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How is abdominal pain with bulky stools and diarrhea treated ?

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I am a 27 year old male that was very healthy. I worked out, ate very healthy (whole grains, lean chicken and vegetables, no fast food, etc). Ive had unusual digestive issues for the past 2 months and has lead to weight loss (from 157lbs to 135lbs from July 7 to August 27).

I have been drinking on and off in my 20s and for the past 18 months became a fan of beers, slowly became a heavy drinker. Whenever I went out I had 2-3 beers with a dinner and during the last month I would binge drink close to a 12 pack every 3 days or so. Since the sickness have had none.

Started w/ yellow diarrhea w/ upper abdominal & back pain for a week. Since then I have had 1-2 bms daily of heavy, soft, tan-colored stools w/ white mucus/fat and white/yellow bits that float. No blood

a week into this BM habit started getting symptoms in anal/rectal area: tense when seated and the anus feels closed off (cant expel gas, extreme bloat).

A month ago and was ordered CBC, Enzymes, Liver Function bloodwork and all came back normal. Prescribed meds ranitidine and bentyl. no change/worse.

Given Flagyl 250mg 3 times daily with 1 Align G.I. probiotic for 10 days

Stool Samples (Campylobacter, C. Diff, EIA, Shiga, E.Coli, Leukocyte Stain, Ova & Parasites, Salmonella & Shigella). All fine.

Sigmoidoscopy showed prominent superficial venous lakes & 1mm round erosions with a white center in rectum. doctor's impression: nonspecific proctitis. performed biopsy. Awaiting results

Flagyl helped, but symptoms returned afterwards w/ strained urination & shortness of breath. Anemia from Malabsorption?. Started eating gluten/lactose-free weeks ago, but now eat pureed meals & baby food to aid digestion and weight/nutrient gain. No change in stools, rectal pressure on and off.

No Vomiting, fever, or STDs

I want updated bloodwork w/ lipase/amylase liver function and b1,b6,b12 and iron, then ultrasound if numbers are off. Any other ideas or tests to consider?
Posted Fri, 27 Apr 2012 in Digestion and Bowels
Answered by Dr. Poorna Chandra K.S 10 hours later

Thanks for the query.

After going through the description provided by you, I feel that the upper abdominal pain with bulky stools and diarrhoea after prolonged and binge drinking brings up a possibility of Pancreatitis and Pancreatic Insufficiency.

The decrease in pancreatic enzymes can cause indigestion and bulky foul smelling greasy stools. Amylase and Lipase enzymes are elevated only in the acute phase and will be normal now.

It would be better to get Fecal Elastase and the Fecal Fat estimation done. A blood sugar profile will give information about the endocrine aspect of Pancreas.

When a person indulges in alcohol there is a high likelihood of practising other high risk behaviours.

Hence get a blood test for HIV serology and Stool Examination for Atypical Organisms.
Other intestinal diseases can also occur in this profile hence a Stool Routine Examination with respect to Pus cells and RBCs as well as the biopsy report will help.

Hope this answers your query. In case of any doubts, I am available for the follow ups.

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