I am a 31 y/o caucasian female. I am an active duty military member, and have been stationed in Adana, Turkey, since June 2002. I have been experiencing chronic diarrhea, and intermittant nausea and abdominal pain for approximately 15 weeks now. The first changes I noticed in my health was that my stools became loose ("cow patty consistency") and light tan-orange in color. Stool frequency also increased to about 7-9 stools a day. Next I began having these "attacks" where I would experience diarrhea (consistency anywhere from loose to watery, and up to 20 stools in one day), moderate to severe nausea (although I have not vomited yet), and a dull, cramping pain in the center of my abdomen (not upper right quadrant). Between these attacks, which may be spaced out as closely as a day to as long as a week, my stools became loose and look poorly digested. I now have to eat Pepto-Bismol tablets like candy--if I don't take one tablet at least three times a day, I will get diarrhea and become nauseous. Also, I experience indigestion and/or heartburn virtually every night. My attacks seem to come on mostly at night. I am usually woken up and have several bouts of diarrhea before I can return to sleep. I can't say for certainty whether or not fatty meals seem to preceed an attack; there doesn't seem to be a rhyme or reason to what I eat and when an attack will follow. I did put myself on a dairy free diet for one month, but did not see any change in my symptoms.
I have received a pretty extensive medical work-up thus far. I first received three separate stool cultures and ova and parasite tests, which were all negative. Repeat CBC and chemistry profiles (including amylase, lipase, and liver enzymes) have all been normal. Colonoscopy with random biopsies was completely normal. I have had two separate abdominal ultrasounds, which were normal (no gallstones seen). I had a barium upper GI series, and initially the radiologist thought I had duodenitis, but endoscopy with random biopsies a week later revealed no pathology. Bloodwork for H. pylori antibodies was negative as well.
My past medical history is as follows. I was diagnosed with overactive bladder 4 years ago, and have been on Detrol-LA 4 mg SID ever since. I did take birth control pills for 1 year, but am not currently taking them. I do have elevated total cholesterol (224), but am not currently taking any medication for it. Otherwise, I am generally a very healthy individual. I have never been pregnant.
My doctor wants to rule out biliary dyskinesia, and plans to send me for a nuclear scan (otherwise he is stumped). My question is, would you consider gall bladder disease (in the absence of stones upon ultrasound) as a possibility? Are there any other rule-outs that you would consider? My symptoms persist, and I am getting extremely frustrated, and just want whatever my condition is to be diagnosed and treated, so I can get on with my life.