Soft Stool: Parasite Infection or Medication Side Effects?

Parasitic infectious diarrhea

Hello, Dr.
Luo.
In April 2021, I experienced a mental health crisis and, in an attempt to avoid being forcibly taken to the hospital by my family, I hid in a public restroom at a temple.
During that time, I completely lost my rationality and felt extremely thirsty.
Believing I had an invincible body, I drank water from the squat toilet (not from the clean water tank) using a paper cup, consuming about two to three cups.
A few days later, I began taking antipsychotic medication, and since then, for over three years, I have noticed that my stools have been soft, loose, wet, and unformed (almost resembling diarrhea), making it very difficult to clean myself afterward.
Occasionally, I also experience some leakage after bowel movements.

I would like to ask the doctor whether the cause of my soft stools/mild diarrhea is due to the side effects of the psychiatric medication or if it could be a result of accidentally drinking contaminated water from the toilet three years ago, potentially leading to an intestinal infection from parasites or bacteria.
Currently, my symptoms are limited to mild diarrhea (I maintain a light diet, consume enough fruits and vegetables, and typically have one bowel movement a day at a consistent time).
I have not experienced fever, vomiting, weight loss, abdominal pain, mucus, or blood in my stools.
What is the likelihood of having a parasitic infection in this case? Should I go to the hospital for a stool examination? Thank you very much for your response, Dr.
Luo.

Miss Lin, 20~29 year old female. Ask Date: 2024/04/25

Dr. Luo Yining reply Gastroenterology and Hepatology

Most intestinal parasites enter the human body through the oral route.
Poor dietary or hygiene practices, such as consuming raw or undercooked food, drinking unclean water, and failing to wash hands before eating or after using the restroom, can lead to the ingestion of parasite eggs and subsequent infection.
Some psychiatric medications may also cause abdominal discomfort or diarrhea.
It is advisable to consult with a psychiatrist to discuss possible medication adjustments.
If diarrhea persists, seeking treatment from a gastroenterologist is recommended.

Reply Date: 2024/04/25

More Info

Understanding the causes of soft stools can be complex, especially when considering both potential infections and medication side effects. Based on your description, there are a few key factors to consider regarding your symptoms.

Firstly, the incident where you consumed water from a public toilet raises concerns about possible exposure to pathogens, including bacteria and parasites. Drinking contaminated water can lead to gastrointestinal infections, which might manifest as diarrhea or soft stools. Common pathogens associated with such exposure include Giardia lamblia, E. coli, and various viruses. However, the absence of additional symptoms such as fever, vomiting, abdominal pain, or blood in the stool makes a severe infection less likely. The fact that you have maintained a stable diet and regular bowel habits also suggests that your body may have adapted to some extent.

On the other hand, the medications you are taking for your mental health condition could also be contributing to your gastrointestinal symptoms. Many antipsychotic medications are known to cause gastrointestinal side effects, including constipation, diarrhea, or changes in stool consistency. If you have started a new medication or changed dosages recently, this could be a significant factor in your ongoing symptoms.
Given that you have experienced these symptoms consistently for over three years, it would be prudent to consult with a healthcare professional. A thorough evaluation, including a review of your medication regimen and a discussion of your gastrointestinal symptoms, is essential. A stool test could help identify any potential infections, including parasitic infections, and rule out other gastrointestinal disorders.

In terms of the likelihood of a parasitic infection, while it is possible, especially given your history of consuming potentially contaminated water, the absence of acute symptoms typically associated with such infections makes it less likely. However, chronic infections can sometimes present with milder symptoms, so it is not entirely out of the question.

In summary, both the potential for a parasitic infection from the contaminated water and the side effects of your psychiatric medications could be contributing to your symptoms. It is advisable to seek medical attention for a comprehensive evaluation. A healthcare provider can perform necessary tests, review your medication, and provide guidance on managing your symptoms effectively. Regular follow-ups and open communication with your healthcare team are crucial in addressing these ongoing concerns.

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