Pain in the lower abdomen and watery stools after eating, weight loss. Has diabetes. Gastric bypass done. Not responding to Flagyl
Rushing to toilet after meals is secondary to an exaggerated gastrocolic reflex. This can occur due to a variety of causes like-
1) Mucosal inflammation - secondary to mucosal diseases; unlikely as endoscopies have been normal. This can be associated with Vit B12 defeciency which may worsen the symptoms.
2) Intestinal dysmotility - which can develop secondary to diabetic affliction of nerves. This can secondarily lead to bacterial overgrowth.
3) Bacterial overgrowth - common in patients with Diabeties and gastric bypass. This can cause secondary mucosal irritation and malabsorption.
Hence get a stool examination (3 days), Fasting serum Vit B12, TSH(Thyroid stimulating hormone), CRP (C reactive protein Quantitative) and a glucose- lactulose H2 breath test. These may help you to localise the abnormalities and susequent management can be worked out
Hope I have answered your query. Please accept my answer in case you do not have further queries.
The pain prior to a bowel movement is because of spasms and these can be brought on by mucosal inflammation or the dysmotility associated with the bacterial overgrowth
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