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Gastritis Acute

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Question: Just diagnosed with acute gastritis and ulcerative colitis. Is it normal not to have a bowel movement yet? I got severe bloody diarrhea last tues around 2:30 am until about 12pm on Wed. I was rushed to the hospital/admitted and put on fluids (sodium chloride and potassium) and later dextrose for Wed-Friday none stop.. Today is now Monday and I still havent had a bowel movement since Wed. I am getting concerned. I mete with my internist and gastrologist this Thurs as a followup so I definetly with let them know. I am also on 500mg of Flagyl 3 times a day and once a day of Levaquin 500mg once a day. Is this normal or should I be concerned that I havent went yet? Is it side effect from the meds or the potassium? I forgot to add that The doctor did perform a colonoscopy & a biopsy. I get results this week from the biopsy

Answer: Hi: I have to assume that the bloody diarrhea was either due to ulcerative colitis (UC), or due to an infectious colitis, such as due to enterohemorrhagic E. coli, shigellosis, ... In order to be diagnosed with ulcerative colitis, they would need to have at least performed a sigmoidoscopy (or colonoscopy) with biopsies for you in order to confirm the diagnosis. If you indeed have UC, then having not had a bowel movement in 5 days is potentially a serious problem and may due to development of toxic megacolon. In that case, you may also have abdominal distention, pain and fever. Toxic megacolon is a potentially life-threatening condition, but based on the information that you provided, it seems you only have constipation rather than anything serious. However, I feel obligated to mention it in the context of constipation after an acute onset of "ulcerative colitis." On the other hand, you may have had an infectious colitis from which you recovered and now you are eating less and are simply constipated. That you were prescribed Levaquin and Flagyl indicates that they are at least treating you for an infectious colitis rather than UC. I think there is no way around calling your gastroenterologist to discuss this, and if you have not yet seen him/her, then call your internist to address your concerns. All the best and I hope you'll get better soon.

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