Gastrointestinal Discomfort After Infectious Mononucleosis

Q: Gastrointestinal Discomfort After Infectious Mononucleosis

Hello： Based on the symptoms, there are signs of gastroenteritis. <br>It is advisable to follow a diet low in oil and dairy, and to keep it light. <br>If there is no improvement, you should consult a physician for a prescription for gastrointestinal medication. <br>Wishing you sa

Gastrointestinal discomfort?

Hello Doctor, I have recently been diagnosed with infectious mononucleosis and have been experiencing a continuous fever for almost three weeks.
The infectious disease specialist mentioned that there is no infection in the liver or other organs, but I feel very uncomfortable in my gastrointestinal tract, particularly concentrated in the area "to the left of the navel and lower left side," where I experience intermittent sharp and dull pains, although they don't last long.
My bowel movements have been unstable, sometimes normal and sometimes diarrhea, for nearly three weeks, and I have noticed an increase in burping, which is distinctly coming from the lower abdomen (this never happened before).
I am unsure if this discomfort is due to gastrointestinal inflammation or other symptoms (which could be why the fever has not resolved).
What kind of illness could these symptoms indicate? What tests should I undergo? Thank you for your assistance.

Huang, 20~29 year old female. Ask Date: 2014/12/08

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello: Based on the symptoms, there are signs of gastroenteritis.
It is advisable to follow a diet low in oil and dairy, and to keep it light.
If there is no improvement, you should consult a physician for a prescription for gastrointestinal medication.
Wishing you safety and health.
Dr.
Chen Qifeng, Gastroenterology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2014/12/08

More Info

Infectious mononucleosis, commonly caused by the Epstein-Barr virus (EBV), can lead to a variety of symptoms, including prolonged fever, fatigue, and lymphadenopathy. However, gastrointestinal discomfort is not uncommon and can manifest in several ways, particularly in the context of viral infections. Your symptoms of localized pain in the left lower abdomen, irregular bowel movements, and increased belching could be related to several factors.

Firstly, the abdominal pain you are experiencing, particularly on the left side, could be due to several reasons. In the context of infectious mononucleosis, the spleen may become enlarged (splenomegaly), which can cause discomfort in the left upper quadrant and potentially radiate to the left lower quadrant. Additionally, the inflammation associated with the viral infection can affect the gastrointestinal tract, leading to symptoms such as abdominal pain and changes in bowel habits.

The irregular bowel movements you describe—oscillating between normal and diarrhea—can also be attributed to gastrointestinal involvement during viral infections. Viral gastroenteritis is a possibility, but given your recent diagnosis of mononucleosis, it may be more related to the systemic effects of the viral infection. The gut can be particularly sensitive during such infections, leading to increased motility and changes in stool consistency.

Increased belching, especially if it feels like it is originating from the lower abdomen, may indicate increased gas production or altered gastrointestinal motility. This can be a result of dietary changes, stress, or the direct effects of the viral infection on the gut.
Given that your symptoms have persisted for three weeks, it is essential to monitor them closely. While the infectious disease specialist has ruled out liver and other organ infections, it may be worthwhile to consider further gastrointestinal evaluation. Here are some recommendations:
1. Follow-Up with a Gastroenterologist: Given your ongoing symptoms, a referral to a gastroenterologist may be beneficial. They can perform a thorough evaluation, which may include blood tests, imaging studies (like an abdominal ultrasound), or even endoscopic procedures if deemed necessary.

2. Stool Studies: Since you have experienced changes in bowel habits, stool studies can help rule out infections or other gastrointestinal issues. This can include tests for pathogens, including viruses, bacteria, and parasites.

3. Dietary Review: Keeping a food diary may help identify any dietary triggers that could be contributing to your gastrointestinal discomfort. Certain foods may exacerbate symptoms, particularly during a viral infection.

4. Symptomatic Treatment: Depending on your symptoms, medications such as antacids or anti-nausea medications may provide relief. However, it is crucial to consult with your healthcare provider before starting any new medications.

5. Hydration and Rest: Ensure you are staying well-hydrated, especially if you are experiencing diarrhea. Rest is also crucial for recovery from infectious mononucleosis.

6. Monitor Symptoms: Keep track of any changes in your symptoms, including the frequency and nature of your bowel movements, the intensity of your abdominal pain, and any new symptoms that may arise. This information will be valuable for your healthcare provider.

In conclusion, while gastrointestinal discomfort can be a common symptom following infectious mononucleosis, persistent or severe symptoms warrant further investigation. It is essential to maintain open communication with your healthcare providers and seek additional evaluations as needed to ensure a comprehensive approach to your health.

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