I have a delicate problem

[netmiff]

well, the problem isn't delicate, but expressing it is ! There aren't enough to help me out here, so here goes. Since I came out of OHS almost 4 months ago, I have had Diarrhoea. Kind-of expected it at first, then thought it was stress (2007 was a eally bad year, and very hectic at the end) It has been better some days/weeks, but always there. I am 52 years old, wearing adult diapers all the time. This is where it gets less than delicate (if it was't before !) but I am not always making it to the toilet, and I live in a one-level 750 sq ft house - how far can I get from the bathroom ??

First thing I did was check with my pharmacist and there seems to be nothing on the list that would cause this; she suggested acidophillus, and I have been taking them for about 2 months now, does not seem to be helping any. Have had a stool work-up done, and there is "nothing abnormal".

Any suggestions/thoughts would be appreciated. I have been using Immodium and kao-pectate to no avail, and have an appointment with my family physician on Monday to figure out where to go from here.

Anyway, here's the list of meds I am on currently

MORNING
Effexor 225 mg
Ramipril 10 mg
Amlodipine 5 mg
Calcium 500 mg
Bisoprolol 10 mg
Acidophillus
Vitamin D 400 IU


EVENING (6PM)
Calcium 500 mg
Aspirin 81 mg
Warfarin Varies - currently 8.5mg daily
Multi-Vitamin
Acidophillus

Hope I put this thread in the right place ??

 

[Trinityheart8891]

hey,

2 ideas to bring to your doc. . .

1-there is an infection in the intestines that sometimes ppl can get when they are in the hospital, not sure what it's called, but it can be really bad, and cause diarrhea (reason #2 can contribute to this too)

2-antibiotics that they fed you during surgery/hospital stay could have knocked out some of the natural "good" bacteria in your gut, this could be causing your diarrhea, if so, probiotics might help, try a more natural form of acidophillus, like drinking kefir (liquid yogurt type product) this tends to work better than taking acidophillus in pill form

when I had my nissen fundo back in feb 06 it took me 3 months to get regular again, my GI tract didnt like being messed with (nissen fundo is an acid reflux procedure)

as always you should check with your doc s/he will know best

also, make sure to stay hydrated, having fluid/electrolyte balance issues can really negatively effect some valve patients!

hope this helps

Morgan, 21

 

[Nancy]

My husband suffered from many bouts of diarrhea very similar to what you described and with the same unfortunate difficulties. It's a really terrible and demeaning problem, but nothing you have done has caused this. Some of his were resolved, but others were not.

You really need to be seen by a gastro guy, and asap.

Here are some of the reasons my dear husband suffered from this debilitating problem:

1.) Intestinal infection with c-diff, or clostridium difficile contracted during one hospital stay.

http://en.wikipedia.org/wiki/Clostridium_difficile

This is a real booger of a problem to get rid of. I am going to be indelicate here too-- This particular diarrhea has a distinctive odor, very powerful and nasty. After many rounds of medication to try to get rid of it, only to have it return again and again, the gastro guy finally put Joe on a course of medication which coated his intestines. this interfered with the absorption of Coumadin, so that had to be watched carefully, but after a couple of months on this regimen, the infection finally resolved and didn't come back.

2.) Antibiotic caused diarrhea, we can all get this, and your gastro man will know how to treat that.

3.) Liver congestion problems from his ascites CHF. This did not go away readily.

Long standing diarrhea is nothing to be ashamed of and needs fast attention. Dehydration can cause terrible problems for you, and also your intestine is not designed to put up with long term irritation such as this. Much worse problems can happen, even hemorrhaging.

So-o-o Call your doctor asap, today if possible, and get in to see him. If he doesn't resolve the problem, get an appt. with a gastro man. If there is any bleeding or dark colored stools or it smells absolutely terrible go to the ER.

It is THAT important!

 

[Nancy]

Should have added that one gastro man did not like the use of Imodium for diarrhea, since it stops the movement of the intestine, and doesn't really solve any problems. That is for very short term diarrhea not long term like you are having.

Kao-pectate can cause your stool to look very dark, masking any bleeding that might be going on.

I think you need to stop trying to correct this yourself, it is beyond what over-the-counter can provide. You need specialized medical help and now.

Good luck with it!

