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Suggest Treatment For Persistent Diarrhea

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Posted on Fri, 6 Jan 2017
Question: Hi,
I have had diarrhoea for the last 2 years and a half, on and off. The first episode lasted for 5 months of continuous diarrhoea. The first time with diarrhoea was without any further symptoms. However, over the last year I have a few episodes of diarrhoea that lasted for a few weeks in which I also had abdominal discomfort, one of the episodes being very painful. At the beginning when I started with the symptoms, I was tested with stool samples that showed that I had Blastocystis Hominis. However, one of the gastroenterologist that I visited about this, seemed to think that my problem was related to something different, not the parasite. Then, later on, after an episode of diarrhoea, I underwent a sigmodoscopy that only checked the rectum and they saw that I had proctitis. They couldn't finish the whole sigmodoscopy as at the time I had haemorrhoids and the procedure was extremely painful.
My episode of diarrhoea finished and I have only had one more episode of symptoms after the procedure. At the moment I have no symptoms. However, it is an issue that I want to get to the bottom of it as I will probably have another episode of symptoms sometime in the future. I have been doing some research on the internet, and I have concluded that I might have spondylitis. This would explain the lower back problems that I have been having for the past 3 years.
So the question is, as I would like to check whether that is what I have, I wonder, considering that I currently have no symptoms and I haven't had any symptoms for a couple of months, whether having a colonoscopy would be able to see any signs of Ulcerative Colitis or Crohns disease. I understand that if I was having symptoms, the colonoscopy could potentially detect an inflamed colon and therefore the gastroenterologist (maybe by taking a biopsy or whatever the signs are to indicate Ulcerative Colitis or Crohn’s disease) would be able to tell what is wrong with me. But my doubt really is whether, considering I have no symptoms at the moment, I wonder whether there are going to be any signs or indications in my bowels so that the specialist can see what is wrong with me. Would I need to wait to have symptoms to have a colonoscopy?
Thank you in advance.
Kind Regards,
Javi
doctor
Answered by Dr. Tayyab Malik (12 hours later)
Brief Answer:
Colonoscopy maybe performed

Detailed Answer:
hi.
thanks for posting query at HCM.

i went through your complete history and understood your concern. as you suffered from diarrhea for a considerable time ( more than 2 years on and off) , you were supposed to have a colonoscopic examination during that symptomatic phase.

anyhow, asymptomatic IBD does exist.
if your NOT have having any symptoms currently, yet colonoscopic examination maybe performed to rule out IBD, as you had a recent history of "chronic diarrhea".

Colonoscopy is a modality which is necessary to perform to rule out IBD.

hope to answer your concern.
any further questions are welcomed .

regards
Dr Tayyab Malik
Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
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Follow up: Dr. Tayyab Malik (9 hours later)
Hi,

Thank you for your response. I am still unclear whether a colonoscopy can detect IBD considering that I have no symptoms at the moment. You seem to be suggesting that a colonoscopy had to be performed while I had my latest flare up, but then stating that assymptomatic IBD exists. Just to clarify I am interested to see whether it would be worth me spending money to have a colonoscopy now that I have no symptoms, or maybe wait until I have symptoms.

I have consulted two GPs about this but have received contradicting views as to whether the biopsy that is taken during the colonoscopy will show any traces of IBD considering that I have no symptoms. I hope you can confirm which statement you believe to be true.

Thank you.

Kind Regards,
Javi
doctor
Answered by Dr. Tayyab Malik (45 minutes later)
Brief Answer:
Silent inflammation in IBD can be ruled out by colonoscopy

Detailed Answer:
hi.
thanks for getting back.

what i meant with my previous answer was that : IBD is always included in the differential of chronic diarrhea ( any diarrhea more than 6 weeks). Colonoscopy can rule out IBD.

IBD symptoms follow a "on and off" phenomenon.
colonoscopy is the only modality that can rule out IBD, including silent IBD ( IBD without symptoms), with or without biopsy, depending upon the colonic mucosal examination.

in short, its NOT certain that you have IBD at presenet BUT there is a possibility that you may have "silent" IBD., which can ONLY be ruled out by performing colonoscopy.

hope i have cleared your doubts.

any further questions are welcomed.

regards
Dr Tayyab Malik
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Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
Dr.
Dr. Tayyab Malik

Gastroenterologist

Practicing since :2009

Answered : 819 Questions

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Suggest Treatment For Persistent Diarrhea

Brief Answer: Colonoscopy maybe performed Detailed Answer: hi. thanks for posting query at HCM. i went through your complete history and understood your concern. as you suffered from diarrhea for a considerable time ( more than 2 years on and off) , you were supposed to have a colonoscopic examination during that symptomatic phase. anyhow, asymptomatic IBD does exist. if your NOT have having any symptoms currently, yet colonoscopic examination maybe performed to rule out IBD, as you had a recent history of "chronic diarrhea". Colonoscopy is a modality which is necessary to perform to rule out IBD. hope to answer your concern. any further questions are welcomed . regards Dr Tayyab Malik