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Nausea, diarrhea and abdominal pains. HIV?

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I was a stay at home dad last year to newborn twins, but they just started daycare this fall. They both immediately got sick with a cold/flu, followed by wife and I as well, as we both returned to work (teaching). However, it's been over 3 weeks and I still have several symptoms that concern me: mainly, nausea (particularly worse in the mornings), diarrhea (comes and goes), fatigue and abdominal pains.

Last winter I had oral sex with a woman (both giving and receiving) but protected intercourse. I was tested for HIV approx. 6 weeks following that incident which came back negative. When doing research into my symptoms online, these flu-like appearances could be indicators of HIV. I took a test recently again, but it has not come back. I am concerned as it's been 3 weeks since the cold/flu hit me and I'm still having these issues. Should I be worried? What could this be?


Category: Family Physician-GP

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Category: Sexually Transmitted Diseases(STD)Specialist
Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

Hello,
Thank you for your query at DoctorSpring.com
I understand your concern.
I should not be worried about HIV in your case because you had protected intercourse. Studies claim that if condom is used properly, the incidence of STDs are below 1 %. The failure of 15-20 percent occurs only due to improper usage or tears.
Unprotected oral sex can lead to other STDs like Gonorrhoea or Herpes. But you didn't develop any rash or discharge following the exposure, and hence STDs are ruled out here.
The flu that you have been having needs to be treated. Once you take a proper antibiotic course, you will recover.
Did you take any medicine till now?
Where exactly is the abdominal pain? Focussed in the center or through out?
Do you drink alcohol?
Did your wife and children recover?
How is your appetite?
Do you have diarrhea everyday?
Once you answer these questions, i will be able to guide you better.
Regards.


Patient replied :

Thank you for your quick reply. To answer your questions:
1. Last week, I was having terrible pain in my jaw, so I was prescribed a muscle relaxant and a high-dose ibuprofen. I took those for about 3 days before stopping because the pain went away. Apart from that, I have not taken any other medication. I did, however, have the flu shot on Friday, but the diarrhea was from before the flu shot.
2. The abdominal pain is in the lower section, both sides and wraps around the back. It feels like a cramping, sometimes sharp pain, although mostly just a dull ache.
3. I drink alcohol, but only about 1 beer a week, not even that sometimes.
4. Yes, both of my children seemed to be recovered. My wife has a bit of a sore throat and recently had conjunctivities, but she does not display any of the symptoms I'm having.
5. My appetite has been strange: Sometimes I'm not hungry at all and the idea of food makes me sick, other times I'm famished. Oddly, when I eat, I still feel like I'm hungry, which never usually happens.
6. I have had diarrhea most every day. It starts off solid enough, but after the 2nd or 3rd trip to the bathroom, it becomes diarrhea. There's not much that comes out....and its usually clear in color.
Thank you for your help.


Expert:  Dr. Deepu Sebin Sebastian replied 3 Days.

Hello,
Thank you for your detailed reply.
So as i can make out from your history, you are suffering from gastroenteritis which has not been treated,and hence the symptoms have still persisted. The cramping abdominal pain is classical of stomach infection. I will also advise you a medicines for intestinal worms, because they can also cause similar symptoms. Please do not be worried about HIV from here on, because it is definitely not due to HIV. Kindly take the medicines for 3 days and if the symptoms still persists, we can run a few tests for you.
1) Tab. Ciprofloxacin 500 mg twice daily for 5 days after food.
2) Cap. Omeprazole 20 mg, once daily before breakfast for 10 days.
3) Tab. Lactobacillus twice daily for 5 days, after meals. ( Probiotics )
4) Syp. Sucralfate 2 teaspoons thrice daily after food.
5) Tab. Loperamide ( SOS to control diarrhea ).
6) Tab. Albendazole 400 mg one single dose, at bed time. ( for worms ).
You will need a prescription for ciplox, kindly get it from your local physician, because the infection definitely needs to be treated.
Get back to me with further updates,
Regards.


Patient replied :

Take all 6 that you listed? that seems like a lot.

What does tab, cap, and syp mean?


Expert:  Dr. Deepu Sebin Sebastian replied 2 Days.

Hello,
Sorry for not clarifying earlier.
Tab- Tablet. Cap- Capsule And syp - Syrup.
The last one albendazole is a one time dose, and in case the infection is due to worms, it will take care.
I have prescribed ciplox suspecting a bacterial infection. Capsule omeprazole and syrup sucralfate is for reducing the cramping abdominal pain. Lactobacillus is a probiotic supplement, it will help in better digestion. You can do without it if you feel like. And also loperamide is SOS, as i mentioned only required if there is persistent diarrhea. I will advise you to take ciprofloxacin,omeprazole and sucralfate. Albendazole is a one time dose and that is also required.
The only way to know if it is due to worms is to give your stool for examination. To avoid that complexity i advised albendazole. Because one time dose will kill all the worms and restrict them from multiplying for the next couple of months, if they are present.
Let me know if you have any further clarifications or queries,
Regards.


Dr. Deepu Sebin Sebastian
Category: Sexually Transmitted Diseases(STD)Specialist
Experience: 
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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