Digestive Issues: When to Seek Medical Help - Gastroenterology and Hepatology

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Bowel-related issues?


Hello Doctor: Approximately two weeks ago (around the 16th), I started experiencing diarrhea.
I am currently taking medication prescribed by the hospital (around the third day of treatment).
I tend to be anxious and nervous (as I have cared for my father with cancer and am worried I might have similar issues).


1.
Previously, I had one bowel movement a day; now, I have two (consistently).
Most of the time, the stools are soft or loose (a large mass), alternating with normal stools.
In the past two days, the consistency has returned to a firmer texture, but the situation remains variable.
The color appears to be from light yellow to brown.
Bowel movements occur with minimal effort.
I do not see any blood or related colors upon visual inspection.
Occasionally, I notice what seems to be grayish-black particles in the stool.
2.
I have visited a clinic (received a three-day medication; the doctor suggested it might be norovirus) and a hospital (prescribed a 14-day medication regimen including Famotidine 20mg and Mebeverine 135mg).
I am currently on the third day of medication.


I have not experienced dizziness, nausea, or vomiting (these symptoms were present in the first three days but have not recurred since the 27th).
I have had mild fever-like sensations (not measured; my cheeks and breath feel warm intermittently).
My weight has not decreased, and I have noticeable bowel sounds (especially when hungry, but they are quite loud; otherwise, they are infrequent).
There is no cramping or unusual symptoms, and I do not exhibit signs of anemia (I have observed my eyelids, and they appear normal).
I have experienced minimal bloating (only one day of noticeable bloating).

I do not consume sugary drinks.
My intake mainly consists of water and coffee (alternating between these two).
I eat fruits and vegetables daily, but the quantity may be insufficient.
I rarely eat barbecued or fried foods (the last time was nearly a month ago).

I generally exercise 3-4 days a week, including step-ups, crunches, and squats (multiple sets for about 10-15 minutes).

I am currently unemployed and spend long hours sitting.
I do not smoke or drink alcohol and usually go to bed around 11 PM to midnight.

1.
Given this situation, is it severe?
2.
If I experience any other symptoms or if this persists for how long, should I seek medical attention again?
3.
I am unsure if this is primarily caused by mental stress or if it is more related to an underlying illness.
4.
Should I consider seeing a psychiatrist? (I briefly consulted a doctor before October last year, who diagnosed me with panic and anxiety; I have since discontinued medication on my own.)
5.
Should I just monitor my condition? Could this be a side effect of the medication? Although the doctor mentioned that the likelihood of severe illness at my age is low, I am still very concerned.

Mr. Chen, 20~29 year old female. Ask Date: 2023/01/27

Dr. Cai Jinji reply Gastroenterology and Hepatology


Hello Mr.
Chen: I am unsure of your definition of critical illness.
I recommend seeking medical attention for a physician to assess whether further examinations are necessary to identify any issues.
If you are experiencing anxiety and nervousness, it may be advisable to consult a psychiatrist.
Nantou Hospital cares about you.
Director Cai Jin-ji, Department of Hepatobiliary and Gastroenterology, Nantou Hospital.

Reply Date: 2023/01/27

More Info


When it comes to digestive issues, understanding when to seek medical help is crucial for ensuring your health and well-being. Based on the symptoms you've described, it seems that you have been experiencing diarrhea for about two weeks, with changes in stool consistency and some accompanying symptoms. Here’s a breakdown of your situation and guidance on what to consider moving forward.


Current Symptoms and Medical History
1. Diarrhea: You mentioned that your bowel movements have increased from once a day to twice a day, with a mix of soft and normal stools. The presence of gray-black particles in your stool could be concerning, as it may indicate undigested food or other issues.


2. Medication: You are currently taking Famotidine and Mebeverine, which are typically used to manage stomach acid and gastrointestinal spasms, respectively. It’s important to monitor how these medications affect your symptoms.

3. Other Symptoms: You reported feeling dizzy and nauseous initially, but these symptoms have since resolved. The occasional low-grade fever and the sensation of heat in your face could be signs of an underlying infection or inflammation.

4. Diet and Lifestyle: Your diet appears to be lacking in variety, particularly in fiber, which can affect bowel health. Regular exercise is beneficial, but it’s also important to ensure that your diet supports your digestive system.


When to Seek Medical Help
1. Persistent Symptoms: If your diarrhea continues for more than a few days without improvement, or if you experience severe abdominal pain, high fever, or blood in your stool, you should seek medical attention immediately. These could be signs of a more serious condition, such as an infection or inflammatory bowel disease.

2. Dehydration: Monitor for signs of dehydration, such as excessive thirst, dry mouth, reduced urine output, or dizziness. If you experience these symptoms, it’s important to seek medical help.

3. Mental Health Considerations: Given your history of anxiety and panic attacks, it’s possible that stress could be contributing to your digestive issues. If you notice that your symptoms worsen during periods of increased anxiety or if you feel overwhelmed, it may be beneficial to consult a mental health professional.

4. Follow-Up with Your Doctor: Since you have already seen a doctor and are on medication, it’s advisable to follow up if your symptoms do not improve within the next few days. Your healthcare provider may want to reassess your condition, possibly conduct further tests, or adjust your medication.


Additional Considerations
- Dietary Adjustments: Consider incorporating more fiber-rich foods into your diet, such as fruits, vegetables, and whole grains. Staying hydrated is also essential, so ensure you are drinking enough fluids, especially water.

- Stress Management: Engage in stress-reducing activities such as mindfulness, yoga, or gentle exercise. These can help alleviate anxiety and may positively impact your digestive health.

- Monitoring Symptoms: Keep a diary of your symptoms, noting any changes in bowel habits, diet, and stress levels. This information can be valuable for your healthcare provider in determining the best course of action.


Conclusion
While your symptoms may not indicate a severe condition at this moment, it’s important to remain vigilant. If you notice any worsening of your symptoms or new symptoms arise, do not hesitate to seek medical attention. Your health is paramount, and addressing both physical and mental health concerns is essential for your overall well-being.

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