Digestive Issues: Diarrhea, Bloating, and Post-Surgery Symptoms - Gastroenterology and Hepatology

More Info

---

It sounds like you are experiencing a complex set of digestive issues following your surgery to remove a fistula, compounded by a history of gastrointestinal symptoms. Let's break down your symptoms and explore potential causes and management strategies.

Firstly, the weight loss you mentioned, approximately 10 kilograms, is concerning and could be indicative of malabsorption or a more serious underlying condition. The fact that you experience an urgent need to defecate shortly after eating, along with the sensation of undigested food being expelled, suggests that your gastrointestinal tract may not be functioning optimally. This could be due to several factors, including the presence of a fistula, which can disrupt normal digestive processes.

The mild gastric ulcer diagnosed via endoscopy could also contribute to your symptoms. Ulcers can lead to discomfort, bloating, and changes in bowel habits. While you mentioned that you have taken medication for this condition, it’s not uncommon for some medications to cause gastrointestinal side effects, including increased bloating or discomfort. If the medications prescribed by your gastroenterologist have made you feel worse, it may be worth discussing alternative treatments or adjustments with them.

Post-surgery, it’s not unusual to experience abdominal pain and bloating. Surgical procedures can lead to temporary changes in bowel function, including increased gas production and altered motility. The sensation of your abdomen being distended with air, especially when lying down, could be due to postoperative ileus, a condition where the intestines temporarily stop moving. This can lead to gas buildup and discomfort.
Additionally, the psychological stress of surgery and the anticipation of recovery can also manifest physically, leading to increased sensitivity in the gastrointestinal tract. Stress can exacerbate symptoms of bloating and discomfort, creating a cycle that can be challenging to break.

Here are some strategies that may help alleviate your symptoms:
1. Dietary Adjustments: Consider keeping a food diary to identify any specific foods that may trigger your symptoms. A low-FODMAP diet, which reduces certain fermentable carbohydrates, may help decrease bloating and gas.
2. Hydration: Ensure you are adequately hydrated, especially if you are experiencing diarrhea. Dehydration can worsen gastrointestinal symptoms.

3. Probiotics: Introducing probiotics may help restore a healthy balance of gut bacteria, which can be beneficial for digestion and may alleviate bloating.

4. Gentle Movement: Engaging in light physical activity, such as walking, can stimulate bowel function and help reduce gas buildup.

5. Follow-Up Care: Since your symptoms have persisted, it’s crucial to maintain open communication with your healthcare provider. They may recommend further investigations, such as imaging studies or additional endoscopic evaluations, to rule out complications or other underlying conditions.

6. Medication Review: If you are experiencing adverse effects from medications, discuss this with your doctor. They may be able to adjust your treatment plan or suggest alternatives that are better tolerated.

7. Stress Management: Techniques such as mindfulness, yoga, or cognitive behavioral therapy can help manage stress, which may, in turn, alleviate some of your gastrointestinal symptoms.

In conclusion, while your symptoms are multifaceted and may be influenced by both physiological and psychological factors, a comprehensive approach involving dietary changes, follow-up care, and stress management may provide relief. It is essential to work closely with your healthcare team to monitor your progress and make necessary adjustments to your treatment plan.