Medications can cause diarrhea
DEAR DR. GOTT: I'm an elderly lady with heart trouble. I developed H. pylori about six years ago and have been hospitalized twice for it, as I became weak from not being able to eat much. I still have diarrhea every morning. Please let me know any information on this sickness.
Also, my heart medications are potassium and torsemide. Lately, my feet and ankles are swelling more than usual, and my physician's assistant wants me to double the torsemide. Would this injure my kidneys? How long is it safe to take? I usually take half a tab, but I would then be taking one whole pill. Is there a way to swallow my larger pills more easily?
DEAR READER: Let's start at the beginning. H. pylori is a bacterium that infects the beginning of the small intestine or stomach. This bacterium is said to be present in 50 percent of all people worldwide. There are instances when H. pylori is present but there are no symptoms, and a person is completely unaware he or she has it. When symptoms are present, they include weight loss, nausea, vomiting, a burning sensation in the abdomen and more.
H. pylori enters the body through the mouth and passes into the digestive system. In developed countries, infection in children is unusual, but it becomes more common during adulthood. Complications can include inflammation of the stomach lining, certain types of stomach cancer and ulcers in the stomach and small intestines.
There are several tests available for analysis, such as blood and stool testing, breath testing and endoscopy. The latter utilizes a flexible tube with a camera attached that allows a doctor to look for irregularities in the digestive tract and to take biopsies.
Treatment might include medication to reduce stomach acid, H2 blockers such as ranitidine, cimetidine, antibiotics and several others.
Finally, to answer your question, there is no direct connection between H. pylori and the side effect of diarrhea. That said, the bacterium could cause gastritis - inflammation of the stomach lining. Gastritis can be tied in with diarrhea, but I haven't found a reputable source that lists it as a common symptom.
Torsemide is a diuretic (water pill) that makes the heart's job easier. Its purpose is to increase urine output. It causes large amounts of potassium to be excreted from the body and is why you have been prescribed potassium. Side effects include headache, stomach upset, blurred vision, loss of appetite, dehydration, dry mouth, heart arrhythmias and constipation or diarrhea. Some of the symptoms are unusual and don't affect everyone; however, I believe you may have the answer here. Speak with your physician to determine whether he or she can switch you to another diuretic or potassium pill or modify the dosage of your current meds.
This medication can lead to water and mineral depletion, so you should take it as your physician directs for as long as necessary. I am unaware of any issues with long-term use. Your doctor is attempting to reduce the swelling in your feet and ankles; however, I would hate to have your diarrhea become so disruptive as to prevent you from leaving home or causing you to lose control over evacuations.
Pills too large to swallow can be crushed inside a plastic bag before swallowing or taken immersed in a teaspoon of applesauce.
To provide related information, I am sending you a copy of my Health Report "Constipation and Diarrhea." Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.
Dr. Peter H. Gott is a retired physician and the author of several books, including "Live Longer, Live Better," "Dr. Gott's No Flour, No Sugar Diet" and "Dr. Gott's No Flour, No Sugar Cookbook," which are available at most bookstores or online. His website is www.AskDrGottMD.com.