My husband has had diarrhea for 5 years

he's had numerous "oscopy's" with no culprit found

he's 44 years old, has had full blown AIDS for 5 years,

he had a catheter when his weight got down to 124lbs, from

it's usual 170. His viral load is low now, but not undetectable(his T's are 30!). They removed the catheter 2 years ago and

he's been on numerous steroids but the diarrhea persisted

and now he's down to 130lbs. His face is hollowed, sunken

eyes, he looks sick. Recently, we've tried adding Metamucel

to the mix of Lonox, Sandostatin, Questran powder, Ultrase, acidophulous and Amodiam (he can't tolerate Opium Tensure) also a low dose of oxycontin seems

to help a little. NOTHING stops it and we're desperate

most days he's on the toilet all day long, I'm pulling my

hair out. What is a suitable dose of Metamucel? IS THERE ANYTHING ELSE WE CAN TRY OR DO YOU HAVE A SUGGESTED SCHEDULE FOR USING ALL OF THESE REMEDIES TOGETHER?

Please HELP!

Whew, this is a very tough problem. I will assume that his GI work-up has been thorough and indeed is negative (in other words has he had enough tests, recently, competently, etc.) Has he been checked for malabsorption? This is likely to be present. If so catheter feedings may be ineffective (i.e. he cannot absorb the nutrients); TPN may be the only therapy to help him get these nutrients that he needs. Certainly 5 years of severe diarrhea is a major stress to the body and leads to further immune problems and difficulty recovering from illness/injury (a vicious cycle).

If he goes on TPN he can put his bowel to complete rest (minimal or no oral feedings) and possibly have control (or at least some control) over the diarrhea. It is not within the bounds of this forum to make specific medical recommendations, so you need to discuss this with his MD.

Alvan Fisher, M.D.