Digestive Issues: Weight Loss and Bowel Changes Explained - Gastroenterology and Hepatology

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It sounds like you're experiencing a complex set of digestive issues following your recent colonoscopy and the removal of polyps. Your concerns about weight loss, changes in bowel habits, and the feeling of food not being absorbed are valid and warrant careful consideration.

Firstly, the fact that you had polyps removed and a benign tumor found during your colonoscopy indicates that you are already under medical supervision for your gastrointestinal health. It's essential to continue following up with your healthcare provider regarding these findings. The weight loss you experienced (from 67 kg to 63 kg) is concerning, especially if it is not intentional. Unintentional weight loss can be a sign of malabsorption, which may occur due to various reasons, including changes in gut flora, inflammation, or structural issues in the gastrointestinal tract.

The changes in your stool, such as the presence of undigested brown rice and variations in color (from light yellow to dark brown), suggest that your digestive system may not be processing food effectively. This could be linked to several factors:
1. Dietary Fiber: If your diet is high in fiber but low in digestible carbohydrates, it may lead to the passage of undigested food particles. Foods like brown rice can be challenging to digest for some individuals, especially if there is an underlying issue with the digestive enzymes or gut motility.

2. Gut Health: The presence of benign tumors and polyps can sometimes indicate underlying issues with gut health. If there is inflammation or an imbalance in gut bacteria (dysbiosis), it can lead to symptoms like bloating, gas, and changes in stool consistency.

3. Infections: You mentioned having syphilis and herpes simplex virus, which can affect your overall health and immune response. While these infections primarily affect other systems, they can indirectly impact your gut health, especially if you are under stress or if your immune system is compromised.

4. Smoking: Your smoking habit can also contribute to gastrointestinal issues. Smoking is known to affect gut motility and can lead to conditions like gastritis or peptic ulcers, which may further complicate your digestive symptoms.

Given these factors, here are some recommendations:
- Follow-Up Care: Continue to work closely with your healthcare provider. Since you have already undergone tests that returned normal results, it may be beneficial to discuss further evaluations, such as imaging studies (like an abdominal ultrasound or CT scan) or even a referral to a gastroenterologist for more specialized care.

- Dietary Adjustments: Consider keeping a food diary to track what you eat and how it affects your symptoms. You might want to experiment with a low-FODMAP diet or consult with a dietitian who specializes in gastrointestinal health. This can help identify any food intolerances or sensitivities that may be contributing to your symptoms.

- Hydration and Fiber: Ensure you are drinking enough fluids and balancing your fiber intake. Sometimes, increasing soluble fiber (found in oats, fruits, and vegetables) while moderating insoluble fiber (found in whole grains and certain vegetables) can help improve stool consistency.

- Probiotics: Introducing probiotics may help restore a healthy balance of gut bacteria, which can improve digestion and absorption. However, consult with your healthcare provider before starting any new supplements.

- Stress Management: Since stress can exacerbate gastrointestinal symptoms, consider incorporating stress-reducing activities such as yoga, meditation, or regular exercise into your routine.

In summary, your symptoms are multifaceted and could be influenced by several factors, including your recent medical history, dietary habits, and lifestyle choices. It is crucial to maintain open communication with your healthcare team and seek further evaluation if your symptoms persist or worsen. Your health is paramount, and addressing these digestive issues holistically will be key to improving your overall well-being.