Cause of daily problem of having multiple loose stools

[Isabeljo]

In 2005, I was diagnosed with parathyroid failure which caused my intestinal muscles not to work normally and autoimmune pancreatic insufficiency, all causing me to have multiple dumps. After the Hpth problem was controlled and I was placed on enzymes for every meal, the stools were better controlled, but increased in frequency. My worm/infection tests on my bowels were negative. In 2006, I was diagnosed with gluten sensitivity (antibody tests were moderately positive), found to have multiple adhesions (including 1 or 2 causing partial obstruction of my small bowel), and diverticulosis (which causes some pain on evacuation and dull chronic pain). In 2007, it was decided that I may not have pancreatic insufficiency, but my enzyme production is low normal based on the PE-1 test (300). My stools now are 8-10 times per day, always loose. I sense that my evacuations are incomplete. Does my stool pattern indicate that the adhesions are the main cause of the multiple dumps and looseness? My pattern is: 3 loose BMs in the morning on rising, 1/2 hour or 1 hour after a main meal at noon, 2-3 loose BMs, and if I drink water after the meal, I continue to have loose stools. If I stop drinking water, they stop. It's like I need water to clear my stools. At night after a meal another 3 BMs or more. I am bloated after I eat, have to move my pants waist down below my belly to prevent a BM accident, my stomach gurgles on the left lower side, some pain around my navel. Does diverticulosis have anything to do with this? Today my gastro doc will discuss what next tests need to be done to monitor and prevent a complete obstruction.

[crux]

A related discussion, Daily Watery Stools was started.

[Josleas]

You say you were diagnosed with gluten sensitivity with a positive antibody test. Did you have a biopsy to check for celiac disease? Multiple loose stools, bloating and stomach pain are classic symptoms of celiac and it should be checked for if it hasn't already. It is often misdiagnosed as irritable bowel syndrome. You risk osteoporosis, anemia, bowel cancer and other complications if you have untreated celiac disease yet it is treated with 'just' a diet change and is easy to diagnose. Do NOT start a gluten free diet until you have been tested (blood test and biopsy) or you will probably get a negative result even if you have celiac as healing will begin as soon as you are on the diet. It is worth getting a proper diagnosis because it's not an easy diet to follow and it would be even harder if there were any doubt in your mind that you needed to follow it. It is worth being tested again even if you have been clear in the past as CD can develop at any time.

[lizziecee]

Your query struck such a cord with me. When I was 26 yrs old, in 1970, I had severe weight loss and diarrohea - no pain. I was treated at some 5 different hospitals in London, England, some of the best teaching/university hospitals and no-one could come up with a proper diagnosis as I didn't "present properly" for Crohn's. My first husband tried to tell me it was "all in my mind". Colonoscopy was unknown then in the UK and I had to endure many weeks in hospital with B12 absorption and Schilling tests, to mention just a few - the worst was a 3 day faecal fat collection I had to do in hospital in an old coffee tin! You don't need to do these tests these days.Medical tests have moved on exponentially.

I had an endoscopic biopsy for coeliac disease which was negative, and to cut a long story short, ended up with a laparotomy, and after 3 days of blood transfusions, with a dx of Crohn's disease. I have lived with this for some 37 years now, and have learned a lot.  As far as I know, the only way to really dx Crohn's is through a biopsy of either the small or large bowel. There is no other way that I know of to determine whether you have it or not.The gastro must send the tissue to a pathologist, and even then the dx can be Crohn's or Ulcerative Colitis, but if you get a good pathologist, they know the difference. It can be a long, lonely road.

I really do hope you don't have Crohn's as it is a life long chronic disease, but if managed properly, is not terminal. I now do self injected methotrexate weekly, and this has brought the symptoms under control, so I now only have watery stools on rising in the morning, and occasional ones in the afternoon after lunch.I have no pain, but a lot of gurgling on the left side of my abdomen.However, I have had many flares and rectal haemmorhages and been hospitalised many times - this only happened some 20 yrs after getting Crohn's. I am doing well now.

I got breast cancer in 2003 which complicated my much needed FEC chemo treatment for that,as I had to stop methotrexate and had horrendous problems,being faecally incontinent in the street, so I would not leave our apt except for chemo treatments for breast cancer.  I have survived now for some 4 years, so there is always light at the end of the tunnel. I will be happy to answer any questions you have, but if I were you, I would ask for an endoscopy of your small intestine, and a colonoscopy of your large intestine.

Treatment and meds have come a long way since I was first dx - then on 60 mg of steroids a day, which made me double my weight from 60 lbs to 120 lbs in 6 weeks with all the attendant side effects like moon face, horrendous amounts of body fat and dreadful mood swings. I now have serious bone density loss through steroids, but it is being addressed by bisphosphatase drugs along with calcium and vitamin D.
If you want to talk privately, please feel free to email me on: ***@**** and I will endeavour to answer your questions. Just wish I had the internet when I was dx, some 37 years ago,  as nobody knew what Crohn's was, and certainly didn't want to know the symptoms/problems. I do know how difficult it must be for you - seems to me like the last taboo, almost like having the bubonic plague  - very isolating, but you can deal with it!
Take care,
love. Liz.

[Kevin Pho, MD]

Adhesions typically would cause constipation, rather than an increase in bowel movements.  

I would consider things like irritable bowel disease or malabsorption.  If there is gluten sensitivity, a gluten-free diet can be considered.  Testing the stools for malabsorption can be considered as well.

An endoscopy can be considered to visualize the bowel for colitis or inflammatory bowel disease.

It is less likely that the diverticulosis is linked to the loose bowel movements.

I would discuss these options with your GI physician.

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.

Kevin, M.D.
kevinmd_