Diarrhea and Abdominal Pain: When to Seek Medical Help

Diarrhea and abdominal pain for several consecutive days?

Hello Dr.
Chen: My husband is 44 years old and has been experiencing abdominal pain (on the right side of the navel) and diarrhea (watery, yellowish...
sometimes with black stools) for four consecutive days.
He has taken gastrointestinal medication (has not seen a Western doctor yet, self-medicated) and consulted a Chinese medicine doctor, who said his gastrointestinal system is fine, but there has been no improvement after taking Chinese medicine.
Additionally, due to his abdominal pain and diarrhea, I have been cooking congee (with salt) for his lunch and dinner, along with some pickled vegetables and fish floss.
However, he insists on having breakfast from outside breakfast shops.
Will this affect his condition? Furthermore, 1.
If he needs to see a Western doctor, which specialty should he consult? 2.
What dietary habits should he pay attention to during this period? 3.
He has a history of frequent bloating and a habit of having several bowel movements a day; could this be a sign of chronic gastrointestinal disease?

Da Tou, 40~49 year old female. Ask Date: 2004/08/25

Dr. Chen Zhiping reply Gastroenterology and Hepatology

Hello,
1.
You can consult a gastroenterologist, general internist, or family medicine physician.

2.
Avoid irritants such as spicy foods, alcohol, greasy foods, and dairy products (milk, cheese), and gradually return to a normal diet as you recover.

3.
If this has been a long-term issue without discomfort, and you frequently experience diarrhea, constipation, or abdominal pain, it may simply indicate a functional difference in your gastrointestinal tract rather than a specific disease.
However, if you have discomfort or are concerned about potential gastrointestinal issues, especially with a family history of colorectal cancer or polyps, you should see a gastroenterologist for evaluation.

Best regards,
Dr.
Chen Chi-Ping

Reply Date: 2004/08/25

More Info

When it comes to understanding diarrhea and abdominal pain, especially in the context of your husband's recent symptoms, it's crucial to approach the situation with a clear plan for medical evaluation and dietary management. Given that he has been experiencing abdominal pain on the right side of his belly button and diarrhea for four consecutive days, it is essential to consider both the potential underlying causes and the appropriate steps to take.

When to Seek Medical Help
1. Duration and Severity of Symptoms: Since your husband has had persistent abdominal pain and diarrhea for four days, it is advisable to seek medical attention. Symptoms that last more than a couple of days, especially when accompanied by severe pain, fever, or the presence of blood in the stool (as indicated by the "black" stools), warrant a visit to a healthcare provider.

2. Potential Complications: Diarrhea can lead to dehydration, especially if it is severe or prolonged. Signs of dehydration include dry mouth, decreased urine output, dizziness, and fatigue. If your husband experiences any of these symptoms, it is critical to seek medical help immediately.

3. Underlying Conditions: Given that he has a history of abdominal discomfort and frequent bowel movements, it is possible that he may have an underlying gastrointestinal condition, such as irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD). A healthcare provider can help determine whether further investigation is necessary.

Which Specialist to See
If you decide to consult a Western medicine practitioner, the most appropriate specialist would be a gastroenterologist. This type of doctor specializes in diagnosing and treating conditions related to the digestive system. They can perform necessary tests, such as blood tests, stool tests, or imaging studies, to identify the cause of his symptoms.

Dietary Considerations
During this period of gastrointestinal distress, dietary management is crucial:
1. Bland Diet: It is advisable to stick to a bland diet that is easy on the stomach. Foods such as plain rice, bananas, applesauce, and toast (often referred to as the BRAT diet) can be beneficial.

2. Hydration: Ensure that he stays well-hydrated. Clear fluids, such as water, broth, and electrolyte solutions, are essential, especially if he is experiencing diarrhea.

3. Avoid Irritants: It would be wise to avoid spicy foods, fatty foods, caffeine, and alcohol, as these can exacerbate gastrointestinal symptoms.

4. Monitor Food Choices: While cooking rice porridge is a good idea, eating from outside (like breakfast from a breakfast shop) may introduce irritants or bacteria that could worsen his condition. It is best to prepare meals at home until his symptoms improve.

Chronic Gastrointestinal Symptoms
Regarding your husband's history of bloating and frequent bowel movements, these could indeed be signs of a chronic gastrointestinal issue. Conditions like IBS can manifest with symptoms such as abdominal pain, bloating, and altered bowel habits. It is essential to discuss these symptoms with a gastroenterologist, who can provide a comprehensive evaluation and recommend appropriate management strategies.

Conclusion
In summary, your husband's ongoing abdominal pain and diarrhea should prompt a visit to a gastroenterologist for a thorough evaluation. Dietary modifications can help manage his symptoms in the meantime, and it is crucial to monitor for any signs of dehydration or worsening symptoms. Early intervention can lead to better outcomes, so do not hesitate to seek medical advice.

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