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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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For the past two or three months, I've been having

Answered by
Dr.
Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2349 Questions

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Posted on Fri, 8 Mar 2019 in Digestion and Bowels
Question: For the past two or three months, I've been having bouts of a couple of days without pooping and then days where I might go two or three times. My bowel movements used to be like clockwork. 90% of the time the poop is a light brown, very soft and mushy consistency where it used to be more solid. I've also been noticing a lot of very foul smelling flatulence--worse than rotten eggs! Occasionally when I wake up in the morning my stomach will be gurgling, rumbling and growling. Many times when I do poop, it feels as though I haven't finished--that there's more there but I just can't get it out. Many times I know I have to go but it seems like I'm going to pop a blood vessel in my head from straining so hard to get the movement started! Only maybe once every 10 days will I have diarrhea. The poop particles literally stick to the toilet bowl wall and even the flushing water can't clear them from the bowl. I have to literally take toilet paper to wipe off the excess, splattered poop. I have been under considerable stress the last several months, but I've been under stress before and have never had bowel problems of this magnitude.
doctor
Answered by Dr. Ramesh Kumar 37 minutes later
Brief Answer:
Please go through detailed answer.

Detailed Answer:
Hello and Welcome to 'Ask A Doctor' service.
I have reviewed your query and here is my advice.

The symptoms you are describing are mostly suggestive of gross problem with overall digestion.
Severe constipation followed by loose motion can be suggestive of Irritable bowel syndrome-like pathology.

1) Rotten smell is an indicator of the formation of colonies of bad bacteria's in the gut. These bad bacteria's acts on food(constipated) and ferments it causing the release of a large number of toxic gases like hydrogen sulfide ammonia etc. This gives the rotten egg-like smell to the stool. A foul-smelling stool is suggestive of development of bad bacterial and fungal colonies in the gut.

2) Now this cause inflammation in the wall of the intestine. This inflammation results in secretion of the large amount of mucous from intestinal cells and as intestine are inflamed absorption process is also hampered therefore stools are sticky.

3) Gurgling and rumbling sounds are again suggestive of formation of a large number of gases inside the gut.

4) As there is inflammation in intestine you have the feeling that you are not finished yet.

Investigations suggested-

Fecal Calprotectin to rule out the level of inflammation in intestines.
An ultrasound of the abdomen if possible a CT scan is a much better option.

Stool routine culture and sensitivity test to rule out toxic bacterial or yeast infection and the species of bacteria involved. Antibiotics could be administered on basis of culture report.

Till the time tests are done-
Take tablets of activated charcoal 2 tablets thrice daily to absorb the gases.
VSL#3 probiotic twice daily. This would help to deplete the good colonies of bacteria in the gut again. So that proper digestion could take place.

Eat lots of probiotic and probiotic rich food like curd, yogurt, kimchi etc.
Eat very easily digestible food for a few days. Avoid red meat and fast food.

Take Isapghul husk 10 gram three times a day. This would swell up when mixed with water and would add bulk to stool.

Hope I was helpful.
Follow-ups are welcome.
Thanks!


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Ramesh Kumar 26 minutes later
Thank you for your response.

I have two quick, follow-up questions:

1. What is the likelihood the inflammation will go away on its own?
2. What is the likelihood we could be dealing with polyps or colon cancer?
doctor
Answered by Dr. Ramesh Kumar 39 minutes later
Brief Answer:
Follow up.

Detailed Answer:
Hello again,

1)Follow a simple home cooked light diet.
Eat light food and the food suggested earlier. Unless there is infection things would start settling down in a few weeks.

2) Usually, the symptoms of cancer are quite aggressive. However, after 40 years of age colonoscopy should be done 5 yearly in every person. Problem with symptoms in gastroenterology is that almost everything has the same presentation as for e.g your presentation can be due to dyspepsia, Irritable bowel syndrome, Inflammatory bowel syndrome or maybe a polyp.

So, to be sure, a colonoscopy should be done. However, as symptoms are developing slowly chances of it being polyp or cancer are low.

Hope I was helpful,
Thanks!

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Ramesh Kumar 1 hour later
Thanks for your help. I know what course to take now.
doctor
Answered by Dr. Ramesh Kumar 12 hours later
Brief Answer:
follow up.

Detailed Answer:
Hello again dear,
Follow the protocol as suggested above-

Go for these tests-
Fecal Calprotectin
An ultrasound of the abdomen.
Stool routine culture and sensitivity test.

Till the time tests are done-
Take tablets of activated charcoal 2 tablets thrice daily to absorb the gases.
VSL#3 probiotic twice daily. This would help to deplete the good colonies of bacteria in the gut again. So that proper digestion could take place.

Eat lots of probiotic and probiotic rich food like curd, yogurt, kimchi etc.
Eat very easily digestible food for a few days. Avoid red meat and fast food.

Take Isapghul husk 10 gram three times a day. This would swell up when mixed with water and would add bulk to stool.

Hope i was helpful,
Follow ups are welcome.
Do rate the answer!
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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The User accepted the expert's answer

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