Persistent Diarrhea and Possible Parasites: A Gastrointestinal Concern

Diarrhea for six months?

Hello doctor, I would like to ask about a situation I've been experiencing.
I previously noticed that my stools have become loose and mushy, and when they are somewhat better, they appear as clumps or thin, broken pieces.
I initially thought this would resolve on its own, but this condition has persisted for over six months.
During this time, I have not had a normal bowel movement, and I often notice blood when wiping.
I frequently feel like my bowel movements are incomplete.
Recently, I've also observed a thin layer of white foam on my stools.
The frequency and volume of my bowel movements have increased as well.
Do these symptoms indicate that something is wrong with my body? Additionally, I have often seen a small white worm in the toilet.
My anus sometimes itches and can be painful, but I do not wake up at night or in the morning due to itching.
Could this be a sign of some kind of parasite? Thank you for your response, doctor.

Niming, 20~29 year old female. Ask Date: 2016/08/28

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, sir.

1.
Please visit the gastroenterology outpatient clinic to check your stool for the presence of parasitic eggs or occult blood.

2.
You may use probiotics and reduce your intake of dairy products and oils to decrease loose stools.

Changhua Hospital cares about your health.

Chen Shih-Tien

Reply Date: 2016/08/28

More Info

Persistent diarrhea, especially when accompanied by symptoms such as blood in the stool, changes in stool consistency, and the presence of unusual objects like small white worms, can indicate several gastrointestinal issues, including infections, inflammatory bowel disease, or parasitic infections. Given your symptoms, it is crucial to seek medical attention for a thorough evaluation.

Understanding Your Symptoms
1. Persistent Diarrhea: Diarrhea lasting more than a few weeks is considered chronic and can be caused by various factors, including infections (bacterial, viral, or parasitic), food intolerances, inflammatory bowel diseases (like Crohn's disease or ulcerative colitis), or even certain medications. The fact that your diarrhea has persisted for over six months is concerning and warrants further investigation.

2. Blood in Stool: The presence of blood in your stool can be alarming. It may indicate several conditions, ranging from hemorrhoids to more serious issues like gastrointestinal bleeding from ulcers, diverticulitis, or even colorectal cancer. Given your family history of colorectal cancer, this symptom should not be taken lightly.

3. Stool Consistency and Appearance: The changes in your stool, including the presence of foam and the description of your stools as "thin" or "broken," can suggest malabsorption issues or infections. Foamy stools can sometimes indicate fat malabsorption, which could be due to conditions like pancreatitis or celiac disease.

4. Presence of Worms: The sighting of small white worms in your stool is particularly concerning and could indicate a parasitic infection, such as pinworms or tapeworms. These parasites can cause gastrointestinal symptoms, including diarrhea, abdominal pain, and itching around the anus.

5. Anal Itching and Pain: Itching around the anus can be a symptom of pinworm infection, which is common, especially in children but can affect adults as well. It can also be caused by irritation from diarrhea or other skin conditions.

Recommended Actions
1. Consult a Gastroenterologist: Given the complexity and duration of your symptoms, it is essential to consult a gastroenterologist. They can perform necessary tests, including stool tests to check for parasites, blood tests to assess for inflammation or infection, and possibly imaging studies or endoscopy to visualize the gastrointestinal tract.

2. Stool Analysis: A stool sample can be analyzed for the presence of parasites, bacteria, and other abnormalities. This is a crucial step in diagnosing the cause of your symptoms.

3. Dietary Considerations: While waiting for your appointment, consider keeping a food diary to track what you eat and any correlations with your symptoms. Certain foods can exacerbate diarrhea, and identifying these may help manage your condition temporarily.

4. Hydration: Ensure you stay hydrated, especially if you are experiencing diarrhea. Electrolyte solutions can help maintain your hydration levels.

5. Avoid Self-Diagnosis: While it is tempting to search for answers online, self-diagnosing can lead to unnecessary anxiety and may delay appropriate treatment. Rely on professional medical advice.

Conclusion
Your symptoms are concerning and suggest that there may be an underlying gastrointestinal issue that needs to be addressed. The combination of persistent diarrhea, blood in the stool, and the presence of worms indicates that you should seek medical attention promptly. A gastroenterologist can provide a comprehensive evaluation and appropriate treatment based on the findings. Remember, early diagnosis and treatment are key to managing gastrointestinal health effectively.

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