Chronic Diarrhea, Abdominal Discomfort, and Post-Vaccine Gastro Issues

Chronic diarrhea + hunger sensation in the stomach + bloating + lower abdominal pain?

I have been experiencing intermittent diarrhea for over three months, with symptoms fluctuating, especially after eating out.
Even when I am not having diarrhea, my stools have become thinner than before, and I haven't had well-formed, solid bowel movements in a long time.
My gastrointestinal system seems to have become very sensitive.
Three weeks ago, after receiving the AZ vaccine, my diarrhea worsened, and I can hardly eat normally; I am only able to consume plain rice or multigrain rice with steamed fish, pumpkin, yam, and carrots.
Eating flour-based products like white buns and noodles also leads to diarrhea.
I found online that flour-based foods are high in FODMAPs, and even eating apples causes diarrhea, although I did not have issues with these high FODMAP foods when my gastrointestinal system was normal.

After adopting this diet and taking the KBT medication prescribed by the clinic doctor, I experienced a temporary cessation of diarrhea for a few days and saw some formed stools, although they were still soft.
The clinic doctor also prescribed an antacid, Mucaine.
However, I initially had no stomach issues, but recently I have started experiencing indigestion, bloating, and some nausea, along with a persistent feeling of hunger.
I then switched to another clinic, where the doctor prescribed Jingtian Stomach Comfort Tablets, Gaslong, and Kuaitong Baili Tablets, which made my stomach feel better.
However, sometimes I still feel slight discomfort in my lower abdomen, and the next morning I experienced watery stools again, with a strong urge to go, resulting in three trips to the bathroom in one morning.
I later took KBT again, which helped stop the diarrhea, but I did not experience pain during bowel movements.
I have checked the side effects of these medications, and they include diarrhea and are not suitable for patients with enteritis.
After taking these medications, I often feel the urge to have watery stools.
Should I seek another doctor to discuss changing my medication? I am unsure if this condition is chronic gastritis or some other disease.
Is it necessary to undergo a gastrointestinal endoscopy soon? Thank you for your assistance.

Jian Dan, 30~39 year old female. Ask Date: 2021/08/24

Dr. Chen Shidian reply Gastroenterology and Hepatology

A gastroenterology outpatient consultation can be provided.
A fecal occult blood test can be performed initially to check for any abnormalities.

Reply Date: 2021/08/24

More Info

Chronic diarrhea, abdominal discomfort, and gastrointestinal issues following vaccination can be quite distressing and may indicate an underlying condition that requires further evaluation. Given the symptoms you've described, including intermittent diarrhea for over three months, changes in stool consistency, and increased sensitivity of your gastrointestinal tract, it is essential to approach this situation methodically.

Firstly, it is important to consider the possibility of post-infectious irritable bowel syndrome (IBS), which can occur after gastrointestinal infections or even after vaccinations. The symptoms of IBS can include abdominal pain, bloating, and altered bowel habits, which seem to align with your experiences. The fact that your symptoms worsened after receiving the AZ vaccine could suggest a potential link, although this is not a common reaction.

Your dietary changes, such as avoiding certain foods like flour-based products and fruits, indicate that you may be experiencing food intolerances or sensitivities. It is not uncommon for individuals with sensitive gastrointestinal systems to react adversely to certain foods, especially after a period of gastrointestinal distress. Keeping a food diary could help identify specific triggers that exacerbate your symptoms.

The medications you have been prescribed, including KBT and other gastrointestinal agents, may have side effects that contribute to your ongoing symptoms. Some medications can lead to diarrhea or gastrointestinal discomfort, especially if they are not well-tolerated by your system. It may be beneficial to discuss these side effects with your healthcare provider and consider alternative medications that may be more suitable for your condition.

Given the persistence and severity of your symptoms, it would be prudent to consult a gastroenterologist for a comprehensive evaluation. A thorough assessment may include laboratory tests, stool studies, and possibly imaging studies to rule out any underlying conditions such as inflammatory bowel disease (IBD), celiac disease, or infections. Additionally, a colonoscopy may be recommended to visualize the colon and obtain biopsies if necessary, especially if there are concerns about chronic inflammation or other gastrointestinal disorders.

In the meantime, focusing on a bland diet that is easy to digest may help manage your symptoms. Foods such as rice, bananas, applesauce, and toast (the BRAT diet) are often recommended during episodes of diarrhea. Staying hydrated is also crucial, as diarrhea can lead to dehydration. Consider electrolyte solutions if diarrhea persists.

Lastly, addressing any potential anxiety or stress related to your symptoms is important, as these factors can exacerbate gastrointestinal issues. Techniques such as mindfulness, relaxation exercises, or even counseling may provide additional support.

In summary, while your symptoms may suggest a functional gastrointestinal disorder such as IBS, a thorough evaluation by a gastroenterologist is essential to rule out more serious conditions. Adjusting your diet, reviewing your medications, and managing stress can also play significant roles in improving your overall gastrointestinal health.

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