MedicalFilter: Long term systemic infection?

August 7, 2006 1:48 PM

How likely was it that I had a long term systemic infection? What can I do to make sure it doesn't return?

Some of this post will likely strike some people as TMI, just to warn you ahead of time.

...

Since the age of 8 or so, I've been pretty much continually constipated and extremely flatulent. It's been a very constant thing throughout my life, causing me to not feel like exercising, being careful about social engagements, high school was not much fun, etc. I'd take a poop every 4 to 7 days. Bringing this up with doctors, repeatedly, did nothing. They'd give me stool softeners, etc. on occasion but nothing lasted or worked exceptionally well. Usually they'd tell me that some people are like that. As well, in my early 20s I developed pretty bad lactose intolerance, whereas previously I'd enjoyed much dairy, if that's at all related.

Almost two months ago, I had surgery (partial thyroidectomy, left side, as talked about in other AskMe questions), and then a bad Staph infection that put me in the hospital for a while. Of course, this resulted in some strong dose antibiotics (kaflex (sp?), clindamycin), and that appears to have really altered my problems.

Dairy seems less of a problem, and I'm having daily (sometimes twice!) bowel movements. They are...hrm...easier to cleanup afterwards, as well. I'm less flatulent, generally feel better, and now am trying to diet to lose some of the weight I've carried around for so long (Weight Watchers, self-administered).

So...repeating the top questions: How likely was it that I had a long term systemic infection? What can I do to make sure it doesn't return?

And...is there a record of this occuring previously with others? I'd love to be an example of a solution for others with this problem. As far as I can tell on the internet, giving people antibiotics for such complaints falls onto the realm of accused quackery.

posted by Kickstart70 to health & fitness (10 comments total)

Maybe it's because you're no longer hyperthyroid (although one symptom hyperthyroidism is increased bowel movement frequency)?
posted by orthogonality at 1:58 PM on August 7, 2006

Regarding the thyroid surgery, all hormone levels were normal. The surgery was done to remove a swelled nodule that was interefering slightly with my swallowing, appeared in February and was not cancerous.
posted by Kickstart70 at 2:03 PM on August 7, 2006

Oh! The antibiotics may have killed the natutal biota in your intestinal tract.
posted by orthogonality at 2:11 PM on August 7, 2006

ortho: I suspect that has something to do with it, and clindamycin apparently often has this effect. But why then are things so much better now, and how did they get bad (and stay bad) when I was 8 or so?
posted by Kickstart70 at 2:14 PM on August 7, 2006

Antibiotics, as ortho says, kill natural bacteria that help you digest. Usually this leads to diarrhea. It's possible that your present state is as close to the runs as your body is able to get.
posted by drmarcj at 2:27 PM on August 7, 2006

how did they get bad (and stay bad) when I was 8 or so?

Is there a chance that at around that age you were put on strong antibiotics for another reason? That might have gotten things going.
posted by contessa at 2:29 PM on August 7, 2006

"as close to the runs as your body is able to get."

Oh, I've gotten those too, on very rare occasions; usually when I have dairy, once in a while for no apparent reason.

"Is there a chance that at around that age you were put on strong antibiotics for another reason?"

Somewhat unlikely...the only thing I can think of happening around that time was my brother breaking my collarbone by pushing me into a tire-rim based sprinkler. I rarely saw a doctor at all during my childhood.
posted by Kickstart70 at 2:42 PM on August 7, 2006

I'm surprised your doctors kept brushing this off. Your symptoms definitely could be due to Irritable Bowel syndrome, although the change after antibiotics goes against this. There are a few other things that could be related too, a good doctor should have investigated at least a bit further.

Whatever was happening, it's very likely that your gut microflora was off somehow and now it's better. Our understanding of what actually lives in there is still very limited and there are many reasons why it can get messed up. Have you ever tried eating probiotics (e.g. live yogurt) or the newer prebiotic products coming out? It sounds like you may not need them now but it would be interesting to know if it had any effect on your problem before.

I actually have irritable bowel syndrome and regularly eating yogurt is the one thing that keeps me, um, regular. The disorder upsets my gut which in turn upsets the microflora, regular yogurt intake seems to keep it in balance. The action of these products on the gut is also still poorly understood, it's probably not the cure-all once thought. For example, new evidence suggests that any changes to gut bacteria from ingesting probiotics is transient, so it doesn't fix things long term. However, if your problems return acidophilus capsules may be beneficial.

Antibiotic therapies for gut disorders are also poorly understood. This doesn't mean it's quackery though, more just that we don't yet understand enough about what's going wrong in many cases so it's difficult to predict how antibiotics will work or how to use them to best advantage. Also just because the bacteria balance is off doesn't mean that's causing the disease, it may be an effect of whatever was wrong in the first place. It is definitely plausible that a strong dose of the correct antibiotic given to the right person will have a beneficial effect (just as it often happens that antibiotics given to someone has no beneficial effect for one of many possible reasons). As an example, I work tangentially with Crohn's disease and it has been shown that the damaged parts of the bowel have messed up gut flora, if this could be wiped out efficiently there is potential to ameliorate the disease in those patients where the microflora is aggravating the symptoms.

So it is totally possible that something similar has happened to you. It's just a pity we can't go back and track what was wrong and how it got fixed. That would give all kinds of useful information.
posted by shelleycat at 4:02 PM on August 7, 2006

I would avoid many of the foods which caused you issue before this time. Quite possible they could bring back the effects, particularly dairy.
posted by BrodieShadeTree at 5:38 PM on August 7, 2006

Followup: After posting this, I started going more and more often, until I was getting a little concerned and went to the doctor and did a little research.

Clindamycin has a nasty habit of disrupting intestinal flora, occasionally ending up with what I had/have: pseudomembranous colitis because of the proliferation of a bacteria called Clostridium difficile. That can do some serious damage, meaning removal of the colon or death, if not treated, which is what's happening to me now (with a different antibiotic).

IOW, I hope this serves as a warning...one that my doctor never gave me.
posted by Kickstart70 at 7:17 PM on August 21, 2006