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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Jun 26, 2002

You are probably as tired of hearing about diarrhea as I am having it. It has gotten so bad I need to know the washrooms enroute to work. I have not had solid stool in over a year now. I am bloated with explosive liquid diarrhea like a tap running water. Barely any warning. My meds were Zerit, Ziagen, Viramune, Paxil and Wellbutrin. Thinking it was the Zerit we recently switched to Videx EC once a day. It is worse than ever and even with Lomitil 12 tabs daily I can't leave the toilet far behind. I am told I must have an extra sensitive bowel. As soon as I eat anything I empty out. I have tried Prodium, Metamucil, calcium and Immodium to no avail. What would you recommend. Is there a good med combination that is less attacking on one's GI system? I have had numerous stool samples done and all are negative. I have been off work due to a hip replacement at age 48 from avascular necrosis and due to return next month. I do not see how I can return if I cannot leave the toilet behind. Any suggestion would be greatly appreciated. Thanks for taking time in regards to this question.

Response from Dr. Boyle

That is truly an awful problem. I am not sure, however, that it is necessarily related to your medications. You might need a thorough work up for diarrhea, including a complete endocrine and gastrointestinal evaluation, with a colonoscopy. If you haven't seen one already, you should get a referral to a gastroenterologist. It sounds like you have tried the usual anti-diarrheals. You might consider trying the addition of a pancreatic enzyme supplement (e.g., Pancrease) or tincture of opium, which have provided some relief to some of my patients.

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