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Loose stools. Taking Barium medication. CT scan shows nodules on lungs. History of IBS. Treatment for loose stools?

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Practicing since : 2000
Answered : 339 Questions
HELP PLEASE...after tests and 'basic' diagnosis. My gastroenterologist (on vacation) other docs
in the group practice are unavailable!

I had a CT 4 days ago (abdomen-pelvis-emphasis on pancreas) with IV and night before, 2 (450ml) bottles of Barium.pri

CT ordered on basis of long term loose stools (no agnother symptoms) Doc suspected pancreatic insuff'cy

Have had IBS on and off 25 years. Also type 2 DM.
It seemed that all barium has cleared YESTERDAY considering my BM yesterday was firm and brown.

(a week before scan stools firmer and more regular (not mostly floating)

Today's BM the same EXEPT a few 1" pieces of gray thick stool on the outside of totally brown stool.
no other symptoms..never had gray in stool before. (residual Barium?) no jaundice-symptomsmos

Doc left for vacation...Nurse would only tell me I had a pancreatic cyst not the type, nor blood work
(amylase-glipase - stool stain)

ALSO she told me there was an incidental finding of 2 lung nodules....No mention of size. No other
Gastro Doc avail. to explain finding. Nurse was surprised about my extreme concern. Doctor ordered
another CT this time, chest, while he's on vacation. No further scans or blood work til my appt with
him on 12/7.

no lung symptoms like cough or breathlessness...I jog fast 5 days a change in endurance
or otherwise.

I've seen on internet sites that half of lung nodules are malignant in smokers over 50
(I'm 57 M smoker)

In contrast, another seemingly reputable medical website stated:
'half of smokers over 50 have lung nodule(s)

If both were true,25% of smokers over 50 HAVE lung cancer.

I'm scared to death about both of these problems. Can't eat or sleep well.Waiting for my
Gastrologist appt will be agony!

Thank You so much
Posted Tue, 1 May 2012 in Digestion and Bowels
Answered by Dr. Poorna Chandra K.S 11 hours later
Hi and thanks for the query
Most of the pancreatitis associated with alcohol eventually do develop some pancreatic sufficiency if one continues to take alcohol (including Beer). With the possibility of pancreatic insufficiency it is very difficult to make a diagnosis of IBS as IBS is a diagnosis of exclusion.
Pancreatic insufficiency could be of endocrine functions where it manifests as diabities or as an exocrine insufficiency which manifests as bulky foul smelling stools and lack of weight gain or weight loss.
Exocrine insufficiency is diagnosed by looking at fat or elastase in the stools. Presence of structural abnormalities on imaging is a surrogate marker of insufficiency.
Stool colour is highly variable in a healthy individual and depends on the diet. Hence i wouldn't be bothered of a grey stool unless it was greasy and sticky wherein it mean excess fat loss.
The clinical significance of the pancreatic cyst and the lung nodules can me decided by looking at it's characteristics on the CT like the density, margins, contents and the surrounding structures. If there is no recent exacerbation of pancreatitis it is less likely to be a pseudocyst. Hence it is best to discuss with the radiologist.
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