Digestive Issues: Insights on Medication and Diet Impact

Q: Digestive Issues: Insights on Medication and Diet Impact

Hello： 1. It may not necessarily be related; if you have concerns, you can stop using it for now. 2. Food should be chewed thoroughly; any formed substances are likely due to inadequate chewing. 3. The frequency of follow-up examinations should be assessed by

Digestion and Defecation

Hello, Dr.
Tsai.
After my gastroscopy, the doctor mentioned that I have some abrasions in my stomach and mild inflammation in my duodenum.
Previously, I was taking medications including Omeprazole (20 mg), Magnesium Oxide (250 mg), and Gastronorm (40 mg) for a month.
Later, I switched to taking Gaviscon (40 mg) and Lactobacillus probiotics for the past two weeks, as the doctor said Gaviscon is more effective for treating gastroesophageal reflux and esophagitis.
Initially, when I started the medication, I experienced diarrhea, constipation, and abdominal pain (I would feel the urge to go but couldn't).
After a few instances, my bowel movements improved, but now my abdomen sometimes feels bloated, and I often experience borborygmi.
My stools are often loose or small and soft (but not diarrhea).
This issue with my bowel movements has persisted for over two months, although it improved for three weeks in between.
My questions are:
1.
Is the current bloating and loose stools (but not diarrhea) related to the long-term use of medication, or could it be due to my diet?
2.
Additionally, when I eat vegetables, they sometimes come out undigested (for example, I ate straw mushrooms the other day, and they came out whole).
How can I improve this situation? Is it due to intestinal inflammation, irritable bowel syndrome, or is my stomach and duodenum still healing? Or could it be that the stomach medication is suppressing stomach acid, leading to decreased digestive capacity?
3.
Previously, due to diarrhea, constipation, and abdominal pain, the doctor arranged for a colonoscopy, during which three small polyps (about 0.5 cm) were removed and found to be benign (hyperplastic polyps).
However, some areas of the ascending colon were obscured by feces, so it was not possible to confirm the presence of polyps there.
Without a complete examination of the ascending colon, could there be other issues? How often should I follow up for further examination? I had two stool occult blood tests before the examination, both of which were negative.

4.
Could my bowel movement issues be related to the incomplete examination of the ascending colon, or could it be a problem with my small intestine or stomach and duodenum?
5.
The doctor prescribed medication for irritable bowel syndrome (Tegaserod), but the doctor who performed the colonoscopy advised against taking it for now.
Should I take medication for irritable bowel syndrome?
6.
I often experience borborygmi (which I believe is intestinal sounds); is this related to the symptoms mentioned above? Is this normal?
I apologize for asking so many questions, and I greatly appreciate your response.
Thank you very much.

A-Wen, 40~49 year old female. Ask Date: 2020/04/16

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: 1.
It may not necessarily be related; if you have concerns, you can stop using it for now.
2.
Food should be chewed thoroughly; any formed substances are likely due to inadequate chewing.
3.
The frequency of follow-up examinations should be assessed by a clinical physician.
4.
Poor bowel cleansing can lead to issues.
5.
Your symptoms will determine the course of action.
6.
There may not necessarily be a problem.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2020/04/16

More Info

Hello! Thank you for your detailed questions regarding your digestive health and the impact of medications and diet on your condition. It’s great that you are actively seeking to understand your health better. Let’s address your concerns one by one.

1. Abdominal Bloating and Loose Stools: The symptoms of bloating and having loose stools can indeed be related to the medications you are taking. Medications like proton pump inhibitors (PPIs), which are often prescribed for conditions like gastroesophageal reflux disease (GERD) and gastritis, can alter the gut flora and affect digestion. Additionally, magnesium supplements can have a laxative effect, which might contribute to your loose stools. It’s also possible that dietary factors, such as high fiber intake or certain food intolerances, could be exacerbating these symptoms. Keeping a food diary may help identify any specific foods that trigger your symptoms.

2. Undigested Food in Stools: Seeing undigested food, such as mushrooms, in your stool can indicate that your digestive system is not breaking down food properly. This could be due to a variety of reasons, including insufficient stomach acid (which can be a side effect of acid-reducing medications), rapid transit time through the intestines, or potential malabsorption issues. If your stomach and duodenum are still healing from inflammation, it might take time for your digestive function to return to normal.

3. Follow-Up on Colonoscopy Findings: Since you had polyps removed during your colonoscopy, it’s essential to follow up with your healthcare provider regarding the timing of your next screening. Generally, if polyps are found and are benign, follow-up colonoscopies are recommended every 5 to 10 years, depending on the number and type of polyps. Your doctor will provide specific recommendations based on your individual risk factors.

4. Connection Between Symptoms and Colonoscopy Findings: Your current symptoms of bloating and irregular bowel movements may not necessarily be directly linked to the findings in your ascending colon, especially since you had a clean stool test for occult blood. However, issues in the small intestine or ongoing inflammation in the stomach and duodenum could certainly contribute to your symptoms. It’s important to communicate these ongoing issues with your healthcare provider, as they may suggest further testing, such as imaging studies or additional endoscopy.

5. Irritable Bowel Syndrome (IBS) Medication: If your doctor has prescribed medication for IBS but another physician has advised against it, it’s crucial to discuss this with your primary care provider or gastroenterologist. They can help determine whether the benefits of the medication outweigh any potential risks based on your current symptoms and overall health status.

6. Borborygmi (Bowel Sounds): The sounds you hear in your abdomen, known as borborygmi, are typically normal and indicate that your intestines are active. However, if these sounds are accompanied by discomfort or changes in bowel habits, it could suggest increased intestinal activity, which may be related to your diet, medications, or underlying gastrointestinal issues.

In summary, your digestive symptoms could be influenced by a combination of medication effects, dietary choices, and the healing process of your gastrointestinal tract. It’s essential to maintain open communication with your healthcare provider about your symptoms and any changes you notice. They can help tailor your treatment plan to address your specific needs and ensure that you are on the right track to recovery. If symptoms persist or worsen, further evaluation may be necessary to rule out any underlying conditions. Thank you for your thoughtful questions, and I wish you the best in your health journey!

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