Where do I go form here?

[speffy]

My problems started when I went to college and my diet was not the best, alcohol intake increase and I smoked. In the past five years I have chronic diareaha, narrow stools, blood on tissue paper and moderate stomach discomfort after eating.  The blood has always been on the tissue paper and Doctors say it just constant irritation from wiping. No lacotse intolerance or food sensitivty of any consistency as I have kept journal of what I eat.  I have quit drinking all alchohol and smoking with limited intake of caffine from soda.  

I have had the following test:

3 colonoscopies,1 Upper GI,1 Hida Scan,Biopsies taken for Sprue, colits and chrons disease,stool cultures,urine test, MRI scan of small intestine,blood test - liver, pancreas, cbc and about everything we can think of - repeatdly.  These test have been performed  by different general surgeon/gastro/proctologist



I have taken the following medications: Asacol, questrum powder, Zantec, metamucil,Metronidazol and I am currently taking one lomotil a day.  This seems to help to reduce the number of stools, but not the form of them or looseness



The only real sickeness/health problems I ever had before this was Epstein Barr Virus when I was 15.  I am not over weight and maintain a healthy life style



All the of the following tests have revealed absolutely nothing of any kind of abnormalty whats so ever.  Eating any type of food seems to trigger my diarreaha as I have diareaha most of the time within 20 minutes after eating.  Eating the most healthiest of meals may cause diareaha.  Some days I am completley fine and the next is just horrible.  Recently I was told there was nothing else left to check and they pretty much said to deal with it.  We'll do another colonoscopy in two years unless something changes.  I am not giving up and there has to be other things to be looked into.  I am looking for any ideas of specific diets and other tests that can be done.  I am willing to go the Mayo Clinic or any specialist in the country that could help.  My symptoms are not that unbearable, but there are more a nuissance than anything.  I just don't quit when I was fine for 20 years  and now the past 5 I have had this problem.



Thanks for any information you can provide me with.

[Kevin Pho, MD]

You may want to consider malabsorption.  These are a collection of diseases that can result in diarrhea associated with food.  I would suggest testing your stools for fat malabsorption and blood tests for celiac disease.  I agree with going to a major tertiary care medical center to another opinion - the Mayo Clinic is an excellent choice.  



Another consideration would be bacterial overgrowth syndrome which can present in symptoms similar to malabsorption.  This is usually diagnosed via a jejunal aspirate - which is normally performed during endoscopy.  You may want to consider this option.  



If everything continues to be negative, then you may want to optimize treatment for irritable bowel syndrome.  



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.



Thanks,

Kevin, M.D.

[yoshi]

my mother has cervical cancer 11 years ago and she has suffered constant diarhea (diarrhea) since then.

i believe in her case it is the cancer treatment she received which upset her system.

in other cases,prolong use of antibiotics could cause diarhea (diarrhea) such as the 14 days prev pac treatment.

adding yogurt with that good acidphil--- bacteria to your diet would help.

[alexandria]

If the malabsorbtion tests come back fine, you may want to consider exploring treatment for irritable bowel syndrome. For loose stools, consider asking your doctor about librax (it works wonders for spastic colon and IBS).

[spofomaha]

My mother was diagnosed with crohn's disease approx. 15 years ago with alot of the same symtoms you are describing.  If you have been checked out for crohn's please disregard this. I hope all goes well for you.