 

[Bina]

Netmiff, what a bummer!
Seriously, you have gotten some good ideas here, and I will echo the intestinal infection possibility, parasites, or Crohn's. This reminds me of when my father's dog had chronic diarrhea..We first dismissed it as being a nervous German Shepherd malady, however when it continued, and very severely, we became concerned about her intestinal condition, possible dehydration and loss of electrolytes. She was put on Flagyl (metronidazole), this is a bactericidal which targets the intestines. Success.
She remains on a small daily dose during stressful times.(we were also told to avoid Immodium).
Best wishes and GO TO THE DOCTOR.

 

[netmiff]

thanks, everyone

thanks, everyone

While I know it's not my fault, it is still a bit embarrassing to admit the severity of the problem. I have been wondering about C. difficile ...I was on an antibiotic in the hospital..... and it does smell nasty. Nancy, if I may say so, you've scared the s**t out of me .

The work-up included looking for blood in the stool and bacterial, they were on separate test requisitions, I am not sure if the secretary realised this or not and maybe only read me the one, but I am seeing him Monday. Nancy, from the link you provided and a job as a bacteriology technician in a previous life, I am also wondering if checking for C difficile is included in the general bacteriological work-up that the doctor ordered. Will ask him Monday, unless I can get DH to call him tomorrow.


I only took and/or take immodium or kaopectate when I know I will be out of range of a toilet for a while, like the hour-and-a-half drive tomorrow to the ACT clinic appointment that I have. I know they are not good for you long-term,.

Bina - go wash your mouth out with soap RIGHT NOW !!! I do not have Crohn's, I can't, just can't, deal with anything else right now !!!!!

The only bleeding I have is external, from rubbing it raw, if you get my meaning!

 

[Nancy]

"Nancy, if I may say so, you've scared the s**t out of me .
"

I meant to make it very pointed! LOL

On Christmas Eve, my wonderful son-in-law started hemorrhaging from diverticulitis that he never knew he had. He just let it go thinking it would go away, it did not. He ended up in the hospital with severe anemia. While he was waiting for his units of blood, he Blue Coded, and ended up in ICU for several days. If this ever happens again to him, he will lose part or all of his colon.

I am not saying this is your problem, but your intestines are soft tissue and delicate. How much trauma and for long can they take it? No one knows.

Get some help for the problem, please.

Everyone hates to talk about these problems, but they are part of everyone's anatomy. Without intestines, where would we all be?

 

[netmiff]

I am going to the doctor, in fact had already been, it was he who ordered the tests; I just wanted to know if you guys had any thoughts - and I thank you for them. I don't feel any worse than usual, maybe a little tired, but, as I say, 2007 was one H**l of a year and I am off work for now until Jan 8th (I have a wonderful boss, myself lol), so I can fall asleep on the couch at 4pm. I think if I was working, I wouldn't do that - there is no couch in the store for one thing.

Still have my sense of humour, which can be a little dark at times, but that's just the way I am.

 

[ALCapshaw2]

I am going to the doctor, in fact had already been, it was he who ordered the tests.

You've had the 'runs' for 4 months now with no improvement?

How long has this Doc been on the case?

If the Doc you are seeing is Not a GastroEnterologist, then I think it's time you saw an 'expert'. It's time for the heavy artillery.

Just my 'opinion'.

'AL Capshaw'

 

[netmiff]

I had a visit with my ACT doctor yesterday (first time I'd seen him, although he said he visited me in ICU but I can't remember that !). He seems to think it may be the coumadin, says one in a thousand get this, and I am switching to another derivative, Sentrim. It is not covered on my benefit plan, so I will have to get him to write a letter explaining the situation etc., to get permission to get it covered.

Anyone have any thoughts on the change of drug? I have so far appreciated all your input, so don't hold back.

I also got a few other things cleared up..... and see my post in anti-coag for some potentially good news ...

I am still seeing family physician Monday, and am going to run (pun intended) it past him, too.

 

[halleyg]

I don't see why the dr. doesn't try and get the diarrhea under control before just taking you off the coumadin?

I had a similar problem after my OHS in Aug. I was having stomach "troubles" on and off. In Oct./Nov. after being on antiobiotics for ten days, I started having really bad diarrhea; it was all day, everyday, with really bad stomach pains. My primary care dr. sent me for an ultrasound of my abdominal area which didn't find anything that would cause the problem. Then she sent me to a GI dr. who thought it may be caused by the warfarin, but she never suggested taking me off. She also thought it could have been antibiotic-induced colitis. She put me on something called protonix, which I took for an entire month, also did some blood tests and stool tests. She also told me to try and take my warfarin on a full stomach, since it could possibly be the drug messing with my stomach lining.

