Chronic Diarrhea

Hi,

I have been away from the forum for a while. I am 10 years out with a surgery with a RNY pouch and a 200cm common channel.

I regained about 15-20 pounds during this time, but have felt well, and taken all my minerals and vits. Labs have generally been good.

I had a colonoscopy and endoscopy in May of this year, just routine tests for my age , I am 60.

While I have had diarrhea occasionally through the years, things had settled down and I had  normal stools for a long time.

After the testing, in May of this year, I have had chronic diarrhea. Both scopes were normal, and nothing of note was found.

I've has stool cultures and testing, CT with and without contrast, been prescribed Creon ( pancreatic enzymes even though my tested dead in the middle of normal) and generic Qrestran. All with little effect.

 I've lost 22 pounds without trying, and am now feeling exhausted. My protein is low, D a little low, PTH a little high, iron a little low, but these are all recent changes. Liver enzymes great, but as expected I was found to malabsorb fat, which was of course present in my stool sample.

I am presently taking Immodium if I have to be away from home, and cannot work due to fatigue and tummy troubles.

Ant ideas from anyone? Some test or diagnosis that should be considered? My need to help is desperate. If anyone has an idea of a forum away from OB, I have an account there but have forgotten how to find it.

I thank anyone who take the time to read this and post to me.

Sally

It sounds an awful lot like C-diffucile, which is basically a bacterial infection in the bowel and can take a long time to cure.  Some do a few rounds of different antibiotic combinations trying to kill it off, for it can be very resistant.

Even if it's not C-diff, we are still prone to bacterial imbalances from time to time where there isn't enough good flora in the bowel to balance out the bad, and the bad takes over.  To help prevent it, enjoy some probiotics daily.  Some simply take a supplement, while others enjoy the live cultures from yogurts and fermented foods.  This helps keep that population in good balance.

Thank you for your reply. I was tested for C-Diff, first by stool sample, and also collection during the colonoscopy. I take tons of probiotics and eat yogurt daily.

The only other thing of note was that the stool was burning my butt up. I believe the Questran does absorb or bind bile salts because at least the burning is improved. I also did the breath test for H Pilori, and for possible overgrowth of bacteria in the small bowel.

Today I was told by my PC, that he would gladly send me to a specialist in a larger city, as he has nothing more to offer.

has your diet changed? The only time I have diarrhea is when I eat carby white flour products,bread,etc.,or sugar alcohols. Anything that ends with "ol" like malitol. 

Hope you find the issue. I would also suggest trying probiotics. There is one that is prescription that a lot of DS ears use,but I don't know the name.

Have you tried Flagyl?  Many times you can have bacterial overgrowth and still have negative cultures.  I was told that there are so many possible strains of bacteria and the cultures only test for a few.

Give that a try and if things improve you have your answer.  Since this is fairly new you may be able to get away with a course of Flagyl along with good probiotics to replenish the good bacteria and keep things in balance.

Did you happen to take antibiotics right before this started?  That starts issues many times.

If the diarrhea improves after Flagyl but gradually starts coming back you may be looking at SIBO or CIBO, which sometimes can be treated with a maintenance dose of Flagyl, although many doctors are reluctant to prescribe that due to resistance concerns.

There is a new antibiotic - Xifaxan - it is expensive but it can help with runs due to SIBO..

I assume you tried all diet - low fiber - things like cooked chicken veggies only...Google elimination diet..

I developed allergies to some food and as long as I avoid that - my gut is much more happy...

Thanks for all suggestions. I have had Flagyl, which I took for 3 weeks, against my doctor's opinion, but he wrote it anyway. The Flagyl gave me severe stomach pain and burning. I did it anyway, but feel it was more negative than positive!

Until I get that referral for more expert help, I'll keep taking the Questran,avoid most fats, taking probiotics, and eating yogurt.

    Sally, I had a WLS open hybrid  surgery  20 years ago, and have had this issue in the past,.. I was needing to use 6 immodium daily to be able to function, work and wear clothing...etc... my  enzymes are insufficient and I don't tolerate dairy/yogurt/cheese usually..  Add liver or buffalo liver extract to build your iron. if enzymes are your issue you may not have ability to absorbiron either...

   . I found that an herb called Rabbit Tobacco, available from herbalists in northern Ga and east Tn, Whole herb or leaves both will work to make tea...I also double tincture and reduce the alcohol in it, to use for same symptoms..(.I use 2cc of double tinctured)..".RT" works well, stops my loose stools and never have diarrhea when I use it as a tea, I use ten leaves or 6 inches of stems, cut up and mashed, steeped for 20 minutes... and i add a peppermint bag ad stevia to it to sweeten and flavor better. Steep  in hot but not boiling water. It replaces many enzymes, and also helps my lactose intolerance. with these amounts the amount I use is  a whole cup sipped warm.

     There is a write up about it by Daryl Paton. if you put the herbal name and his name in the search engine should pull up the article. This is where I got my info.. I have been using it for about 7 years.. I pick mine wildcrafted, so no one  source I can recommend , strength varies with the nutrients in the soil, so start with the amounts ai gave and add slowly til you find how to make it for you.. a heavy amount will make you cramp. but that amount is measured not in leaves, but by the ounce.( If you use it daily one ounce to 16 oz water, makes 16 doses..)  .If you live in the southeast, ask an old farmer.he may be able to find you enough to try.   This works for me and does take care of the lactose intolerance as well. I can enjoy egg nog again at Christmas!

I have had non-specific chronic diarrhea for over 3 years. I haven't had my surgery yet. All my tests are negative. OTC diarrhea medications do not work for me. My physician has me on Colestipol Micronized 1 GM 3 times a day as needed. It works well and, in fact, a little too well. I no longer have to take it as much. You may want to ask your physician about it. I hope you are able to find a resolution soon.

~Donna