persistent diarrhoea

[gnw]

I was diagnosed with ibs 6 months ago after suffering abdominal pain, constipation, wind and mucus.  3 weeks ago i started with diarrohea going up to 6 times a day and went completely off my food. my appetite has slowly returned, however, the diarrohea is still continuing, the stools are very loose, however, i have calmed down to once or twice a day. the doctor thinks i have suffered a bout of gastroenteritis. i have had a rectal exam, blood tests and a stool test, all of which were negative.  My question is is it normal for diarrohea to persist for 3 weeks after gastroenterits and if so, when can i expect a return to normal (I am 42 and female) there is no blood in the stool but I am very concerned i have colon cancer

[Kevin Pho, MD]

Hello - thanks for asking your question.



Chronic diarrhea is defined as loose stools for more than 4 weeks.  Causes include irritable bowel syndrome, inflammatory bowel disease, chronic infections or malabsorption syndromes.  



You stated you have an tests for stool tests - make sure that these included tests for chronic infection such as Whipple's disease, Giardia, Amebae, Cryptosporidium, and Cyclospora.  



Most of the diagnoses for chronic diarrhea requires some sort of endoscopy - either colonoscopy or sigmoidoscopy.  This should definitely be discussed with your personal physician.  If negative, tests for malabsorption (i.e. fecal fat tests, and tests for celiac disease) should be considered.



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.

[GI.PA]

In a patient with a history of IBS, any type of bacterial or viral illness can leave the gut a bit unstable for up to six months afterwards causing a "flare" of their IBS symtoms.  This can persist long after the infection has cleared but usually tapers down in time back to you normal pattern.



If this is not the case, re-evaluation of your situation is called for.  



Erin

GI.PA

[shubunkin]

I have a question. My great grandmother, my grandmother and my mom all had colon cancer. My great grandmother and my mother both died of this horrible cancer. I am 29. My mother was 47 when she died. How early should I get screened? Such as colonoscopy. I take it you are capable to answer this by your earlier comments. Are you a doctor? If so there are several things I would like to ask you. This horrible cancer is destroying my life mentally. Please email me at ***@****. Bless you! Danielle

[GI.PA]

If your mother had colon cancer at the age of 47, by the current guidelines you should start colon screening at the age of 37 (or ten years prior to your mom's diagnosis).  Despite those guidelines I would have a low threshold for ordering a colonoscopy betweeen now and age 37 if you were having any other symtoms (ab pain, bleeding, change in bowel pattern) just to be sure.  



Erin



GI.PA (Physician Assistant in Gastroenterology)

[surgeon]

mucus production isn't really typical of ibs alone. It can be due to infection, inflammatory disease, or certain tumors, especially benign ones called villous adenoma. It sounds, as has been said, as if you need more of an evaluation, which ought to include colonoscopy, in my opinion

[JB STEVENS]

Hi:



My wife was diagnosed with GASTROPARESIS.  She had been constantly nauseated and having diarrhea.  The "SPECIALISTS" determined her stomach was just not working and needed to be removed.  They assured us that she would not be able to throw up after this surgery.  They removed her stomach and connected her esophagus to her upper intestine and made a small pouch for food in her intestine.  She still stays nauseated almost all the time and can throw up as easily as before and has diarrhea constantly.  She used to weigh about 150lbs and is now hovering around 100lbs.  She is very sick and has to go to the hospital now about every 4 to 6 weeks to get fluids and such to help with dehydration and malnutrition.  She has a pretty good appetite and can sometimes only eat just a little and other times amazes me at how much she can eat and not get sick.  The Doctors have said they have tried every medication available to help her.  She takes Xanax and Phenegran which seems to help with the nausea sometimes.  She only seems to be getting worse and I am afraid I am going to lose her.  I can not take that as an answer.

I am currently searching for a specialty clinic/hospital that may be able to help her.  For those of you whose Doctor suggests stomach removal and there is no cancer or other life threatening diseases, please get lots of opinions.  



If anyone has any ideas, please let me know.  You can e-mail me directly at ***@****.



Sincerely desperate,

John B. Stevens

[rhyanen]

I would definitely get the Celiac tests done if I were you.  IBS and Celiac disease are often misdiagnosed as one or the other.  Good luck.