Dr. Peter Bryant Rapsing Grutas
General Medicine
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
Hello doctor,
I am a 27-year-old female weighing about 120 lbs, 5 feet 5 inches. I am using plant-based diet for 9 years (take vitamin B12 supplement in addition to eating fortified soy milks and cereal). I am on oral birth control (Lutera) and take it for three months straight (skipping placebo week) to avoid periods (I have been on ortho tricyclen lo, switched to Lutera in 2018).
I work in an elementary school. I have been doing training since mid August, and the last three days we have had three separate phases of kids come in.
I ordered pizza two days ago (no cheese, veggies, garlic oil and marina dipping sauce) and have had two slices of pizza and one to two breadsticks for dinner on Wednesday and Tuesday night. Breakfast has been cereal with soy milk (normal), lunch with orange, mixed nuts, trail mix, carrots and healthy fruit smoothie for snack (normal foods) for me.
I felt perfectly fine last night, and was a little bloated from all the carbs, but did not feel sick. My partner also had pizza both nights, and is not sick. I woke up at 6 AM having to rush to the bathroom, had diarrhea that lasted five minutes (liquid, green). From 6 - 6:50 AM, I had to use the bathroom urgently at least four separate times, each with liquid stool that lasted 3-10 minutes. I also felt very naseous.
I called out sick from work at 7 AM. From 7 AM to 4 PM, I have had diarrhea at least six times, same as before in duration, color, and consistency. I have tried eating two ritz crackers a few hours apart, and some plain, unsalted unroasted almonds two hours ago, and have diarrhea 15 minutes to an hour after eating. I have no appetite, and have been sipping on drinking water. No vomiting, but I have been nauseous on and off all day.
My legs and arms started feeling sore and achy around 10 AM and still do, I might have had chills and a fever for a couple hours. It is hard to tell as I do not have a thermometer and get hot and cold easily normally (have hyperhidrosis).
Should I get a COVID-19 test before returning to work, or is this most likely just some stomach bug that I can wait and see how I feel. I am not exposed to anyone with COVID-19 that I am aware of. My partner works from home.
Hello,
Welcome to icliniq.com.
Do you have any other symptoms such as fever, cough, difficulty breathing, and body malaise? Have you been recently exposed with anyone who is confirmed COVID-19 positive for more than 15 minutes or at least one meter away from him? I will need your answers to provide appropriate medical advice.
Patient's Query
Thank you doctor,
I have not had any problems such as coughing, chest pain, or difficulty breathing. My arms and legs feel a bit sore achy, but I am guessing that is due to not eating much and possibly dehydration (I am drinking fluids, but probably should be drinking a lot more). I do not think I have had a fever, but I also do not have a thermometer to check.
My diarrhea stopped around 5 PM last night, and around 11 PM, I finally ate some noodle soup, plain boiled potato, and a few bites of a coconut-milk based mint no added sugar ice cream.
This morning I slept until 9 AM, and did not have any bowel movements. I have not ate anything today from 9 AM to 3:20 PM, as I have no appetite and have just been sleeping on and off and drinking my powerade. At first, I had a bowel movement, still really loose but not as bad as yesterday.
I did find out that my partner left the pizza out for over five hours before putting it away, so I am thinking it might just be mild food poisoning? I have always been more prone to food poisoning then him, even if we eat the same foods. No vomiting, just nauseous. I have had no exposure to anyone that I am aware of that is confirmed COVID-19 positive.
Hello,
Welcome back to icliniq.com.
I understand and thank you for these information. Based on your history and symptoms, what you are experiencing is least likely to be COVID-19. Most common symptoms of COVID-19 would be fever, dry cough, difficulty breathing, and tiredness. COVID-19 may manifest as diarrhea but this is less common and may be attributed to other factors other than COVID-19. You also mentioned that you have had no exposure to someone who is COVID-19 and that you are following medical protocols so this is least likely to be COVID-19 at this point.
Most likely, what you are experiencing is an acute gastroenteritis and most common symptoms of this is changes in bowel movement. This is usually self-limiting and resolves on its own. However, what you need to watch out for is dehydration that is why it is important that you replace your fluids by drinking water or ORS (oral rehydration solution). It is a good thing that the diarrhea has stopped already and you started trying to eat already. I would recommend that you follow a BRAT (bananas, rice, applesauce and toast) diet in the meantime while you are starting to get comfortable with eating. I would also recommend you increase your fiber intake and fluid intake up to two to three liters per day. Avoid non-clear liquids such as milk, juices, and sodas, because these can make the diarrhea worse because of high sugar content. If symptoms persist, worsen or new onset of symptoms such as fever, increasing abdominal pain severity, further consult is advised.
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General Medicine
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