Chronic HBV and Intestinal Issues

Hello:

I want to begin by saying that I have an appointment with a world-reknown gastroenterologist scheduled for January to address these issues. I have immediate concerns, however, and am curious whether I should go to the hospital for a faster examination. If you can give me some advice, such as go to an ER immediately or what I may expect to hear from the GI doctor in January (to easy my anxiety), please do so.

Background:

I am a 27 year old male. I tested positive for Hepatitis B in or around September 2006. It was determined that the infection was chronic roughly two months later. PCR tests done around the time diagnosis and around one year ago showed a drop in viral load from 10million per unit to around 6 million per unit. I was, at one point, on entecivir but took myself off roughly two months later due to side effects.

Question:

In the past three years I have noticed changing symptoms, most of which were related to the coloration, quantity, or quality of my stools. The initial symptom I developed, which persists to this day on an intermittent basis, was a dull ache in my upper right abdomen that radiates toward my back just below and including portions of my lower back ribcage. The dull ache could last hours or days, then go away, and return. I have mostly kept it to myself.

In the past year and a half I have noticed a change in the consistency and color of my stools. I remember there were a couple times in 2009 when I would have a hard stool, but it would be a metallic, bilious green. From there the consistency began changing, where stools would float and more dense stools were less common. The stools would look solid or relatively solid in the toilet, but when I wiped myself it would be tarry and difficult to keep my rectum clean (I would manage, but it might have used half a roll of toilet paper).

About six months ago, I noticed the the color of my stools began turning more 'clay-like' but still somewhat bulky. The main thing was when I would wipe the toilet tissue would be covered in a bright yellow liquid. The liquid would smell very putrid. Every BM would have this yellow liquid upon wiping.

In the past month, the yellow liquid is no longer there. However, my stools are clay-colored and have no consistency at all. I find pieces of undigested food in them. Food is moving through me, from chewing to evacuating, within an hour to three hours. When it comes out it has no bulk, and is so delicate that when I flush the initial 'back draft' of the water pressure in the toilet before the suction toward the drain causes the entire BM to puff into a, like, a cloud of smoke.

I have read about fiber... so I began changing my diet around a week ago, eating less fats (unless high in protein), and more leafy greens. For breakfast I will eat plain oatmeal, a banana, an apple, and grapefruit juice blended into a smoothy. Around 9:30, I will have a hardboiled egg or a container of yogurt. For lunch I will have a sandwich with low-fat meat, such as turkey, a piece of cheese, some sort of herb mix, and no mayo on a high-fiber bread; an apple; some whole grain snack crackers; and an orange. Around 2:00 o'clock, I will have another high protein snack, like a can of low-sodium tuna fish. For dinner I will have steamed fish and vegetables.

This diet, despite making me tone up and giving me more energy, has not changed my stool... I have tried soluble and insoluble fibers, they move right through me almost completely undigested. I have suspected that the dull ache has not been the liver itself, but perhaps my gallbladder and I have a biliary duct obstruction -- this remains to be determined until my meeting with the GI doctor in January.

Anyone else experience symptoms like these? What caused the slow dissipating in the coloration, consistency, quantity, and quality of your BMs? I am concerned it may be something serious like liver or pancreatic cancer. (I have also had repeated protruding hemorrhoids.) What does this sound like, and what could I possibly expect to hear from my GI doc?

Thanks.

[jonny168]

i've somewhat similar stool condition. but not always ... i guess i'm just saying it happens to other people to. i just don't know what it implies myself.

[StephenCastlecrag]

I don't know what to say.  Science has moved on a bit since the days when stool was used as a diagnostic tool.
If you have gallstones, bile duct obstruction can cause severe pain, like the one you described.
I am not a doctor, to ease your anxiety, why don't you get a liver functions test and assay for hbvdna, the results will be useful when you see your specialist, he/she would most probably order the same tests anyway.

[PinoyHBVDNA]

Yes pls see a doctor and what u have may or may not be related to hepb.