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What causes diarrhea post colonoscopy?

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Posted on Mon, 1 Jun 2015
Question: My husband had a colonoscopy 2 weeks ago. He has malignant tumour in caecum. Chemotherapy is to start in 10 days. Appetite and all functions were normal before colonoscopy. Since the clean out he has been unable to get back to normal eating. A couple of nights ago he had severe upper left cramping. Yesterday doctor advised low residue diet. Started this last night. After breakfast diarrhea started. Is this all after effects for colonoscopy? How can we getting him eating again ready to start the chemo?
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Answered by Dr. Grzegorz Stanko (27 minutes later)
Brief Answer:
Partial bowels obstruction can be the problem.

Detailed Answer:
Hello!

Thank you for the query.

It all depends if the tumor is causing bowels obstruction or not. As he has diarrhea, partial bowels obstruction might be present. If so, he wont have proper appetite as his bowels do not function property.
Other symptoms of partial bowels obstruction are nausea, bloating, cramps. If he has also this symptoms, surgery (stoma creation) before chemotherapy might be necessary. Diet wont solve his problem. I suggest him to consult general surgeon as soon as possible. Abdominal x-ray should be done.

If no obstruction will be present, Megace can stimulate his appetite.

His symptoms are not caused by colonoscopy for sure.

Hope this will help. Feel free to ask further questions.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Grzegorz Stanko (12 minutes later)
The tumour is located only in the caecum and isn't obstructing the passage through the bowel. He has had scans including PET/CT to confirm. I wasn't suggesting that the colonoscopy caused the problem but that the preparation for the colonoscopy when the bowel was emptied might mean that helpful bacteria have been stripped out and need to be restored.
doctor
Answered by Dr. Grzegorz Stanko (9 minutes later)
Brief Answer:
The lump can cause an obstruction after the colonoscopy.

Detailed Answer:
Well, if this lump is located only in the caecum why dont they remove it first? Giving chemo before colon cancer removal is not a standard procedure. Surgery is the main treatment of colon cancer.
PET/CT does not tell much about possible bowels obstruction. Abdominal x-ray or CT enterography can do that.
Even lump seen in the colonoscopy which does not cause an obstruction during the test, can give such complication few days after it.
So I would insist to have bowels obstruction ruled out. You may add probiotic to his diet but I do not think it will solve the problem as his symptoms are not typical for lack of good bacteria.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Grzegorz Stanko (5 minutes later)
Sorry, I didn't also add that there are secondaries in the liver. Hence chemo is the first line of attack.
doctor
Answered by Dr. Grzegorz Stanko (8 minutes later)
Brief Answer:
Obstruction is very probable.

Detailed Answer:
Still this is not a standard procedure. As bowel is a very special part of body, so the approach to its cancer is also quite different. Leaving the tumor inside the intestine and giving chemo first makes the risk that the tumor will obstruct the intestine. In such case chemo will have to be stopped and surgery done.
As there are liver metastases, tumor inside the intestine is not a small one for sure. So this makes bowels obstruction even more possible.
Just take a look at his abdomen. If its bigger than it was obstruction is very probable. And try to knock to it gently. If it sounds like a drum, obstruction it is.

Please do not wait with it. He should see general surgeon right away.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Grzegorz Stanko

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What causes diarrhea post colonoscopy?

Brief Answer: Partial bowels obstruction can be the problem. Detailed Answer: Hello! Thank you for the query. It all depends if the tumor is causing bowels obstruction or not. As he has diarrhea, partial bowels obstruction might be present. If so, he wont have proper appetite as his bowels do not function property. Other symptoms of partial bowels obstruction are nausea, bloating, cramps. If he has also this symptoms, surgery (stoma creation) before chemotherapy might be necessary. Diet wont solve his problem. I suggest him to consult general surgeon as soon as possible. Abdominal x-ray should be done. If no obstruction will be present, Megace can stimulate his appetite. His symptoms are not caused by colonoscopy for sure. Hope this will help. Feel free to ask further questions. Regards.