Anyhow, I am feeling much better now, and I am still on warfarin. If any other problems arise I will definitely go back to the GI dr. since I am sure in that case she will want to do more testing. She eventually wants to do a colonoscopy since colitis runs in my family. But, like I said, I am "all better" now. If I were you I would make an appt. with a GI dr. before going off warfarin to see if your troubles might be managed while still on it, since it is an important drug. Just my 2 cents.

 

[netmiff]

I won't exactly be going off warfarin, just switching to a slightly different type of the same thing, but it is different enough that the problems that plague me now won't with the new drug. It will be some time before I can actually make the switch because of the cost and benefit-related issues, and I am seeing family physician Monday and will run the whole thing past him, anyway.

Thanks as always for the input.

 

[ALCapshaw2]

I won't exactly be going off warfarin, just switching to a slightly different type of the same thing, but it is different enough that the problems that plague me now won't with the new drug. It will be some time before I can actually make the switch because of the cost and benefit-related issues, and I am seeing family physician Monday and will run the whole thing past him, anyway.

Thanks as always for the input.

Netmiff -

You keep mentioning that you are going back to your FAMILY Doctor when you have a Serious GI problem.

I do not understand why you are not seeing a GI Specialist, i.e. a GastroEnterologist, to get to the root cause of this problem, if for no other reason than 2 heads are often better than 1, not to mention that a specialist is more likely to have more detailed knowledge of the problems and their cures.

'AL Capshaw'

 

[Blanche]

Netmiff:

I tryed to check out the drug "Sentrim" with my on-line pharmacy and could not find a listing. Is this something that is available in Canada and not in the United States? The corner pharmacist has no info on this drug either?????

I certainly do agree with the others who have urged you to take this up with a specialist, a gastro enterologist. I switched doctors years back because my doctor would not refer me to a gastro when I had terrible problems after a bout with food poisoning. I loved my family doc, but he just didn't provide the specialized services that I needed in my early 50s.

You need to find some relief for this problem. I believe your next step is seeing a specialist.

Kind regards,
Blanche

 

[netmiff]

Blanche, I mis-spelled it, sorry for confusion ! found this on wikipedia

"Acenocoumarol is an anticoagulant that functions as a vitamin K antagonist (like warfarin).

It is a derivative of coumarin and is marketed under the brand names Sintrom and Sinthrome®."​

Will get back to the rest of you later.

Jeanette

 

[dj/utvolsfan]

Have you by any chance had your gall bladder removed in recent years??

Post gall bladder, pre-OHS I had some issues with diahrrea. Post-OHS and post-lymphoma surgery, my 'issue' wasn't so subtle. Finally gathered up the nerve to go to gastro guy a couple of months ago and have been placed on a prescription med - Kalifate - and it is taking care of my problem. Turns out having the gall bladder removed can cause some people difficulty with bile, etc.

May have nothing to do with your problem, but I thought I would throw this one out there.

Good luck.

 

[Blanche]

Beware - Sinthrome

Beware - Sinthrome

Jeanette:

I am very concerned for you. I looked up Sinthrome on the net and suggest that you run a search yourself before you agree to thake this drug. Just enter the name Sinthrome and you will find many items, most from drug companies and medical orgainzations. THis drug has tons of precautions.

I am totally concerned because your doctor is prescribing a drug that is NOT a one size fits all, and it does require frequent INR testing. Also this drug has some tricky problems.

Today, my cardiologist told me that in the 25+years he has been in practice, neither he or a single one of the 15 partners he has have ever treated a patient who had intestinal problems because of an allergy to Coumadin/Warfarin.

Jeanette, I am so worried for you because your doctor wants to switch you to this really problematic drug because he thinks you may have an allergy. Yet, he has no, none, nada medical facts to support his suppositions. And, you are willing to "try" this without having first consulted an expert, a gastroenterologist, who deals with your problem every day. Here is one link for you. The paragraph that might interest you is the following:

"The anticoagulant effect of Acenocoumarol is measured in terms of the prothrombin time, which is the time taken for blood clotting to occur in a sample of blood to which calcium and a substance known as thromboplastin have been added. This time is expressed as the International Normalized Ratio (INR). YOUR DOCTOR WILL TAKE REGULAR BLOOD SAMPLES and ADJUST YOUR DOSE as necessary to make your INR fall into the range that has been shown to be effective at preventing blood clots in your particular condition."
http://www.netdoctor.co.uk/medicines/100002389.html

Kind regards,
Blanche