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Kevin Pho, MD  
Male

Specialties: Internal Medicine

Interests: Gastroenterology

KevinMD.com
Twitter.com/kevinmd
Fecal Incontinence
Nov 12, 2009 07:33AM in the Gastroenterology Expert Forum
There are several potential causes for the incontinence. Various types of infections are possible, along with malabsorption or inflammatory bowel disease. More uncommonly, but still possible, is cancer - which can cause any sustained change in bowel movements. I would send the stool off for culture and analysis. A colonoscopy would be a good idea. ...
skinny stools, follow up question
Nov 11, 2009 08:12AM in the Gastroenterology Expert Forum
I agree with the colonoscopy. Of course, with changes in the stool shape or caliber, most will focus on excluding cancer first. Other, less serious, causes would include non-cancerous polyps, or irritable bowel syndrome, both of which can cause your symptoms. But the colonoscopy is needed to rule out dangerous possibilities first. This answer is ...
re: gallbladder
Nov 09, 2009 08:14AM in the Gastroenterology Expert Forum
You clearly had a comprehensive evaluation. There are small studies suggesting that removing the gallbladder in cases of low ejection fraction may help the symptoms. The problem is, however, there is no guarantee and the data behind this is not conclusive. I would consider another GI or surgical opinion to ensure there isn't any other causes. If not...
fullness, skinny stools
Nov 06, 2009 07:26PM in the Gastroenterology Expert Forum
With the extreme fatigue, I would do some basic blood tests, including a blood count looking for iron deficiency. Changes in stool shape or caliber warrants a colonoscopy, especially if this is in the setting of anemia. This test can exclude cancer, masses, or other anatomical causes. A feeling of fullness can be due to upper GI disorders. If your do...
Colonoscopy needed or can it wait?
Nov 06, 2009 07:03PM in the Gastroenterology Expert Forum
I can't give specific recommendations over the internet. In general, a colonscopy would be the more comprehensive test, as the sigmoidoscopy only looks at 1/3 of the colon. That said, blood in the stool with changes in the stool shape or caliber may warrant a more thorough evaluation, especially if you're having symptoms up in the rib area. Eithe...
Stomach upset and overall bad feeling
Nov 06, 2009 06:57PM in the Gastroenterology Expert Forum
I would consider an upper endoscopy at this time to further evaluate the upper digestive tract for various causes of dyspepsia, including an ulcer, inflammation of the esophagus or stomach, or GERD. I agree with the Nexium. If the upper endoscopy remains negative, a 24-hr pH study can be done to exclude GERD, or a gastric emptying scan can be done to look...