Managing Long-Term Diarrhea: Causes, Treatments, and Next Steps

Q: Managing Long-Term Diarrhea: Causes, Treatments, and Next Steps

Hello： If further examination is needed, a physician's assessment can determine whether a stool test and a stool fat test are necessary. <br>Changhua Hospital cares about your health. <br>Dr. <br>Tsai An-shun.

Chronic diarrhea

I have been vegetarian from third grade to senior high school, and after starting college, I switched back to eating meat.
Since then, my bowel movements have gradually changed, and I often experience diarrhea.
In the second semester of my sophomore year, I underwent a colonoscopy, but nothing was found.
When I take the medication prescribed by the doctor, my stool changes from loose, thin shapes to more solid, round shapes.
However, after finishing the medication, I did not return for a follow-up appointment.
My bowel habits fluctuate; most of the time, my stool is either thin or shaped like a log.
I drink water daily, have regular meals, and maintain a normal sleep schedule.
I also exercise once a week and have bowel movements 2-3 times a week.
Should I undergo any further tests, or could this be irritable bowel syndrome?

Da Hei, 20~29 year old female. Ask Date: 2017/11/26

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: If further examination is needed, a physician's assessment can determine whether a stool test and a stool fat test are necessary.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2017/11/26

More Info

Managing long-term diarrhea can be a complex issue, especially when it follows a significant dietary change, as you've experienced transitioning from a vegetarian diet to including meat. The symptoms you've described, such as alternating between loose and formed stools, could suggest a few potential underlying causes, including irritable bowel syndrome (IBS), food intolerances, or even post-infectious diarrhea, especially if you had any gastrointestinal infections in the past.

Understanding the Causes
1. Dietary Changes: Shifting from a vegetarian to a meat-inclusive diet can alter your gut microbiome, which may lead to digestive issues. The introduction of new proteins and fats can sometimes overwhelm the digestive system, particularly if your body is not used to processing them.

2. Irritable Bowel Syndrome (IBS): This is a common functional gastrointestinal disorder characterized by symptoms like abdominal pain, bloating, and changes in bowel habits (diarrhea or constipation). Stress and dietary changes can exacerbate IBS symptoms.

3. Food Intolerances: You might have developed an intolerance to certain foods, especially if you are consuming more dairy or gluten after your dietary change. Lactose intolerance or gluten sensitivity could lead to diarrhea.

4. Infections or Inflammation: Even if your colonoscopy did not reveal any significant issues, it’s essential to consider that some infections or inflammatory conditions may not be visible during such procedures.

Treatment Options
1. Dietary Adjustments: Keeping a food diary can help identify any potential triggers. You might want to try an elimination diet to see if certain foods exacerbate your symptoms. Gradually reintroducing foods can help pinpoint intolerances.

2. Probiotics: Incorporating probiotics into your diet can help restore the balance of good bacteria in your gut. This can be particularly beneficial after dietary changes or antibiotic use.

3. Medications: If your diarrhea is frequent and disruptive, medications such as loperamide (Imodium) can help manage symptoms. However, it’s crucial to consult with a healthcare provider before starting any medication.

4. Stress Management: Since stress can significantly impact gut health, incorporating stress-reducing techniques such as mindfulness, yoga, or regular exercise can be beneficial.

Next Steps
Given your ongoing symptoms and the fact that they fluctuate, it would be wise to follow up with a healthcare provider. They may recommend additional tests, such as:
- Stool Tests: To check for infections, parasites, or malabsorption issues.

- Blood Tests: To evaluate for signs of inflammation or nutritional deficiencies.

- Further Imaging: If necessary, to rule out other gastrointestinal disorders.

Conclusion
Long-term diarrhea can be distressing and may indicate an underlying issue that needs addressing. Since you have already undergone a colonoscopy, it’s essential to communicate with your healthcare provider about your ongoing symptoms. They can help determine whether further testing is necessary or if a specific treatment plan should be implemented. Remember, managing your diet, keeping track of your symptoms, and maintaining a healthy lifestyle are crucial steps in addressing your gastrointestinal health.

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