‘Beaver fever’ fears
DEAR DR. ROACH: Last summer I went camping and ran out of clean water. I had to boil water and drink it without any treatment tablets.
That evening, I had painful cramps in my stomach, and in my upper abdomen, under my ribcage. Since then, my digestion has been horrific. I have constant rank gas and bloating when eating foods I’ve never had a problem with before, even fruits and vegetables.
I have been a big eater of probiotic foods, with no digestive disturbances. However, since this incident, any form of probiotic, whether from capsule or natural foods like sauerkraut or kimchi, gives me the worst gas and bloating I’ve ever had.
I had parasite and bacterial stool testing done with my doctor, and I came up clear. I feel like I need antibiotics or something to clear whatever is going on with my digestive system, but am hesitant because I have had four rounds of antibiotics in 2017 from surgeries.
I am worried about “beaver fever.” What do you recommend?
ANSWER: There are several infections one can get from drinking unprocessed water while camping. “Beaver fever” is a name for infection from the parasite Giardia lamblia, which is found in water where animals (especially beavers) are found.
It’s a reasonable thought — it’s one of the few waterborne infections that can persist for months. However, I think Giardia is unlikely. Symptoms from Giardia normally begin one to two weeks after exposure, and the parasites are killed very rapidly by boiling water.
Your symptoms are very much like irritable bowel syndrome, and I do wonder if it might have been triggered by some event that day you were camping.
Usually, three sets of cultures for parasites are done to make sure there isn’t an unwelcome guest in your intestine causing symptoms.
A gastroenterologist would be a good choice to help you track down an identifiable cause and to get some symptomatic relief. Antibiotics are not recommended without knowing what you are treating.
DEAR DR. ROACH: I am a 76-year-old female in good health who eats a sensible diet and exercises regularly.
Despite many years of experimenting with different medication (including hydralazine, candesartan and atenolol) for high blood pressure, my pressure remains high (today’s reading is 183/107).
I also am suffering with water retention and swollen legs and ankles, despite taking a diuretic. Please tell me about the connection between high blood pressure and water retention.
ANSWER: The most likely cause of swollen legs and ankles in you is probably the hydralazine, which works by opening up blood vessels. Swelling, also called edema, is a common side effect of hydralazine and other blood pressure medicines that work this way, especially the calcium channel blockers, like amlodipine.
However, there other potential causes. The first is that many people, especially older women, develop leaky veins due to the valves in the veins wearing out over time.
Many, if not most, older women will notice a little fluid in the ankles and feet at the end of the day, especially if sitting or standing for much of the day. This normally is a benign condition.
The blood pressure you noted today is very poorly controlled, and continued high numbers may damage the kidneys and heart.
Leg edema can be a sign of damage to these organs, and in addition to getting the blood pressure under better control promptly, your doctor may wish to consider looking for damage to the kidney (especially protein in the urine) or heart (with an echocardiogram).
Email to ToYourGoodHealth @med.cornell.edu.