Persistent Diarrhea: Insights into Colitis and Digestive Health

Q: Persistent Diarrhea: Insights into Colitis and Digestive Health

Hello： If the Veterans General Hospital performed a complete colonoscopy and reported no issues, then there should be no need for excessive worry. <br>However, the change in diagnosis from irritable bowel syndrome (IBS) to ulcerative colitis should be clarified with your physicia

Persistent loose stools?

This summer, on July 13, I suddenly developed a fever and diarrhea (without pain).
After that, I continued to have diarrhea (I consulted a doctor at a clinic).
Around July 23, I was referred to Taipei Veterans General Hospital for further evaluation, where they scheduled me for an upper gastrointestinal endoscopy and a colonoscopy.
Since there was no pain, the actual condition was unclear.
The doctor said my stomach was fine, but during the colonoscopy, they found a red spot about 30 centimeters in, and another red spot at 80 centimeters, both of which were benign.
The doctor only prescribed me intestinal pills and anti-flatulence medication.
During this period, I continued to have diarrhea; sometimes it was formed but always thin and soft.
On August 28, I suddenly felt a tightness in my abdomen without pain and had to rush to the bathroom six times, prompting another visit to the hospital.
They scheduled a follow-up sigmoidoscopy (without anesthesia, and the doctor only looked for about two minutes, which made me worry he didn’t examine thoroughly).
The report stated that I was fine and didn’t need medication, but the diagnosis given to me was not irritable bowel syndrome but ulcerative colitis...
(During the diarrhea period, I only felt pain twice, including the tightness on August 28).
Currently, my condition is: "I have bowel movements 2 to 3 times a day (previously I had severe constipation).
During the day, my first bowel movement is formed, and it feels like thin, soft strips, but by the time I flush the toilet, it has already turned mushy.
The second bowel movement is unformed, mushy stool, not watery." "I have been eating a lot of vegetables now (which is the opposite of before), and my stool contains a lot of vegetable residue, sometimes even greenish stools, which smell." "Sometimes I feel a localized pain in my abdomen, not very intense, lasting 1 to 2 seconds, intermittently, mostly in the lower left and right abdomen, particularly about 9 cm above the navel." "I have a lot of gas." "I’m not sure if it’s because I’m eating much less than before, but I feel like I’m losing weight rapidly: from 107 kg on July 13 to 90 kg on September 8." Doctor, I apologize for taking up so much of your time with this message, but I am really worried.
I would like to ask if my current condition is concerning?

Feichang Youlv de Ren, 20~29 year old female. Ask Date: 2013/09/08

Dr. Ke Fangxu reply Surgery

Hello: If the Veterans General Hospital performed a complete colonoscopy and reported no issues, then there should be no need for excessive worry.
However, the change in diagnosis from irritable bowel syndrome (IBS) to ulcerative colitis should be clarified with your physician.
IBS is caused by impaired intestinal motility and is not a serious condition (though it can be quite bothersome).
Ulcerative colitis, on the other hand, is an autoimmune disease where the immune system attacks the intestinal mucosa, leading to ulcers and bleeding in the intestines, which is considered a significant health concern.
It is the physician's responsibility to clearly communicate which diagnosis you have and to establish a treatment plan.
Regarding the issue of weight loss, since you were already overweight and have been eating irregularly, it is difficult to determine whether your weight loss is a positive development or a result of the disease.
It is recommended that you consult with a family medicine physician for nutritional counseling to promote your overall health.

Reply Date: 2013/09/08

More Info

Understanding persistent diarrhea, especially in the context of colitis and digestive health, is crucial for managing symptoms and preventing complications. Based on your detailed account, it appears that you have been experiencing significant gastrointestinal issues, including persistent diarrhea, which has led to weight loss and changes in bowel habits.
From your description, it seems that you were diagnosed with ulcerative colitis, which is an inflammatory bowel disease (IBD) characterized by chronic inflammation of the colon. The presence of red spots in your colon during the endoscopy suggests areas of inflammation, which can be common in ulcerative colitis. The fact that these lesions were deemed benign is reassuring, but it is essential to monitor your condition closely.

Your current symptoms, including the frequency of bowel movements (2-3 times a day), the consistency of your stool (soft and sometimes mushy), and the presence of undigested food particles, indicate that your digestive system is still adjusting. The changes in your diet, particularly the increase in vegetable intake, may contribute to the changes in your stool consistency and frequency. High-fiber foods can lead to more frequent bowel movements and can sometimes cause gas and bloating, which might explain the increased flatulence you mentioned.

The intermittent abdominal discomfort you are experiencing, particularly in the lower abdomen, could be related to the underlying inflammation from ulcerative colitis. It is not uncommon for patients with this condition to experience cramping or discomfort, especially during flare-ups. However, if the pain becomes severe or is accompanied by other symptoms such as fever, significant weight loss, or blood in the stool, it is crucial to seek medical attention promptly.

Your significant weight loss from 107 kg to 90 kg in a short period is concerning. While some weight loss can occur due to dietary changes or gastrointestinal issues, rapid weight loss can indicate malnutrition or dehydration, especially if you are experiencing diarrhea. It is essential to ensure you are consuming enough calories and nutrients to support your health. Consider consulting with a nutritionist who specializes in gastrointestinal disorders to help you create a balanced diet that meets your needs.

Regarding your concerns about your current condition, it is essential to maintain regular follow-ups with your gastroenterologist. They may recommend additional tests or imaging studies to monitor your condition and ensure that there are no complications, such as strictures or abscesses, which can occur in patients with ulcerative colitis.

In summary, while your current symptoms may not indicate an immediate crisis, they warrant ongoing monitoring and management. It is essential to maintain open communication with your healthcare provider, adhere to any prescribed treatment plans, and report any new or worsening symptoms. Additionally, focusing on a balanced diet, staying hydrated, and managing stress can significantly impact your overall digestive health and well-being.

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