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Gastroenterology (Expert Forum)
Looking for direction
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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Looking for direction
by cmls, Jul 21, 2005 12:00AM
One year ago I was diagnosed with retractile calcific sclerosing mesenteritis based upon presenting symptoms (abdominal pain diarrhea and vomiting) exploratory surgery and a CAT scan. I was told that there was no know cause for this condition but it was suspected to be autoimmune in nature.
After I left the hospital I consulted with a rhematologist and since my symptoms had ceased it was recommended that I be sent home with no medications. I seemed to recover and did fine up until about six weeks ago when I suffered my second episode and was hospitalized over night.
Since that second episode I have expeienced progressively loose bowels, but only when I eat solid food.
I do not have classic diarrhea, but in the morning I will have what starts out as a normal stool then it gets progressievly looser and then it almost looks like a fine powder or as if I have taken too much fiber.
My doctor is at a loss for the source of this diarrhea. A stool sample came back negative for parasites.
What should I be doing next to find the cause of my diarrhea, what other tests should my doctor and I be considering?
Your assistance in this matter is greatly appreciated.
Michael L Saggese
After I left the hospital I consulted with a rhematologist and since my symptoms had ceased it was recommended that I be sent home with no medications. I seemed to recover and did fine up until about six weeks ago when I suffered my second episode and was hospitalized over night.
Since that second episode I have expeienced progressively loose bowels, but only when I eat solid food.
I do not have classic diarrhea, but in the morning I will have what starts out as a normal stool then it gets progressievly looser and then it almost looks like a fine powder or as if I have taken too much fiber.
My doctor is at a loss for the source of this diarrhea. A stool sample came back negative for parasites.
What should I be doing next to find the cause of my diarrhea, what other tests should my doctor and I be considering?
Your assistance in this matter is greatly appreciated.
Michael L Saggese
Doctor's Answer
by Kevin Pho, MD, Jul 22, 2005 12:00AM
, Jul 22, 2005 12:00AM
Stool tests looking for any source of infection should be considered. This can include a stool culture, ova and parasites as well as tests for giardia.
If the diarrhea is chronic, then an endoscopy would be the next step - either a colonoscopy or flexible sigmoidoscopy. This can evaluate for signs of inflammatory bowel disease or colitis.
If the tests remain non-revealing, you can opt for more specialized testing like blood tests for celiac disease or stool tests looking for various malabsorption syndrome.
Irritable bowel disease can also be considered - but other diseases should be ruled out first.
You can discuss these options with your personal physician, or in conjunction with a GI evaluation.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
If the diarrhea is chronic, then an endoscopy would be the next step - either a colonoscopy or flexible sigmoidoscopy. This can evaluate for signs of inflammatory bowel disease or colitis.
If the tests remain non-revealing, you can opt for more specialized testing like blood tests for celiac disease or stool tests looking for various malabsorption syndrome.
Irritable bowel disease can also be considered - but other diseases should be ruled out first.
You can discuss these options with your personal physician, or in conjunction with a GI evaluation.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
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