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Doctors' Answers to "Frequently Asked Questions" - Intestinal Problems

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Food Poisoning Concerns [posted 11/24/98]
Question:  Is it possible that I am more prone to attacks of food poisoning than my partner? I have had vomiting and diarrhea in Feb, two weeks ago and yesterday, while my partner who has more or less the same food had no symptoms! Are there and food types or behaviors that I should avoid? Is eating yogurt a way of preventing this illness?  

Answer:  Yes, it varies a lot from individual to individual depending on their own genetic factors. Avoid foods that have been insufficiently cooked or which have been sitting after cooking for any time. Prevention centers on avoiding bacteria in your food. Clean hands, clean surfaces and complete cooking. 

Stomach/Intestines [posted 8/11/98]
Question: My intestines make so much gurgling sounds that I can hardly sleep at night. This goes on day and night. I have had ultrasound for gall bladder, been tested for reflux, upper GI, and finally sent home with an appointment in 6 months. What should I do? Also, bowel movements are not normal as of approximately a month ago. I have lots of burping as well as discomfort in my throat and neck.

Answer: A few possibilities. First, most likely is that you will have this problem forever, and no treatment will be found to be helpful. Second, try a treatment for giardia (a fairly common intestinal once cell parasite). This would be Flagyl 250 mg tid for 10 days or so. Lastly, ensure that a HIDA scan of the gall bladder has been done (this is a functional test of the GB and can show an abnormality without stones being present).

Intestinal attacks
Question: Our 17-year-old son has had five attacks over the last four years. The source of the pain would indicate appendicitis, but when we take him to the emergency room, that is ruled out. After the last attack, we requested other tests. The intestinal area was X-rayed and the report was that there was a "fullness" in the cecum that could not be explained. So, our doctor ordered a cat scan. This was perfectly clear. Our doctor does not think it is necessary for us to see a specialist. What do you think? We are concerned about some chronic condition such as colitis. Would the clear cat scan rule out such a condition, or should we pursue this further? Our son's attacks do not seem to be related to the food he has eaten. They last about five-six hours, starting gradually, building up to severe pain, then subsiding. He has little or no fever, nor any other symptoms such as bleeding, diarrhea, or constipation. Other than these attacks, our son seems healthy but small for his age -- 5'6" and 125 lbs.

Answer: There are several possibilities. First, this may be a congenital problem which will take some special x-rays. Second, it could be colitis-a colonoscope is necessary to visualize the colon. Usually, there is some diarrhea or bloody stools with this diagnosis but not always. Third, it could be different colonic or intestinal parasites. Has his stool been checked and/or treated for parasites. Fourth, there is a familial problem called porphyria which manifests itself with spells of abdominal pain. A urine test during a spell for porphyrins will make this diagnosis. If your primary physician doesn't seem to have a plan to diagnose this problem, I'd see another physician-- preferably a pediatric GI(they will be aware of congenital problems that adult GI may over look.).

Intestinal Pressure
Question: Is it normal to have an intestinal build-up of pressure, after a meal, so great that you can not hold your bowl movement? I'm 33, male. I recently ate dinner, 30 min. later I felt the intestinal pressure, needing to make a bowl movement. Within 10 min. of feeling the first pressure pains, I could not stop myself. The worst part was that I was still driving in my car.

Answer: If it is a recurrent condition it needs to be evaluated. This represents rapid flow of partially digested food out of your stomach and through the small intestine. Since there is no time for absorption of the fluid/water it moves rapidly causing a large, poorly controlled BM. This will happen on an occasional basis-especially if you have trouble with dairy products, or got a small amount of food poisoning. However, any more than once every 6 months or so is usually abnormal and represents some trouble with your stomach and upper small intestine.

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