Soft Stool: Parasite Infection or Medication Side Effects?

Q: Soft Stool: Parasite Infection or Medication Side Effects?

Hello： Theoretically, for the toilet water in a public restroom to contain parasites, it would require that a person who had feces with parasites used the toilet just before. <br>Additionally, parasites cannot survive outside the human body for an extended period, so the likeliho

Parasitic infection

Hello Dr.
Lin, I experienced a mental health crisis in April 2021.
To avoid being forcibly taken to a hospital by my family, I hid in a public restroom at a temple.
During that time, I completely lost my rationality and felt excessively thirsty.
Believing I had an indestructible body, I used a paper cup to scoop water from the squat toilet (not from the clean water tank) and drank about two to three cups of it.
A few days later, I started taking antipsychotic medication, and since then, for over three years, I have noticed that my stools have been consistently soft, loose, wet, and unformed (almost resembling diarrhea), making it very difficult to clean myself.
Sometimes, I also experience fecal leakage after bowel movements.
I would like to ask the doctor whether the cause of my soft stools/mild diarrhea is a side effect of the psychiatric medication or if it could be due to the contaminated water I ingested three years ago, possibly leading to an intestinal infection from parasites or bacteria.
Currently, my symptoms are limited to mild diarrhea (I only have one bowel movement a day, and the timing is very regular), and I do not experience abdominal pain, mucus, or blood in my stools.
What is the likelihood of a parasitic infection in this case? Should I go to the hospital for a stool examination? Thank you very much, Dr.
Lin.

Miss Chen, 20~29 year old female. Ask Date: 2024/04/23

Dr. Lin Wufu reply Internal Medicine

Hello: Theoretically, for the toilet water in a public restroom to contain parasites, it would require that a person who had feces with parasites used the toilet just before.
Additionally, parasites cannot survive outside the human body for an extended period, so the likelihood of contracting parasites from a single instance of drinking toilet water is low.
Of course, it is advisable for you to visit a hospital for a stool examination to confirm your condition, and it is still most likely that the diarrhea is caused by medication.

Reply Date: 2024/04/23

More Info

Understanding the causes of soft stools can be complex, especially when considering both medication side effects and potential infections. Based on your description, there are two primary factors to consider: the psychiatric medication you have been taking and the incident involving the consumption of contaminated water.

Firstly, many psychiatric medications, particularly those used to treat conditions like schizophrenia or bipolar disorder, can have gastrointestinal side effects. Common side effects include constipation, diarrhea, and changes in stool consistency. Medications such as antipsychotics can affect the gut's motility, leading to softer stools or diarrhea in some individuals. If you have been on these medications for an extended period, it is possible that they are contributing to your ongoing symptoms. It would be beneficial to consult with your prescribing physician about your current medication regimen and any potential side effects you may be experiencing.

On the other hand, the incident where you ingested water from a public toilet raises concerns about possible infections. Drinking contaminated water can expose you to various pathogens, including bacteria, viruses, and parasites. While you mentioned that you have not experienced significant symptoms like abdominal pain, mucus, or blood in your stools, it is still possible to have a low-grade infection or a parasitic infestation that could lead to changes in stool consistency. Common parasites that can be contracted from contaminated water include Giardia lamblia and Entamoeba histolytica, which can cause gastrointestinal symptoms.

Given your history and the symptoms you are experiencing, it would be prudent to consider a stool examination. A stool test can help identify the presence of parasites, bacteria, or other pathogens that may be contributing to your symptoms. It is also essential to rule out any other gastrointestinal conditions, such as irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD), which could also lead to similar symptoms.

In summary, both the psychiatric medication and the potential for an infection from the contaminated water could be contributing to your soft stools. It is advisable to consult with a healthcare professional who can evaluate your symptoms in detail, review your medication, and recommend appropriate testing. This comprehensive approach will help determine the underlying cause of your symptoms and guide you toward effective treatment options. Remember, maintaining good hydration and a balanced diet can also support your gastrointestinal health during this time.

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