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Have diarrhea, watery and burning stools, stomach pain, gurgling in stomach. Family history of intestinal disorders. Help

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I have chronic daily episodes of explosive diarrhea. This has been happening for a few years now. Some days are worse than others. I do get constipated at times, maybe once a month, however it never lasts very long. The stools are extremely watery, and normally burn. My tummy often hurts, and I get strange bubbling and gurgling feelings mostly on the left-hand side of my lower intestine. Sometimes the episodes are so bad that I need to stay home from the office, as I run constantly to the bathroom all day. My family has a history of intestinal disorders, including IBS, colitis, and diverticulitis. I take mutli-vitamins every morning, along with bio-k to help replace the intestinal flora. I am also diabetic, type 2, although I am very thin and underweight. I was put on metformin about 2 years ago (500mg a day) as well as apo-methyldopa. Other than that, I take Omega 3 (1 daily), magnesium (daily), and vitamin D (weekly). I eat a lot of fruits and veggies, drink enormous amounts of water, and try to exercise regularly. I sleep terribly, and generally wake up with a headache every morning, along with explosive diarrhea. I am 35 years old, female. I am fed up of losing sleep over this. I know that metformin may cause stomach upset, however this issue has nothing to do with metformin as I have been experiencing this way before I began the medication for diabetes. I have tried fiber supplements, but they don't help. I have also had a number of allergy tests. I am NOT gluten intolerant, or lactose intolerant. I have an allergy to eggs, and nuts, which I avoid eating. The stools are always watery, like someone turned on the tap. The odor is sort of like burnt rubber at times. I have had stool samples evaluated for blood and parasites, everything came back negative. There have also been times where I could not control the bowel movement, and had accidents (luckily I have always been at home when this has happened). It's embarrassing, painful... and I am fed up.
Posted Sun, 2 Sep 2012 in Digestion and Bowels
Answered by Dr. Om Lakhani 31 minutes later

Thanks for writing in.

The kind of diarrhea you have mentioned is what is typical of small bowel type of diarrhea. Before I answer your question I would like to have the following information

1. Since how long have you been taking omega 3 ?
2. Is your diabetes under control ?
3. Have you lost any weight ?

Diabetes is often known to cause autonomic dysfunction that is it damages the nerves that control certain involuntary functions of the gastrointestinal tract. These often manifest as diarrhea , constipation, GI upset etc. Also sometimes because of abnormality of bowel movement there is sometimes excessive growth of intestinal flora which can cause symptoms of diarrhea and malabsorption. I would advise you the following tests (which would be done by a Gastroenterologist)

1. A upper GI endoscopy with biopsy of the duodenum - which would rule out other cause of malabsorption
2. A hydrogen breath test- which would diagnose the small intestinal bacterial overgrowth that I talked about.
3. An anorectal manometry (the accidents you talked about- sometimes loss of bowel control can be because of the explosive diarrhea, but sometimes diabetes can damage the nerves that control the bowel continence and hence we need to check for it)

Also I would advise you to stop Omega 3 fatty acid as it is known to cause diarrhea and foul smelling stools. If the above tests come to be normal then you can be prescribed anti-diarrheals which can reduce the diarrhea episodes.

Hope I have answered your query. If you have any further questions I will be happy to help

Dr. Om Lakhani
Above answer was peer-reviewed by
Follow-up: Have diarrhea, watery and burning stools, stomach pain, gurgling in stomach. Family history of intestinal disorders. Help 1 hour later
Hi Doctor,

I have been taking Omega 3 as part of my diet since I was a teenager. I have tried stopping it for a while, however it made no difference in my condition. I was diagnosed with type 2 diabetes 2 years ago. Since then, I have been on metformin and apo-methyldopa. I had many problems during my first year after being diagnosed in keeping it under control. I had many episodes of hypoglycemia. I had to take leave from work for a few months in order to help concentrate on getting everything under control. My weight tends to fluctuate between 103 and 110 pounds. My height is around 5 feet and 5.5 inches. I am underweight for my height, however it is almost impossible to keep any weight that I gain on me. Doing muscular exercises seems to help with some weight gain, however, it is not always possible to find the time to do them, as well as the fact that I am often tired and feel very run-down.
I have done the breath-test that you mentioned above, as it was suggested by a dietician that I was seeing during my leave from work. The results came back normal. The other tests mentioned, I have never done.
In the past 3 months, I have lost 8 pounds. I was 110 pounds during the month of May. When I weighed myself this week, I am back to 103 pounds. My diabetes is not yet totally under what I would call "control". I still have trouble with peaks and drops, and the dose of my medication has changed a few times. The one thing that I have found that seems to stabilize it is Alpha Lipoic Acid.
Thus far, the only remedy that I have found for the intestinal burning and pain is to take 2 drops of peppermint oil when I am really in a lot of pain. This also seems to help with the intestinal bloating and gas. However, I am not sure if it is good to take this often, so I only take the peppermint oil when I am really in a bind. Luckily, I have the option of working from home, therefore on bad days (which sometimes tend to be more often than not), I work at home so that I can be close to the bathroom.
I have phoned to make an appointment with a specialist (however, it will probably be months before I actually get to see him). I will take note of these tests that you have mentioned above and ask about them.
Other than that, is there anything else that I can try myself?
Answered by Dr. Om Lakhani 15 minutes later

Great to hear from you again.

We have ruled out Small intestinal bacterial overgrowth as you said you have got hydrogen breath test done.

Till you get an appointment with a specialist you could do the following:

1. Try changing the probiotic you are taking (Bio-k). Different probiotics preparations contain different bacteria in different concentration. You can try VSL#3 if it is available in your country.
2. Make a food and symptom diary. Sometimes writing a diary of what you did or ate on the bad days can point out some causative factor which you can avoid .
3. If a specialist appointment is going to take a while you can consult a GP and ask him to prescribe you anti-diarrheal agents in the mean time.

Hope this helps.

Dr. Om Lakhani
Above answer was peer-reviewed by
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