not work, he plans to use Praziquantel. Doctor, I would greatly appreciate your opinion on how Albendazole and Praziquantel should be dosed in my case, as I have been asked about the dose and duration. Your opinion would be greatly appreciated. I also want to express my gratitude, as your message has helped us be taken more seriously.

Hi,

Welcome back to icliniq.com.

Ideally, both of you should be evaluated by the same infectious disease specialist. This approach will facilitate diagnosis and subsequent treatment. The recommended dose of Albendazole is 400 mg twice daily for a duration of 7 to 30 days, depending on the response to the treatment and the extent of the infection. I would suggest a dose of 400 mg twice daily for 15 to 20 days. The dose of Praziquantel is 5 to10 mg per 2 pounds of body weight. Regarding these worm infestations, it is true that they are less common in developed countries. If you require further information, feel free to reach out to me at any time.

I hope this information will help you. Please revert in case of further queries.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Mian Shah Yousaf
Dr. Mian Shah Yousaf

Medical Gastroenterology

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