poor digestion and fatigue

I'm a 25 year old female who has a healthy, balanced diet and plenty of exercise. I moved to a farm in France in late January. In February the diarrhea began, accompanied with quite serious anal itching (especially at night) and some bleeding. This lasted for nearly two months. I thought it may have been a parasite but because the symptoms eventually ceased I tried not to worry about it. However, ever since then my digestion just doesn't seem the same and I am often fatigued/low energy during the day which shouldn't be the case as I get no less than 8 hours of sleep per night. I used to be quite energetic and had normal stools. Now I often feel poor digestion, a rumbling, weak stomach, bloating, with too much gas (quite odorous), especially after meal times. Stools are soft, sometimes runny and wholly undigested (again, abnormally odorous). I have not lost weight and have possibly gained some if I'm honest. A few months ago I took flubendazole (one tablet and then a second 15 days later) for possible worms in the digestive tract. Hasn't helped. Also, this may not be related but the day after I arrived in France I had food poisoning-like symptoms of very intense stomach pain and diarrhea which lasted about 8 hours. My father and his father have had diverticulitis. One grandparent is diabetic. No other serious illnesses in family. Do you think these are symptoms of parasites in the intestines or could it be something else? What sort of testing should I expect when I see a doctor? Thanks for your help in advance.

[Kevin Pho, MD]

If parasites are a concern, the stool should be sent and analyzed for parasites and ova.  

With the persistent symptoms, I would suggest an upper and lower endoscopy.  The lower endoscopy (colonoscopy) can exclude inflammatory bowel disease or infection.  
The upper endoscopy can look for gastritis or an ulcer.  

More specialized tests would include blood tests to look for celiac disease and sending the stool off to look for malabsorption.

These options can be discussed in conjunction with a GI referral.

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.
www.kevinmd.com
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