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A persistant problem

Dec 16, 2009

Dear Dr Bob,

I wrote to you on the 2nd Nov, with an embarassing problem... loose stools!

i followed your advise and saw a doctor, he prescribed me `smecta` over a 4 week period, the first few weeks , there was a big improvement and then things became just as bad again! I had a lad test done for parisites, infections and nothing showed up!

The only conclusion i can come to is that it must be related to my HIV virus. i hope there is still something i can do to improve the situation, for example if i start eating a cereal packed with fibre (All Bran), would this help? is there anything else i can do? other foods i should try?

i`d really appreciate your advise,


Response from Dr. Frascino


Smecta is aluminum and magnesium silicate plus monohydrated glucose. It has antidiarrheal properties and is used primarily for acute diarrhea.

What type of doctor did you see for this problem? If your HIV specialist hasn't been helpful, I'd suggest you see an HIV-knowledgeable gastroenterologist. I would not assume your problem is related only to HIV at this time. Additional evaluation (stool specimens, etc.) is warranted. There are also a variety of other medications for symptomatic relief of loose stools. Don't try to control this chronic problem only with diet. Additional workup is warranted.

Good luck.

Dr. Bob

Loose stools, not on meds! Nov 2, 2009

Dear Doctor Frascino,

I was infected with HIV in December `08 and diagnosed in March `09. I currently have CD4 of 729, and a VL which has dropped form over 10,000 to 1,400. According to `resistance tests` , i have a virus which is resistant to most meds. but i`m not at a stage where i need meds yet.

My question is , for several months now i have had loose stools, things don`t seem to be as regular as they were before! I don`t have a fantastic diet, however i have n`t changed anything!

Could this be related to my HIV? or some other type of infection? or a cancer ?? i feel embarassed to visit the doctor, but i have made an appointment with one (not the one that treats my HIV). I would prefer not to tell this Doctor about my status. Are they`re any foods or medicine that could help improve the situation? I live in Europe!


Response from Dr. Frascino


That you have contracted a virus that is "resistant to most meds" should be a warning and wakeup call to everyone reading this forum. It is indeed possible to contract a strain of virus that is already resistant to one or even many HIV medications, making treatment much more difficult.

I cannot diagnose the cause of your loose stools over the Internet. Could it be related to HIV? Yes, it's possible. Could it be some other type of infection or condition? Yes, that's possible as well and most likely is the case. Is it cancer? No, that would be highly unlikely.

I'd suggest you have your HIV physician evaluate this problem for you. He could check for both HIV-related as well as the more routine underlying conditions. However, if you do wind up seeing another physician, I'd recommend you disclose your HIV status. It will help him in the evaluation.

Treatment of your condition will depend on the underlying cause of your symptoms.

Dr. Bob

Dr. Bob ,, Please look at this today so I can make a decision.
Hiv risk from unprotected oral sex with an African Female Sex Worker

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