Chronic Diarrhea and soft voluminous stools since last 6 months.
Need more information
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.
I would like to have some more information before I can give my opinion.
1. Any blood or mucus in stools?
2. Small or large volume diarrhea?
3. Night time loose stools that wake you up from sleep?
4. Do you have abdominal pain?
5. Is there weight loss?
6. Any relief after taking Rifaximin?
7. Are you on any other medications?
1. No blood or mucus in stool. Done 4 times fecal occult blood test (negative).
2. Large volume diarrhea Stools
3. No night time loose stools.
4. Yes some times but tenderness always
5. Weight loss about 5 kg but then recovered around 4 kgs.
6. After taking rifaximin no feeling of urgent motion.
7. NO other medication
Kindly suggest accordingly.
Weight loss was totally unintentional.
Answer given below
Thanks for the details.
There are two possibilities -
1. Malabsorption syndrome - Points favoring are large volume diarrhea, unintentional weight loss. Endoscopy and a small bowel biopsy will help to know whether you have any malabsorption issue
2. Irritable Bowel syndrome - Though most of the symptoms point towards IBS, weight loss is one point against it. You can avoid milk and milk products and take low FODMAP diet and see whether there is any improvement. You can also take T.Librax 1-0-1 and C.VSL#3 1-0-0 and look for improvement.
Though floating and difficult to flush stools with high blood sugar and weight loss point towards chronic pancreatitis as a possible cause of chronic diarrhea, a relatively normal pancreas in MRI scan makes this diagnosis less likely.
Can it be EPI since whatever symptoms are there it also suggest that one as pancreas is bulky. Is it possible.
If yes what test should I go for to get it confirm and what medication should be used for that.
A bulky pancreas with other relevant features indicate acute pancreatitis which is not associated with EPI.
Only chronic pancreatitis is associated with EPI.
Stool fat analysis and fecal elastase test may be done for confirmation.
Pancreatitis enzyme supplements have to be taken for relief from EPI.