Chronic Diarrhea

[bostongal]

Hi.  Last September/October I had three surgeries.  The first removed my gallbladder, the second removed adhesions around my small intestine and abdominal wall and the third was for a small bowel resection because of bowel obstruction.  I was in the hospital the third time for 17 days including 2 days in the ICU for blood pressure/heart rate problems.  Since that surgery I have consistent persistent diarrhea - average is 10-25 times a day but I have had as many as 32 times in one day.  I had vomiting for about 6 months but that has passed.  I have lost over 80 lbs because of this and now am unable to eat most days. I have had numerous tests including a colonoscopy, barium upper and lower GI studies, blood work.  I don't have anything apparent (Crohn's, diverticulitis, etc) and the GI doctor believes that I have the diarrhea because of the bile from the liver being passed into the intestines.  I have had IBS for about 20 years but always tended towards constipation, not diarrhea. I am having a problem also with keeping potassium - I have been hospitalized for IV fluids and potassium because of this problem. Medications we have tried Lomotil (2x), Immodium, Colestid, Cholestrymine powder, pamine forte and opium tincture.  I am either allergic or have no results from them except the opium which worked but caused hives.  My GI doctor called on Monday to tell me that he is out of treatment options for me.  

My questions are - why is this happening (is it common for bile to do this)?  Will this correct itself or am I dealing with a life long problem? How can I make sure that I am not dehydrating and doing damage to my body when I cannot keep anything in my system (water and food passes very quickly)?

thanks.

Meg

[Kevin Pho, MD]

Although uncommon, it may be possible for excess bile to lead to chronic diarrhea.

The colonoscopy would rule out many of the major causes such as colitis or a lesion/mass.  

I would assume that common infections have been tested for such as C Difficile (a common hospital-acquired infection), ova and parasites.

The stool can also be tested for fat malabsorption and a jejeunal aspirate (or breath tests) can be considered for bacterial overgrowth.

In the meantime, continued nutrition and hydration is important in the face of fluid and electrolyte loss from the diarrhea.

These options should be discussed with your personal physician.

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.
kevinmd_

[yoshi]

This may just be a speculation but since you have been in and out of hospital so many times,may be you have contracted some bacterial infection?
I know my mother has cervical cancer and underwent radiation treatment,she has diarhea (diarrhea) many times a day as her flora has been altered,we figure this is the reason why she keeps going to the bathroom.

[bostongal]

I've been tested multiple times for everything including parasites and C-Diff, all were negative.  This started while I was still in the hospital and has not changed (other than the vomiting and nausea resolving).  

I hope your mom is doing better.  Radiation can take it out of a person and diarrhea can certainly result.

thanks for responding - it was a good thought process.

Meg

[merilu]

lately I have had constant diarrhea (6 months) can not make it go away.  I have over used every over the counter medication available with no results. It seems to get better for a day and when I eat anything it comes back.  I have no diet right now because I a afraid to eat.  I have no control, when the movement comes I can't even make it to the bathroom.  I am 78 years old female and my life has gone south in the last few months from this.  I am a very nervous person with issues with depression, I also have been suffering from a sleep disorder due to RLS for a very long time.  My concern is that most of my life I have suffered from constipation problems and now this constant uncontrollable diarrhea which I just can't stop.  My doctors blame it on nerves, problems with my back, etc.  I had a colonoscopy and it came out clean.  I don't know what to do anymore, my quality of life is down to nothing.  I don't go anywhere or do anything anymore.  I am using a relative to send this question since I have no access to a computer but if there is any suggestion, I would appreciate the input.  I appreciate any response I may receive.  It seems that I live at the doctors.  Can dearrhea be a sign for stomach cancer???

[..]

I was curious what does your back has to do with getting diarrhea. Your doctor thinks there is a correlation?

[bostongal]

Kevin:

Since I have done all of your suggestions (had the stool studies, had the colonoscopy and other tests and other than a case of IBS everything has been clean) and have no answers as to why I am still suffering with the diarrhea can you tell me how to keep my electrolytes in balance and not dehydrate?  All food and water exits almost immediately and I am unable to keep my electrolytes balanced.  I have had IV fluids three times in the past 6 weeks and don't want to have them again.

thanks

Meg

[deburke]

