getting a little worried

two weeks ago I began having some diarrhea which was light yellow in color and watery.  I allowed this to happen for a few days but it did not get better on its own and eventually became grass green water.   i went to my Dr. a week later and he prescribed immodium and keopectate and Flagyl. All the tests he did on my stool, including O and P, C and S and red blood cells were negative.  The dirrhea continued.  I had been on the Atkins diet for the better part of a year off and on but had to discontinue this in the middle of the second week when it became clear i could no longer tolerate vegetatables or salad and began eating mostly bread, bananas, boiled chicken, etc.  Nothing however worked.  Now the stool was becoming darker after having turned back yellow  and he startd me on Colestid, 1 gram bid.  ( i am 5ft tall and weight about 120 pounds.  He said by tomrorw I should see some results.  I began the colestid Tuesday evening and today is Thursday.  (Christmas day). Today my stool continue to be watery and now they are black liquid.  Is the Colestid going to suddenly kick in tommorw?  I keep rading on the posts that Metamucil will help.  Immodium and Kaopectate maybe slow the stools down for a time but that is aobut it.  Meanwhile my mucous membranes remain moist  my urine is clear and I am not really losing any weight.  I am a nurse, an RN, and all kinds of horrible tnoughts are going through my mind./  Also I just ended one job and will begin insurance with another in two weeks but it if is really an acute situatin i can go to the county hopsital.  Please give me some advice...I am getting very worried about all o fthis.  Colon cancer?  Pancreatitis?  You know nurses are the worst!  There is no pain and very little crampy just hollow, tinkling, loud bowel sounds.  Thank you

[Kevin Pho, MD]

First off, I cannot make any recommendations as to whether you should go to the hospital or not without examining you.

There are several causes for persistent diarrhea.  This can include infection, some endocrine tumors, malabsorption, inflammatory bowel disease and irritable bowel syndrome.  

Metamucil and other fiber supplements may help if the etiology is irritable bowel syndrome.  You note that stool tests were negative.  The next step would be some kind of endoscopy - either flexible sigmoidoscopy or colonoscopy.  This can evaluate for inflammatory bowel syndrome or other inflammatory causes.  

If the stools are black, you may also want to consider an upper GI source of bleeding.  This can be evaluated with an upper GI series or upper endoscopy.  

I would suggest a GI referral if the diarrhea continues.  

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.

***I will be away and have limited internet access from December 26th to January 4th. I wish everyone a safe and happy holiday season.***

Take care,
Kevin, M.D.