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Gastric Problems, Diarrhea, Done Stool Test. Treatment?

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Posted on Tue, 2 Oct 2012
Question: Hello,

I've been having digestive issues for years, but I'm tired of them and want to get the problem fixed.

Every few days, I will get really bad gas, often leading to diarrhea. Sometimes I will have no problems for as long as a week, but other times I have problems for several days in a row. I've been keeping a food journal for the past three weeks, but am having trouble identifying which foods might be causing the problem, because sometimes I will eat them and be fine, and other times it will cause problems almost immediately after eating. But I believe that greasy foods cause the problem consistently.

I had a stool test performed at a local clinic and fortunately no problems were apparent. But I still don't know what's causing these problems. Hopefully you can help me.

You can view my live food journal on Google Docs at:
www.www.www
It includes a few entries from last December. Then cuts to the beginning of September of this year. Hopefully this information will be helpful in determining what might be causing my problem and what I can do to resolve it. Let me know if you need any more information.

Thank you for your help, and have a great day!
XXXXXXX XXXXXXX
YYYY@YYYY
doctor
Answered by Dr. Vaibhav Banait (10 hours later)
hello Mr. XXXXXXX XXXXXXX

Thanks for the query. I have gone through your food journal also.

From your descriptions, it seems you are having flatulence with episodic diarrhea. This is common with carbohydrates malabsorption. Lactose (milk ) intolerance and bacterial overgrowth especially in patients who had abdominal surgery in the past or had diabetes or hypothyroidism for example .

It is important for me to know the if you have any other symptoms like fever, abdominal pain, weight loss or appearance of blood in the stool, to clearly answer your query.

I will also be obliged if you can provide me with whatever investigations done so far.

I hope, I have answered your query.

Awaiting your reply with answers to my questions.

Regards.
Above answer was peer-reviewed by : Dr. Jyoti Patil
doctor
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Follow up: Dr. Vaibhav Banait (1 hour later)
Thank you for your answer.

To answer your questions, yes, there is abdominal pain sometimes along with the gas and stomach gurgling.

As for weight, I have weighed between 120-130 pounds since I was 16 years old, and have never really gone outside those ranges. For about two months (May-Jul, 2011) I was also taking a weight gaining supplement (protein shakes that I think had additional carbohydrates, whey isotopes, and digestive enzymes, but I don't remember the exact ingredients). Along with a little weight lifting, over these two months, I was able to gain a little muscle, and even a tiny bit of fat, but am still less than 130 pounds. While taking the shakes, I also noticed I had fewer problems with gas and diarrhea. Interestingly, I took the shakes with milk twice a day, so I don't think that milk products are causing me any problems.

I can't find a link to the exact product I took, but I think it was similar to this one:
WWW.WWWW.WW

I have no other symptoms. No fever. No blood in the stool. However, sometimes my anus has been so sore that is has bled a little bit when I wipe it. But not much blood. For example, I dab the toilet paper on my bottom and there is a little dot of blood on it. This has happened a couple times in the past few weeks. But the blood doesn't appear to be in the stool -- just right around the hole.

The only investigation I've done so far is a stool sample, which came back showing no problems (no bacteria, blood, parasites or anything negative, really).

I anxiously await your reply. :)

Thank you for your help, XXXXXXX
doctor
Answered by Dr. Vaibhav Banait (25 hours later)
Hello.

Thanks for the elaborate answer.

I am happy to know that there are no warnings signs - bleeding, fever, weight loss. These signs indicate serious problem.

The possible reason for this problem may be
1. Carbohydrates malabsorption . In this conditions, avoidance of milk may be attempted . If macrocytosis is seen on blood smear, you should be further investigated.
2. diet , antimotility agent and there are few trials that suggest a course of antibiotic rifaximin help.
3. As you are having prolonged history, it is unlikely that Colonoscopy will yield anything. Had it been a relatively short history of diarrhea, I would have suggested Colonoscopy to rule out any colonic pathology.
4. Food allergies do occur. But from the data you provided, no particular food could be identified. Moreover no history of itchy rash, or asthma is there (though allergies could exist without these problem ). I think you should not restrict your diet based on presumed allergies. The restriction may lead to malnutrition and other nutritional consequences.

I would suggest getting basic health check up and basic blood and stool examination done. If we get any indicator, it may help pinpoint a problem

Hope I have answered your query adequately and is helpful to you.

Wish you good health.

Regards
Vaibhav Banait
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Vaibhav Banait (25 hours later)
Thank you for your help.

I went to get a blood test today, but they weren't sure which type of blood test to perform. Which type of test should I tell them to do?

The people at the clinic were also wondering if gluten intolerance may be an issue. What is your opinion there?

I will try to remove milk products from my diet for week or two and see if that has any effects, to rule out a carbohydrates absorption issue.

I will also see if I can get a basic health checkup by a doctor here, to see if they can find anything unusual.

Would it also help if I were to take digestive enzyme pills or anything like that with each meal?

Thank you again for your help, XXXXXXX
doctor
Answered by Dr. Vaibhav Banait (19 hours later)
Hello.

Thanks for the reply.

I meant "complete blood count with blood smear, creatinine, SGOT, postmeal blood sugar, calcium, phosphorus, albumin, stool and urine examination". I am sorry, I could not elaborate it during last advise.

I highly appreciate your decision to go ahead with basic health check up. That should help sort out the issues in better way.

We can also look for other possibilities like gluten intolerance, etc.

Digestive enzyme pills in absence of documented deficiency may not be recommendable as they are hardly of any help.

Hope I answered your query. I will be there if you need any further clarification.

Wish you good health.

Regards.

Dr Vaibhav Banait.
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Above answer was peer-reviewed by : Dr. Jyoti Patil
doctor
Answered by
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Dr. Vaibhav Banait

Gastroenterologist

Practicing since :1997

Answered : 65 Questions

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Gastric Problems, Diarrhea, Done Stool Test. Treatment?

hello Mr. XXXXXXX XXXXXXX

Thanks for the query. I have gone through your food journal also.

From your descriptions, it seems you are having flatulence with episodic diarrhea. This is common with carbohydrates malabsorption. Lactose (milk ) intolerance and bacterial overgrowth especially in patients who had abdominal surgery in the past or had diabetes or hypothyroidism for example .

It is important for me to know the if you have any other symptoms like fever, abdominal pain, weight loss or appearance of blood in the stool, to clearly answer your query.

I will also be obliged if you can provide me with whatever investigations done so far.

I hope, I have answered your query.

Awaiting your reply with answers to my questions.

Regards.