I also have chronic, frequently incontinent diarrhea.  My physician finally diagnosed it as "Severe Refractory Diarrhea Predominant Irritable Bowel Syndrome."  Whatever.  Although I refuse to give up all hope of eventually overcoming this affliction, I have lately been coming to terms with the realization that for however long, it is my reality and I have to find ways to cope rather than allow it to virtually end my life.  I have been home bound for almost the whole past year since the situation has become more severe.  All that time I kept hoping it would turn out to be due to a medication or a food allergy or something that I could control.
  Yesterday I made the firm decision to fight back.  Today I have been online looking at incontinence products.  I already use Depends Adjustable Underwear.  (Basically an adult diaper that you can pull up like underpants, but if you are in a bathroom situation where it is inconvenient to take off your pants, these have perforations in the hip areas that allow you to tear them down the sides and remove them that way.  You can also tear them at the sides to put them on without taking your pants off.  They have velcro-like tabs on the sides you can fasten them with if you need to use them that way.  They are wonderful if you are in the unfortunate position of needing them.  I am and I use them everyday.
  There have been infrequent times when the volume was too much for them to contain and so I have been seeking out a waterproof panty that I can wear over them when I go out to make sure nothing can leak out.  I found a place (llmedico.com) wear you can purchase exactly that.  They also carry a swim product that you can wear in a pool that I plan to use to finally take advantage of the hot-tub I have been afraid to use the whole time we've had it.
  I plan to pack an "incontinent bag" with extra diapers, moist wipes, a change of clothes, and plastic bags to contain anything that gets soiled.  And I plan to go out to a movie with my husband.
  I guess the point I want to make to you is don't let it end your life either.  Certainly you should continue to try to find a "cure" or a treatment plan that works but don't wait around for it because it's actually possible that you won't find either.  
  There are some really excellent sources of information and support groups consisting of people sharing information and suggestions for coping that you can find on the internet.  You'll be amazed to find out how many people are in exactly the position you are.  I guess one of the main values of that is that it really does help to feel a little less like a freak.
  Best of luck to you.

[bostongal]

Thanks for the post.  You are the first person who is dealing with the same thing I am.  I have been homebound since last October with occasional days outside the home.  I don't have the incontinence but I do have the severity.

I have not been able to find anything on the internet with others dealing with this.  Would you email me a link at ***@****?  

I hope you are getting out with your husband.  I think your plan is a good one and I agree that you have to continue living life.  Does the diarrhea tire you out completely or can you function with it?

My biggest issue right now is about working for a living - I can't function most days,can't work and none of my doctors can give me a clear definition of what's wrong with me or how long it will last.  

Thanks again.

Meg

[yoshi]

My mother has found a powdered milk product for baby who suffers from loose bowel and it helps.
The doctor would not revisit any thread he has responded,have you tried tablets which contain potassium etc.

[bostongal]

I have persistent diarrhea, not constipation.

thanks

Meg

[SkylerMA]

Merilu, you should re-post your "lately I have had constant diarrhea (6 months) can not make it go away. I have over used every over the counter medication..." post as a Question in a new thread, so that the doctor will answer it--he doesn't read Comments.

[SkylerMA]

Alphaazul is a spammer; he's posting that same ad on every thread.

Regarding your problem, all I can suggest is:

For hydration, keep a bottle of mineral water or Smartwater (which has electrolytes but no sugar) always by you and take small sips frequently, instead of drinking a bunch at a time.

For the diarrhea, you might try Garden of Life Primal Defence, a probiotic supplement that contains "a unique whole food blend with Homeostatic Soil Organisms (HSOs). The HSOs in Primal Defense are important probiotics you would get in abundance if your food came from soil untouched by pesticides, herbicides and other widely used chemicals." It's expensive, but great stuff.

Good luck, and get well soon.

[bostongal]

Thanks for your reply.

I was drinking Smartwater and my primary told me to drink water with a tsp of sugar, tsp of salt and juice of a lime or lemon instead.  He said that it would give me what I needed.  I try to sip all day long but when I do I am running for the bathroom.  Anything over 10x and I am wiped out.

I did a three month course of probiotics and all it did was cause my diarrhea to increase so my docs told me not to do more of those.  I do eat yogurt with live cultures frequently though just to keep the good flora.

Meg

[bostongal]

Thanks for your help.

My GI doctor called and said I have Microscopic Colitis from my colonoscopy.  I am starting a steroid today.

Meg

[helpren]

I work with a research professor who had chronic, severe diahrrea following her cholecystectomy.  She researched and discovered Cholestyramine.  She has taken it for over ten years and swears by it.  The drug is a cholesterol reducing drug, but it actually binds to the bile produced by the liver, reducing the amount of bile that goes into your intestine.  Without your gallbladder to regulate your bile release, it can really help...at least it did her and she tried many other drugs and tests before finding it.

[bostongal]

I did try Cholestyramine and Colestid (the pill form) twice.  No improvement.

Glad your boss found relief.

Meg

[Nikki44]

HI, I am a 21 year old female and am experiencing the same problems. I had my gallbladder removed in 2001 when I was a sophomore in High School. They found gall stones. Ever since then I have had problems with diarrhea. Its ruining my life. I was diagnosed with IBS about 3-4 years ago. I was put on some meds and they didnt work, i lived on immodium and would buy it 72 at a time at sams club. I don't go anywhere because im afraid i will have problems. If i know i have a doctor appt or college class, i wont eat anything until afterwards and then i pig out. My symptoms have recently gotten worse. I went to the doctor and she put me on medicine for chrons and colitis. Its called Disadvantage IBD. It is suppose to help relieve the symptoms of Inflammatory Bowel Disease. I started taking it last sunday and so far it has helped a lot. I can eat without getting sick right away. I actually have had my first solid stool in 3 years. Hopefully I have found something that works. I know what people mean when they cant even get a real jon because of their disease. I stay at home and watch kids so that I can be close to a bathroom all day. I am glad I found this sight and know that I'm not the only one going through this.

[sam 1]

Corn gave me diarrhea, read lables.