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Gastroenterology (Expert Forum)
Re: chronic diarrhea
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.
Re: chronic diarrhea
by HFHSM.D.-rf, Jan 01, 1995 12:00AM
Posted By HFHSM.D.-rf on May 09, 1998 at 21:02:37:
In Reply to: chronic diarrhea posted by Jean on May 06, 1998 at 12:39:44:
I have had chronic diarhhea since December. I was diagnosed in
January with Giardia (a parasite). I took three prescriptions
for Flagyl (250 mg 3x day for 5 days; 250 mg 3x day for 7 days
and 250 3x day for 14 days)over a three month period and each
time the symptoms returned (chills, foul smelling diarrhea
(no blood), weight loss). Stool samples did not find Giardia
again. After flagyl, I was having chills, fatigue, loss of
appetite and diarrhea (no blood) in the morning. I had a
colonoscopy which showed some very minor irritation in my colon
but ruled out Crohns. Small bowel xray was normal.
I had a fecal fat (72 hr) test which was normal.
And normal blood work (last week) and no anemia.
My symptoms currently are weight loss (10 lbs since Dec)
and difficulty gaining weight.
I now have diarrhea (malformed soft stool, no blood)
each morning as soon as I wake up (it wakes me up usually -
no incontinence just pressure to go).
Sometimes there is mucous in my stool.
I have eliminated dairy and sugar which hasn't made much
of a difference. Please provide any insight into this
and possible treatment options.
Should I seek a second opinion on test data since my current GI
Dr has a wait and see attitude and wants to see me again in 6 weeks.
___
Dear Jean,
Thank you for your recent letter. Your case is quite perplexing. Although your physician has excluded some of the more common causes of diarrhea, the list of conditions that can cause this problem is quite long.
In order to direct the evaluation, the doctor requires additional information. How old are you? Do you take medications at this time? Do you suffer from other medical problems? How did you acquire the Giardia? Was it by travelling, camping? Have you taken antibiotics recently? What is your source of water? With regard to the diarrhea the physician should know the number of stools per 24 hours, the stool consistency and the stool volume (large or small bowel movements).
One of the diseases that must be considered when someone develops chronic diarrhea is AIDS. If you have risk factors for this condition (drug use, multiple sexual partners etc) you should be tested for HIV infection. AIDS can be associated with a number of intestinal infections. Special tests are required to exclude all the different possible infections. Another possible cause of your diarrhea and weight loss is hyperthyroidism. This disease can be easily evaluated by a blood test. The fecal fat study excludes malabsorption from the possible causes of your diarrhea.
If you have diarrhea despite not eating, it is possible that you have a SECRETORY DIARRHEA. There are a number of conditions that can cause this problem. Evaluation by a gastroenterologist with expertise in this field is required. Finally, some people have changing bowel patterns without a specific cause being identified.
You need several additional tests in addition to the ones outlined above. As a first step, you should have a 24 hour stool collection weighed to determine how much stool you are actually passing. Second, the stool sodium and potassium concentrations should be measured. These two pieces of information may help your physician direct your investigation.
If you want Dr. Fogel of the Division of Gastroenterology at Henry Ford Hospital, one of our experts in the evaluation of patients with diarrhea, would be happy to see you. He would review your outside records and arrange for the necessary tests to complete the evaluation of your diarrhea. You can arrange for an appointment by calling the Henry Ford Physician Referral Line at (313) 876-2393.
This response is offered for your general information and should not replace the conclusions drawn from a careful and complete evaluation by your physician.
HFHSM.D.-rf
*keywords; diarrhea, intestinal infection, Giardia, malabsorption, secretory diarrhea
0.4
In Reply to: chronic diarrhea posted by Jean on May 06, 1998 at 12:39:44:
I have had chronic diarhhea since December. I was diagnosed in
January with Giardia (a parasite). I took three prescriptions
for Flagyl (250 mg 3x day for 5 days; 250 mg 3x day for 7 days
and 250 3x day for 14 days)over a three month period and each
time the symptoms returned (chills, foul smelling diarrhea
(no blood), weight loss). Stool samples did not find Giardia
again. After flagyl, I was having chills, fatigue, loss of
appetite and diarrhea (no blood) in the morning. I had a
colonoscopy which showed some very minor irritation in my colon
but ruled out Crohns. Small bowel xray was normal.
I had a fecal fat (72 hr) test which was normal.
And normal blood work (last week) and no anemia.
My symptoms currently are weight loss (10 lbs since Dec)
and difficulty gaining weight.
I now have diarrhea (malformed soft stool, no blood)
each morning as soon as I wake up (it wakes me up usually -
no incontinence just pressure to go).
Sometimes there is mucous in my stool.
I have eliminated dairy and sugar which hasn't made much
of a difference. Please provide any insight into this
and possible treatment options.
Should I seek a second opinion on test data since my current GI
Dr has a wait and see attitude and wants to see me again in 6 weeks.
___
Dear Jean,
Thank you for your recent letter. Your case is quite perplexing. Although your physician has excluded some of the more common causes of diarrhea, the list of conditions that can cause this problem is quite long.
In order to direct the evaluation, the doctor requires additional information. How old are you? Do you take medications at this time? Do you suffer from other medical problems? How did you acquire the Giardia? Was it by travelling, camping? Have you taken antibiotics recently? What is your source of water? With regard to the diarrhea the physician should know the number of stools per 24 hours, the stool consistency and the stool volume (large or small bowel movements).
One of the diseases that must be considered when someone develops chronic diarrhea is AIDS. If you have risk factors for this condition (drug use, multiple sexual partners etc) you should be tested for HIV infection. AIDS can be associated with a number of intestinal infections. Special tests are required to exclude all the different possible infections. Another possible cause of your diarrhea and weight loss is hyperthyroidism. This disease can be easily evaluated by a blood test. The fecal fat study excludes malabsorption from the possible causes of your diarrhea.
If you have diarrhea despite not eating, it is possible that you have a SECRETORY DIARRHEA. There are a number of conditions that can cause this problem. Evaluation by a gastroenterologist with expertise in this field is required. Finally, some people have changing bowel patterns without a specific cause being identified.
You need several additional tests in addition to the ones outlined above. As a first step, you should have a 24 hour stool collection weighed to determine how much stool you are actually passing. Second, the stool sodium and potassium concentrations should be measured. These two pieces of information may help your physician direct your investigation.
If you want Dr. Fogel of the Division of Gastroenterology at Henry Ford Hospital, one of our experts in the evaluation of patients with diarrhea, would be happy to see you. He would review your outside records and arrange for the necessary tests to complete the evaluation of your diarrhea. You can arrange for an appointment by calling the Henry Ford Physician Referral Line at (313) 876-2393.
This response is offered for your general information and should not replace the conclusions drawn from a careful and complete evaluation by your physician.
HFHSM.D.-rf
*keywords; diarrhea, intestinal infection, Giardia, malabsorption, secretory diarrhea
0.4
