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Could Gastritis Cause Diarrhoea With Excessive Mucus In Stool?

Posted on Tue, 24 Dec 2013

Question: I posted before and this is a follow up. My wife came down with a stomach bug. Basically lots of pressure, gas possibly slightly loose stool but for the most part solid. She had it for 2-3 weeks pretty steady then it seemed to taper off but took around a month for her to get back to normal. I came down with the same symptoms about 10 days after her first symptoms. The one thing we both noticed was lots of mucus when wiping. We even discussed it with each other. I called my gastro after 4 weeks of symptoms and she couldn't get me in so I went to the ER. They ran full bloodwork on me( liver, pancreas, kidney, etc... and a fecal occult stool. All was normal. Doctor thought I might possibly have something called giardia but said he would let my gastro confirm it? I finally saw gastro yesterday and explained the symptoms (mucus in water and on stool, intermittent loose stool, a clear very thin film on water and my hemorrhoid was flared up). She didn't seem alarmed at all and scheduled me for an endo/ colonoscopy to take a look but it isn't until january. I questioned that and she said if she was concerned at all I'd be in the next day for the procedures. I have had off and on gastritis for 10+ years with endoscopies and colonoscopy every 2-3 years with no findings other than mild gastritis. All biopsies always normal. She was so laid back about my symptoms and at the same time busy, I forgot to ask her what she was thinking it probably was and if gastritis could cause diarrhea when really flared up as I think it has several times in the past but I honestly don't remember for sure. I asked about the residue on water and she referred back to the mucus. She has always referred to my gastritis as "irritable bowel type" symptoms. I am treated for gastritis/GERD/ LPR because I never get heart burn just regurgitation with gastritis flare ups. I'm on PPI's but they've never worked that great. Whats your thoughts on my situation?

Answered by Dr. Dr. Prasad J (9 hours later)

Brief Answer: A routine stool test to be done... Detailed Answer: Hi, From what I understand, you been suffering with on and off abdominal pain/indigestion diagnosed as gastritis for more than 10 years. Proton pump inhibitor has not been helpful. And for the last 4 weeks, you have abdominal fullness/abdominal pressure, gassy with lots of mucous and water in stool. Incidentally your wife suffered the same complaints 10 days before your onset. It would be interesting to know what was your wife diagnosed with and how was she treated. Based on your symptoms, - fairly recent history and proximity between your complaints and your wife's problem, I would first rule out infective conditions before I think of irritable bowel as the culprit here. You mentioned fecal occult blood as negative. But did you have routine stool test? I would order routine stool test to look for ova and cyst to rule out common gut infections. Gastritis is not responsible for chronic loose stools. Therefore the current symptoms isn't related to the gastritis. If routine stool test is negative and if your abdominal pressure/pain is not severe, I wouldn't be very concerned. I would start you on probiotic (yoghurt or lactobacillus supplement) and prebiotic supplements (fibre rich fruits and vegetables) and a small dose of antimotility drug (like loperamide) for few days to see if you improve with it. Your local physician will know about the aforementioned drug. I would push for colonoscopy, if symptoms do not resolve with the above mentioned treatment. You might also consider visiting another gastroenterologist if your first doctor is unable to fix the scopy at an earlier date. In the mean time, I would also recommend that you follow a healthy lifestyle. Healthy life style includes: - Staying relaxed - Physical exercise - Restricting caffeine, smoking and alcohol (if any) - Low spicy food at regular intervals - Lastly good hydration. Hope this helps. Let me know if you need clarifications. Regards

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Dr. Prasad J (6 hours later)

