Severe Diarrhea: When to Seek Gastroenterology Care

Q: Severe Diarrhea: When to Seek Gastroenterology Care

Hello： If there is no improvement, you should first go to the emergency department. <br>Changhua Hospital cares about your health. <br>Dr. <br>Tsai An-shun.

Severe diarrhea?

Hello Doctor, I went to the Philippines for six days (from January 31 to February 4).
The first three days were normal, but around the fourth day, I traveled to an outer island where I had lunch consisting of local seafood.
I don't recall eating anything particularly stale.
Before going to the island, I drank an energy drink, and after arriving, I remember only eating grilled fish and grilled chicken.
On the way back, I had a can of Sprite.
That night at midnight, I started having diarrhea, with watery stools.
From the fourth to the fifth night, I went to the bathroom about 4 to 5 times.
Since then, I have lost my appetite and have difficulty swallowing food, which has continued until now.
My main symptoms include: diarrhea (averaging once every 1 to 1.5 hours), abdominal bloating and pain, and I have noticed that I have not passed gas at all.
Additionally, I had an episode of acute gastroenteritis around December to mid-January.
Today, I visited a clinic where the doctor told me that the food might not have been fresh and advised me to eat a bland diet for three days.
However, after eating three meals, I still haven't felt any improvement.
Could you please advise whether I need to see a specialist? It will be difficult to get an appointment due to the upcoming holidays, and I don't like to keep going to the emergency room.
I have been to the ER before, and I understand that doctors can't solve every problem.

Gaozhongsheng, 10~19 year old female. Ask Date: 2016/02/05

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: If there is no improvement, you should first go to the emergency department.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2016/02/05

More Info

Based on your description, it sounds like you are experiencing a significant gastrointestinal issue that may require further evaluation by a gastroenterologist. Your symptoms, which include frequent watery diarrhea, abdominal pain, bloating, and a loss of appetite, are concerning, especially given your recent travel and consumption of seafood.
Acute diarrhea can be caused by various factors, including infections (viral, bacterial, or parasitic), foodborne illnesses, or even stress. In your case, the timing of your symptoms following a meal of local seafood raises the possibility of a foodborne illness, particularly if the seafood was not fresh or properly cooked. The fact that you have not been able to pass gas (flatulence) is also noteworthy, as it may indicate a blockage or significant gastrointestinal distress.

Given that you have already seen a doctor who suggested a bland diet for three days without improvement, it may be time to seek specialized care. Gastroenterologists are trained to handle complex gastrointestinal issues and can perform diagnostic tests such as stool cultures, blood tests, or imaging studies to determine the underlying cause of your symptoms.
Here are some reasons why you should consider seeing a gastroenterologist:
1. Persistent Symptoms: Your diarrhea has been ongoing for several days, and you have not seen any improvement with dietary changes. Persistent diarrhea can lead to dehydration and electrolyte imbalances, which can be serious if not addressed.

2. Severe Abdominal Pain: The abdominal pain you are experiencing, especially if it is severe or worsening, warrants further investigation. It could be a sign of an underlying condition that needs to be treated.

3. Bloating and Inability to Pass Gas: The inability to pass gas can indicate a blockage or other serious gastrointestinal issue. This symptom, combined with your other symptoms, should be evaluated by a specialist.

4. History of Gastrointestinal Issues: Since you mentioned having had acute gastroenteritis in the past, there may be a pattern or underlying condition that needs to be addressed. A gastroenterologist can help identify any chronic issues that may be contributing to your current symptoms.

5. Travel History: Your recent travel to the Philippines and consumption of local seafood could expose you to different pathogens. A gastroenterologist can help identify if you have contracted a travel-related infection.

In the meantime, it is essential to stay hydrated, especially if you are experiencing diarrhea. Drink plenty of fluids, such as water, oral rehydration solutions, or clear broths, to prevent dehydration. Avoid dairy products, caffeine, and high-fat or spicy foods until your symptoms improve.

If your symptoms worsen or you develop additional symptoms such as fever, blood in your stool, or severe dehydration (e.g., dizziness, dry mouth, decreased urine output), seek medical attention immediately, as these could be signs of a more serious condition.

In summary, while your initial visit to a general practitioner was a good first step, the persistence and severity of your symptoms suggest that a consultation with a gastroenterologist is warranted. They can provide a more comprehensive evaluation and tailored treatment plan to address your gastrointestinal issues effectively.

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