What should I do if I have persistent diarrhea?
Hello, Dr.
Lin! I have been experiencing diarrhea for over a year, but it's not daily.
However, I have episodes every two to three days (when it's better), and every time I eat, I get stomach pain and rush to the bathroom! Sometimes the pain lasts for about a minute! I had my gallbladder removed three to four years ago, and I also have a history of mitral valve prolapse, ischemic heart disease, hepatitis B, acute gastroenteritis, anemia, and other conditions.
I saw on the news that a celebrity with long-term diarrhea was diagnosed with colon cancer.
Could my symptoms also be a sign of colitis? Should I schedule an appointment with internal medicine or gastroenterology?
Xiao Rong, 20~29 year old female. Ask Date: 2006/07/06
Dr. Lin Minghui reply Gastroenterology and Hepatology
Hello: 1.
There are many causes of diarrhea, including dietary factors (such as unclean or greasy foods), intestinal inflammation, and the presence of growths in the intestines (such as polyps or tumors), as well as biliary and pancreatic diseases.
Early-stage cancer may not present symptoms, but if there is persistent diarrhea, blood in the stool, unexplained weight loss, and anemia with a family history of colorectal cancer, further examination is recommended.
2.
You can schedule an appointment with either a gastroenterologist or a general internist.
Sincerely, Dr.
Lin Ming-Hui, Internal Medicine.
Reply Date: 2006/07/06
More Info
Chronic diarrhea can be a distressing condition, and your symptoms warrant a thorough evaluation. Given your history of gallbladder removal and other medical conditions, it’s essential to approach this situation with care. Chronic diarrhea, defined as diarrhea lasting more than four weeks, can have various causes, including infections, inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), malabsorption syndromes, and even certain cancers, such as colorectal cancer.
Your experience of abdominal pain accompanying diarrhea, especially after meals, could suggest a few possibilities. One common cause in individuals who have undergone gallbladder removal is bile acid diarrhea. The gallbladder stores bile, which helps digest fats. After its removal, bile can flow directly into the intestines, potentially leading to diarrhea, particularly after fatty meals. This condition can often be managed with dietary adjustments or medications that bind bile acids.
Given your medical history, including ischemic heart disease and hepatitis B, it’s crucial to consider how these conditions might interact with your gastrointestinal symptoms. For instance, certain medications used for heart conditions can sometimes lead to gastrointestinal side effects, including diarrhea. Additionally, chronic liver conditions can affect digestion and absorption, leading to gastrointestinal symptoms.
Your concern about the possibility of colorectal cancer is understandable, especially given the alarming stories often highlighted in the media. While chronic diarrhea can be a symptom of colorectal cancer, it is essential to remember that many other benign conditions can cause similar symptoms. However, your history of chronic diarrhea, especially with abdominal pain, does necessitate further investigation to rule out serious conditions.
When seeking medical help, it would be advisable to see a gastroenterologist, as they specialize in digestive system disorders. They can perform a thorough evaluation, which may include a detailed history, physical examination, and possibly diagnostic tests such as blood tests, stool studies, imaging studies, or a colonoscopy. A colonoscopy is particularly important if there are any alarming features, such as blood in the stool, significant weight loss, or changes in bowel habits.
In summary, while your symptoms could be related to several conditions, including post-cholecystectomy syndrome or even more serious issues, it is crucial to seek professional medical advice. A gastroenterologist will be best equipped to diagnose the underlying cause of your chronic diarrhea and recommend appropriate treatment. Early intervention can often lead to better outcomes, so don’t hesitate to make an appointment. Your health is paramount, and addressing these symptoms sooner rather than later is the best course of action.
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