What is the effective treatment for my persisting chronic diarrhea?

Question

Hello doctor,

I have been experiencing chronic diarrhea for the past nine months. I contracted amoebiasis at that time, which was treated with Metronidazole. I have already completed the prescribed medicine. After a few days of taking Metronidazole, my diarrhea stopped, but on the eighth day, it came back. Even though I have already completed my 10-day treatment, I am still experiencing diarrhea. I underwent blood tests and stool tests again, and everything was clear. There were no signs of bacteria in my CBC (completed blood count) and stool tests. My stool test is showing nothing abnormal except for fat globules or undigested food particles. I have changed doctors three times. They prescribed me with other antibiotics such as Rifaximin, another doctor gave me Ciprofloxacin, and I was prescribed Metronidazole again. None of them have solved my diarrhea. So, I went to a gastroenterologist. My gastroenterologist required me to undergo a colonoscopy. The colonoscopy revealed nothing but proctitis, and it is not severe. The gastroenterologist gave me Ciprofloxacin for my proctitis, and I completed the medication. However, I still have diarrhea. My gastroenterologist urged me to have an ultrasound because she wants to see my pancreas. The ultrasound revealed a dilated biliary duct, but it is not clear if it is due to gallstones or a new growth. Then, she asked me to do a CT scan to determine the cause of the dilated biliary duct. In my CT scan, the bile duct shows normal. It is not dilated at all. So, everything appears normal, but I still have diarrhea. I do not think this is Irritable bowel syndrome because I am not experiencing pain. So, what could be wrong with me?

Kindly help.

Answer 1

Hello,

I appreciate that you have chosen icliniq.com for your medical needs.

I am here to give you the best care possible.

I have reviewed your attached reports (attachment removed to protect the patient’s identity). Please share your stool reports as well as baseline blood reports, including a complete blood profile. I also need a few more details regarding your stools:

What is the average frequency of stools you have in a 24-hour period?
Do you experience more stools during the daytime or at night?
Have you noticed any presence of blood or black-colored stools?
How frequently do you eat out?
Is there any family history of chronic diarrhea?

Looking forward to your response in order to help you.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

I have reviewed your blood report and stool analysis (attachment removed to protect the patient’s identity). You had a significant infection three months ago. Currently, this could be post-infectious IBS (irritable bowel syndrome). I suggest repeating your current stool analysis (detailed report) to assess the current stool status. In the meantime, consider adding probiotics to your diet. Rifaximin is a good medication option, and you can take it for two weeks. I suggest you take tablet Rifaximin 550 mg twice daily after breakfast and dinner. Consult your specialist doctor, discuss with them, and take the medicines with their consent. Ensure that your eating and drinking sources are clean, such as using boiled water and maintaining good hygiene while preparing home-cooked meals.

Hope I have solved your query. I will be happy to help you further.

Thank you.