I hevent had diareaha except for a couple times and this isn't the loose stool i'm referring to. maybe i'm not describing it correctly. I'm talking about basically solid stool, maybe a bit mucousy at times. 90% of the time the stool is solid, brown and though vary in size a bit, look pretty normal. I would have to say that I know when gastritis is flared up in the past I get a lot of stomach churning and maybe a few evacuations of very acidic diarrhea. My previous GI said that Gastritis can affect your entire system "from the hole at the top opening to the one at the bottom" when it's inflamed. The IBS reference to my symptoms isn't a new thing and she didn't even mention IBS during my consultation. I was explaining what not only one but probably 5 GI doctors have labeled my issues over the last 13 years. My wife took only imodium but for 7 days. She had the exact same onset of symptoms (initial few movements lots of mucus this soon resolved and was followed by continued gas and bloating with an often urge to go but honestly more not going than diarrhea type issues). The only thing she couldn't verify was seeing some residue on the surface of the water but she said she did see mucus strands off of her stool for up to 6 weeks. She said she didn't ever look at her BM until I asked her. I guess its a girl thing. Anyway, thats a better explanation. Your saying you would try to get scoped sooner? My last endoscopy was 2 years ago and my last colonoscopy was 4 years ago, Same GI. She looked at all my bloodworm, my old scopes during my last consult 2 days ago.

Answered by Dr. Dr. Prasad J (15 hours later)

Brief Answer: Less concerning now... Detailed Answer: Hi, If your stools are well formed (solid) and not watery/loose as I thought initially, it appears less concerning now. Now infective conditions of intestine wash away normal commensals from the gut. As the commensal slowly take its place, one could experience symptoms of indigestion/abdominal bloating and frequency. It either looks like the post infective symptoms that should resolve gradually or part of IBS symptoms now. Since you aren't suffering from loose stools in particular, I would go slow on scoping you now. Gastritis by definition is a condition of stomach. However the symptoms can be well spread to the entire gut - reflux of secretions up to the mouth, indigestion, abdominal bloating and some people also experience urgency / loose stools. And as this is a recurring condition which flares up in stressful situation, you need to treat this well. If your current PPI is not helping you, perhaps your doctors can change this to a better one. I recommend esomeprazole 40mg once daily tablets along with prokinetic (domperidone). In all, your symptoms appear less concerning now that you do not have loose stool. We can wait for colonoscopy. I would try regular probiotics which adds to the commensal flora along with regular fibre rich + low on calorie diet first. In addition to this plenty of water and physical exercise should make you feel better in a few weeks. Change of PPI as elaborated above is also entailed. Be stress free. I am sure you will be fine soon. Hope this helps. Let me know if you need clarifications. Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr. Prasad J (17 days later)

All my symptoms have pretty much gone. I was given some suppositories (anucort) and after 3 days on them my hemorrhoid stopped bothering me. My primary thinks I had giardia and perscribed a med but said that since I have gotten pretty much back to normal he reccomended staying of of the flagyl he prescribed. He did say that recovery from giardia can come and go as by now I have seen with my wife as she has intermitently passed mucus. My only question is I still notice that clear film on the water when I have a movment. It's hard to see but still there( some days more than others). I was told it was just mucus by my doctors and not to be concerned. My docs refered back to my bloodwork( full work up) and said everything checked out okay and to wait for my scope. My scope has been pushed back until the 17th of dec. Does this sound correct? Is that stuff mucus? how long does giardia take to pass?

Answered by Dr. Dr. Prasad J (8 hours later)

Brief Answer: Yes, the clear film is most likely the mucous... Detailed Answer: Hi, Yes, I concur with your doctor. Clear film is most likely the mucous layered on the stool. Like I said earlier, we see plenty of mucous during and after active inflammation (infection). I am happy that most of the symptoms are pretty much gone. You can follow your doctor's instructions. If stool mucous layers worsen, you can try requesting for an early colonscopy. Giaridiasis is not easy to diagnose. Since the symptoms mimic other medical entities including irritable bowel symptom, I wouldn't be very sure if you indeed have been infected with the parasite. That being said, I am extremely pleased most of your symptoms have pretty much gone. As far as how long giardiasis persist, about 90% this condition passes in 2-3 weeks with or without antibiotics. About 10% may have recurring/persisting symptoms. In short, follow up with your doctors for scopy. Add Pre and probiotics to your diet. Hope this helps. Let me know if you need clarifications. Regards

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Above answer was peer-reviewed by : Dr. Prasad