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What Causes Foul Smelling Diarrhea And Abdominal Bloating?

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Posted on Tue, 14 Feb 2017
Question: Hello,
I have had foul-smelling loose diarrhea for years with abdominal bloating and Rectal discharge that usually soaks thru my boxers and pants. It happens throughout the day but I noticed that worse when I wake up in the morning. I have been to the Gastro doctor and did two colonoscopies with two EGD's and the pill cam. Everything was normal and all they found was some erosion in my small intestine and a small hernia. They labeled me with IBS which I still don't think it is.. I have tried so many probiotics and medications such as lotronex and viberzi and nothing has helped.. all the doctors are speechless and don't know what to do. I don't notice it getting worse with any food I eat and I was tested for food allergies and It all came back negative. I have no idea what it could be and this is so embarrassing that I want to go away.
Thanks, XXXXXXX
doctor
Answered by Dr. Ramesh Kumar (5 hours later)
Brief Answer:
Details beliw

Detailed Answer:
Hi dear,
Have noted all your details.
I appreciate your concern.

Irritable bowel syndrome is a diagnosis of exclusion.When all gastroentrological investigations are normal its termed as irritable bowel syndrome ,As you have already tried almost all the medicine used to treat irritable bowel syndrome and was not relived,Its time when we should go for some other rare problem which mimics your symptoms but are rare.In medical sciences rare things are very rare but they are there and when they are there they are very often missed.
There are two uncommon diseases that mimic IBS and need to be ruled out with proper studies when patient is nit relieved by treatment of irritable bowel syndrome
a) Celiac Disease, which is an autoimmune disorder caused by sensitivity to Gluten—a protein present in wheat, barley, and rye—can be ruled out with blood tests and a small intestinal biopsy obtained through an endoscope.Though you mentioned that endoscopy has been done yet please make sure whether biopsy was done or not.As biopsy only will confirm celiac disease.

b)Sarcoidosis is a systemic disease of unknown aetiology that may affect any organ in the body. The gastrointestinal tract however is only rarely affected outside the liver. Symptoms may be non-specific. Irritable bowel syndrome (IBS) is a diagnosis but the patient with gastric sarcodiosis though presents with all symptoms of IBS will respond to immunosuppressive therapy.

Apart from these two a number of uncommon disease can present with symptoms of IBS. Some of the common one are-
Abuse of laxatives or antacids
Use of sorbitol or other artificial sweeteners.
Lactose intolerance.
Inflammatory bowel disease
Tumors of the digestive system.
Problems with the pancrea
.Addison's disease.
Thyroid disease.
Diverticulitis.
.Gall stones
Gastroesophageal reflux disease (GERD).     Malabsorption syndrome, such as celiac disease or long-term inflammation of the pancreas (pancreatitis).*     Microscopic Colitis
A very detailed whole body test have to be done to rule out these rare diagnosis.
Apart from consulting gastroenterologist you should also contact Endocrinologist.

See you must also be understanding that its not a simple case so we have think every possible possiblity and should rule out evere possible cause.

Test advised
Thyroid profile
Biopsy of intestine
CT abdomen
usg whole abdomen

Apart from medicines you are on some general advices are-
Avoid dairy product
Drink XXXXXXX warm water with some honey in it in morning
Eat a lot of vegetaables and green salad
Dont eat meat,chicken,egg etc
No Burger.Pizza and fries
Try to follow vegans diet a natural dier
isapghulu husk should be taken 2tsf before sleeping every night


Thank you

Follow up with reports!
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ramesh Kumar (18 hours later)
Thanks for the reply,
I know they tested me for celiac disease in both colonoscopies and it was negative. I'm not sure they went through the whole small intestinal though. I know I'm 6"4 and have lengthy bones and fingers and people keep thinking I have Crohn's but I figured that would show up on a colonoscopy. Is it normal to have erosion in the small intestine? I'm not sure what causes that. I think it may be a lactose intolerance or gluten intolerance but it's so hard changing your diet.. I had a CT scan at least five years ago and it was normal. Maybe I should do a repeat CT. I just feel that food goes right through me and my diarrhea is so foul smelling
doctor
Answered by Dr. Ramesh Kumar (3 hours later)
Brief Answer:
Details below!

