Question: I am a 74 year old male, in generally good health. I take simvastatin, citalopram, ranitidine, Lisinopril, fluticasone and a low dose aspirin every day. I had a bout of upset stomach for about two weeks in January after eating perhaps bad food from the refrigerator (cheese and lettuce, and chili). I went through stool sample test which were negative. A gastroenterologist suggested Omeprazole, but that did not help and was discontinued after two weeks. I have been using a rather bland diet since then, but some foods result in grumbling and gas much more than is usual. I had a CT scan of the stomach and pelvic area on March 28th. Results were negative except for a "moderate amount of retained fecal material throughout the colon." Specifically I have had no trouble with oranges, orange juice, turkey, chicken, eggs, wheat, noncaffeinated tea, milk and other dairy products. I did have trouble with strawberries and lettuce this past week.

I have an appointment with a nutrionist on May 4th. However, I am wondering about some things I read on the internet, such as dysbiosis, unbalanced bacteria, etc. I also had suggestions that I simply try a laxative and "start over." I would appreciate any suggestions.

Hello Dr. Kini,

Thanks for your review of my condition and suggestions. If I may say, your diagnosis matched my own, but our local gastroenterology doctors lean toward surgery-colonoscopy, endoscopy, etc., and so it has taken a long time (in my view) to get back to the basics.

I would like to ask some questions on this subject.
1) Is there a better stool test than the one I took-I think there were 9 categories in the one I took? Should I undergo another/better stool test
2) Are there any other tests such as breath or urine that I could have taken to diagnose the problem?
3) Why do you think an infection was not suggested in the first place? And would an antibiotic have helped solve the problem?
4) How much Miralax should I try-once a day, several days?

Regarding probiotics, are they intended to restore bacterial balance? Is there some information online that you would suggest for me to read before proceeding with that type of "solution?"

Thanks very much.

Hello Dr.,

Thanks again for your reply.

I have uploaded two versions of the stool tests as you requested.

I am a little hesitant to start the laxative treatment until I know what to do about probiotics. I read through the articles on the subject on WebMD. However, it seems that there are all sorts of claims and little definitive information about probiotics to guide me in trying to restore my stomach to normalcy. For instance, it seems from the WebMD articles that some probiotics are aimed at rebalancing problems with lactose intolerance. Then there are a great number of products listed on XXXXXXX whose descriptions are so general that they mean little to me.

Thus I would think knowing what food types seem to cause me trouble might be necessary in selecting the "appropriate" type of probiotic. Am I right about this? Or should I consider a "general" probiotic? The gastroenterologist/surgeon who has been overseeing my case did mention VSL3, but he mentioned that product or brand as simply one that some of patients there use.

Thanks.

Hello, I am sorry for the problem with the upload. The only way I saw to upload was to use the upload button on this page. It seemed to work. I sent two versions-wordperfect and word, hoping that one of them would work for you.

I'll try it again shortly.
Two reports have been sent again-I hope that they get through alright.

Having a bad day, with gas and grumbling all day. The problem was probably ground chicken from the refrigerator. I think I will check the refrigerator temp.
Re: the stool test results, let me try pasting them here.

No, for some reason, that did not work.