Tan Stools, Fear of Malabsorption and a long 2 Months
Hello everyone, I just want to warn you that this is a very long post and I deeply appreciate anyone who reads through it, wether you have anything to add or not. I am very frustrated at the moment about this and have been through a lot of trial and error in a short amount of time to no avail, and just knowing someone out there can relate or pass on some additional help, resources or information will give me a lot of hope. Thank you and bless your heart:
I am a 27 year old male that was very healthy (at least I thought). I worked out every other day and ate very healthy (whole grains, lean chicken and vegetables, no fast food, would cut down on my milk intake w/ almond milk, etc). Ive had unusual, concerning digestive issues for the past 2 months and has lead to massive weight loss (from 157lbs to 135lbs from July 7 to August 27).
It should be noted that I have been drinking on and off throughout my 20s and for the past year and a half I became a fan of craft beers, slowly became a heavy beer drinker. Whenever I went out I had 2-3 beers with a dinner and during the last month or so I would binge drink close to a 12 pack every 3 days or so. Since the onset of the sickness I have not touched a drop of alcohol. I am not blind to the idea that this has caused my problem, hence so much concern on my part.
It all started with watery, yellow diarrhea coupled with upper abdominal & back pain for a week. Since then I have had 1-2 bms daily of heavy, soft, tan-colored stools w/ a visible white mucus/fat that is mingled into the stool and small white/yellow bits that float; at times when I flush the stools completely breaks apart.
About a week into this BM habit I started getting symptoms in the anal/rectal area: Very tense feelings in the area that is prominent when seated and the anus feels completely closed off (cant expel gas for up to 24 hours despite being extremely bloated and being able to feel the gases travelling in my bowels). When gas does come out it is very little and I must strain a lot to get it out.
(I have pictures of my feces, unfortunately, lol, but I wont post them publically. I don't want to gross anyone out randomly).
Saw the family doctor on July 21 and was ordered bloodwork (CBC, Enzymes, Liver Function) and all came back normal. I was given samples of Nexium (which I never took) and prescribed 2 Ranitidine 150mg tablets daily from the 21st-28th. I was then prescribed Bentyl 3 times daily on the 28th when I went back due to the symptoms worsening in my anal/rectal area. I then developed constipation and difficulty urinating from the 30th to August 1st, when my physician took me off the Bentyl.
On August 3rd Abdomen X-Rays were taken and no obstructions were found. I began to eat bland meals and cut out gluten and lactose to give my colon a break; the symptoms would fluctuate from moderate to severe day-by-day. I was given Proctofoam-HC and it helps with the swelling a bit.
Saw a GI doctor on the 10th of August and he prescribed a 10-day treatment of Flagyl 250mg 3 times daily with 1 Align G.I. probiotic daily and ordered Stool Samples (Campylobacter, C. Diff, EIA, Shiga, E.Coli, Leukocyte Stain, Ova & Parasites, Salmonella & Shigella). All came back negative/normal.
A sigmoidoscopy was performed the 19th of August. The anal canal, sigmoid colon, descending colon, and splenic flexure were normal. The rectum showed prominent superficial venous lakes and multiple 1mm round erosions with a white center. The doctor's impression is that it could be a nonspecific proctitis and performed a biopsy. Awaiting results.
Had an 8-panel STD test performed showing negative for all STDs except HSV-1. I have had cold sore outbreaks on my lip since childhood so that is not a major finding.
During the Flagyl medication I noticed that I constantly felt short of breath and I would change between straining to urinate and suddenly urinating 3-4 times within hours. I did get significantly better in my anus/rectal area but after the Flagyl treatment I have started getting the symptoms back, albeit less severe: one day I am feeling tons better and passing gas very well to feeling bloated and beginning to feel the inflammation in my rectum, especially after passing my morning BM. Oddly enough, I still have straining urination and the occasional shortness of breath. I am beginning to believe these 2 symptoms, along with my sudden loss of weight/muscle are the result of Anemia.
I explained the returning of my symptoms to my GI over the phone and he gave me a prescription for Flagyl 500mg 3 times daily for 7 days. I have stalled on taking these until the biopsy results are in.
I stopped eating Gluten-free, though I am still staying away from lactose. Now, in an attempt to get nutrients and weight back I am eating roasted chicken pureed with either baked potato or Malanga and supplementing that with Gerber baby foods such as stage 2 Banana, Blended fruits with Oats, Sweet Potato, Banana & Mango, Mixed Vegetables and Stage 3 Mixed vegetables with chicken/turkey. The results are still the same; day-to-day fluctuations between promising and discomfort with the fear I will get a full blown flare-up again or the worse fear that my bowels or urination will suddenly stop functioning.
The positives that I can provide are the fact that I have not had any visible blood in my stool at anytime (except a small bit after my sigmoidoscopy) and I have not had fever.
I am considering getiing a urinalysis and updated bloodwork done that includes a CMP,CBC, Lipid Profile, Amylase & Lipase, ESR, Liver Function and Vitamin blood tests for B1, B6, B12 & Folates, Iron & TIBC, and Ferritin. If any abnormalities come up I will then heavily consider an abdominal ultasound. Since the possibilities of STIs/STDs and bacterial/viral infections has been eliminated I fear that the major issue behind all this may lie either in the small intestine, liver or pancreas.
Welcome to the gastroenterology community! I completely agree with you waiting to take the Flagyl again. I personally think that doctors who perscribe antibiotics for GI problems without knowing what is going on, are not helping their patients and are just possibly causing more problems. Unless your GI doctor can give you a very good reason to take the Flagyl again, I would refuse. I would recommend that you continue taking the probiotics. You had a CBC which you said was normal so you don't have anemia. You may have low iron/ferritin but low iron can't cause any symptoms until it causes iron-deficient anemia (although some people will disagree with me on this). However if you have low iron, treating it is a good idea so that it doesn't turn into anemia. An abdominal ultrasound is very unlikely to show anything at all. A CT scan of the abdomen or a colonoscopy is much more likely to show something.
Thank you so much for your response! I can tell the GI Doc I have now is a brilliant, caring person, but despite that I know he hasnt gotten a full picture and I just feel my body telling me there is more to this than just a bout of nonspecific colitis/inflammation. Until then I think I can bare the pain and frustration for the sake of keeping it safe. My body feels so much frailer than it did 2 months ago and I feel as though every decision I make will count in the long run.
I have some iron pills at home, but I have been weary on taking them yet because I heard they may cause constipation; I feared taking ANYTHING that disrupts bowel function unless I need it but at this point I think it is time to give them a go. I have been taking b-12 sublingually daily for the past week or so and it feels like it is working a bit. Coupled with the iron pills and my multi-vitamin I may start to see a more significant change (unless my body isnt absorbing the vitamins and it is coming out in my wastes).
When I talk to my GI doc next week I will definitely suggest at least an abdominal CT scan and possibly propose an iron and vitamin B tests. Thank you for your suggestions!
I am not trying to scare you, but I think you need to be evaluated for pancreatitis or pancreatic cancer. Three people I know had the same symptoms. They were all 1 pack a day cigarette smokers, and had light or white stools, low back pain and abdominal bloating. They also had yellowing of the skin and eyes. They all died within 6 months of being diagnosed with pancreatic cancer. Just get checked to rule it out.
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