Detailed Answer:
Hi again,
Kindly attach the details of colonoscopy or mention the size and exact location of erosions.
Erosions and ulcerations less then 5mm are non specific,however if they are more then 5 mm they are indicative of inflammatory bowel disease.It can be due to a number of causes but inflammatory bowel diseases are the most common cause,But again as i said size creates a difference and only erosions more then 5mm are significant.If Ct was done 5 years ago then yes it should be repeated again.
Thanks!
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ramesh Kumar (22 hours later)
Hello,
Thanks for the quick and through replies! I could not find the reports of my colonoscopy. My gastro doc said it was nothing to worry about so I'm assuming they will small. He wants me to see a another specialist for a second opinion. I lost 20 pounds in the last 3 months and nothing changed with my diet. I was under some stress the last month but I can't imagine that would do it. The only medication I'm taking is clonazepam and lexapro for anxiety and synthroid. I had a left thyoidectomy done due to a benign nodule tha appeared suspicious. My thyroid levels have also been in range as well. I do get anemia some times and my liver enzymes are sometime slightly elevated. I will make sure to ask my doctor for another ct or small bowel follow through
Thanks, XXXXXXX
doctor
Answered by Dr. Ramesh Kumar (9 minutes later)
Brief Answer:
.

Detailed Answer:
Good luck XXXXXXX and have a quick recovery!
Thanks
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Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2906 Questions

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What Causes Foul Smelling Diarrhea And Abdominal Bloating?

Brief Answer: Details beliw Detailed Answer: Hi dear, Have noted all your details. I appreciate your concern. Irritable bowel syndrome is a diagnosis of exclusion.When all gastroentrological investigations are normal its termed as irritable bowel syndrome ,As you have already tried almost all the medicine used to treat irritable bowel syndrome and was not relived,Its time when we should go for some other rare problem which mimics your symptoms but are rare.In medical sciences rare things are very rare but they are there and when they are there they are very often missed. There are two uncommon diseases that mimic IBS and need to be ruled out with proper studies when patient is nit relieved by treatment of irritable bowel syndrome a) Celiac Disease, which is an autoimmune disorder caused by sensitivity to Gluten—a protein present in wheat, barley, and rye—can be ruled out with blood tests and a small intestinal biopsy obtained through an endoscope.Though you mentioned that endoscopy has been done yet please make sure whether biopsy was done or not.As biopsy only will confirm celiac disease. b)Sarcoidosis is a systemic disease of unknown aetiology that may affect any organ in the body. The gastrointestinal tract however is only rarely affected outside the liver. Symptoms may be non-specific. Irritable bowel syndrome (IBS) is a diagnosis but the patient with gastric sarcodiosis though presents with all symptoms of IBS will respond to immunosuppressive therapy. Apart from these two a number of uncommon disease can present with symptoms of IBS. Some of the common one are- Abuse of laxatives or antacids Use of sorbitol or other artificial sweeteners. Lactose intolerance. Inflammatory bowel disease Tumors of the digestive system. Problems with the pancrea .Addison's disease. Thyroid disease. Diverticulitis. .Gall stones Gastroesophageal reflux disease (GERD). Malabsorption syndrome, such as celiac disease or long-term inflammation of the pancreas (pancreatitis).* Microscopic Colitis A very detailed whole body test have to be done to rule out these rare diagnosis. Apart from consulting gastroenterologist you should also contact Endocrinologist. See you must also be understanding that its not a simple case so we have think every possible possiblity and should rule out evere possible cause. Test advised Thyroid profile Biopsy of intestine CT abdomen usg whole abdomen Apart from medicines you are on some general advices are- Avoid dairy product Drink XXXXXXX warm water with some honey in it in morning Eat a lot of vegetaables and green salad Dont eat meat,chicken,egg etc No Burger.Pizza and fries Try to follow vegans diet a natural dier isapghulu husk should be taken 2tsf before sleeping every night Thank you Follow up with reports!