Occasional diarrhea, dull abdominal pain, itchy palms/soles

49 yo male, borderline hypertensive (no medications), mild mitral valve prolapse (no regurgitation). Gallbladder removed 2 years ago (small stones). Have been eating well and moving stool regularly since. For the last 3 months, taking two LOFTYL 300 mg pills (buflomedile hydrochloride) daily, due to ear concussion in April.

2 weeks ago, right after family lunch (concluded w/ ice cream), felt sudden intense abdominal pain. Lied down for short while & got severe itch in palms and soles! Pain subsided after 5 min, itch went away after 20 min. 1 week ago, had another family lunch (& ice cream) - a few minutes after that more diarrhea and foul smelling stool. 4 days after that, after eating home-made pasta w/ red sauce & grated cheese, again foul smelling watery stool.

In between these episodes bowel movement normal. Very careful with my diet now - have been passing rather soft-looking light brown stool. GI specialist (will see him tomorrow) asked me to stop taking LOFTYL, put me on DUSPATALIN 200 mg (mebeverine hydrochrolide) for 2 weeks and mentioned the possibility of a colonoscopy IF symptoms persist.

Your take on my rather unusual set of symptoms? Should I have more test BEFORE I take the colonoscopy (e.g. blood tests, barium, orthoscopy)? Is there a substantial possibility of colon cancer (no family history)?

Thank you,
John P.
Greece

[Kevin Pho, MD]

At this time, I would proceed with the colonoscopy.  This is the most comprehensive test to evaluate for colon cancer, and can also look for colitis and other forms of inflammatory bowel disease.

Other possibilities include malabsorption, Celiac disease, and lactose intolerance.  Tests to evaluate for these conditions include sending the stool off for analysis, obtaining antibody tests to exclude Celiac, and going through breath tests to look for lactose intolerance.

These options can be discussed with your personal physician.

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 Pho, M.D.

KevinMD.com
Twitter.com/kevinmd