Severe Diarrhea: Causes and Solutions for Gastrointestinal Issues

I have recently started experiencing severe diarrhea?

I have been experiencing frequent diarrhea for the past two months, with a maximum of 10 times a day and at least 5 times daily.
Sometimes the stool is solid, but most of the time it is liquid.
Before having a bowel movement, I sometimes feel intense abdominal pain, while other times I just have a normal urge to go.
I have been experiencing this for over a month without any weight loss; in fact, I have gained weight.
After each bowel movement, I feel extremely hungry, and I eat three meals a day without any increase in quantity.
Occasionally, the stool resembles thick mucus with many bubbles, and when mixed with water, it turns a golden yellow color, somewhat resembling tar when it comes into contact with water.
I also feel a yawning sensation in my stomach, as if it is about to burst, which is very painful.
I am unsure if this is due to being overweight.
I have seen a doctor who suggested it might be irritable bowel syndrome, but the severity of my symptoms seems quite serious.
I have been on medication for a week with no effect.
Interestingly, my stool tests came back normal.
Additionally, I have noticed an increase in my sleep duration, but I feel fatigued shortly after waking up and spend most of the day sleeping.
What could be the issue?

A, 10~19 year old female. Ask Date: 2015/11/10

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, in addition to stool tests, colonoscopy or barium enema may be considered.
Additionally, it is important to rule out any previous history of antibiotic use.
Sincerely, Dr.
Chi-Feng Chen, Attending Physician, Department of Gastroenterology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2015/11/10

More Info

Understanding severe diarrhea and gastrointestinal issues can be quite complex, especially when symptoms persist over an extended period. Based on your description, it seems you are experiencing a combination of frequent diarrhea, abdominal pain, and unusual stool characteristics. These symptoms can be indicative of several gastrointestinal disorders, and it is essential to approach this issue with a comprehensive understanding of potential causes and treatment options.

Firstly, the frequency of your bowel movements—up to 10 times a day—along with the varying consistency of your stool (from solid to liquid) suggests that you may be dealing with a form of irritable bowel syndrome (IBS), specifically IBS-D (diarrhea-predominant). IBS is a functional gastrointestinal disorder characterized by abdominal pain and altered bowel habits without any identifiable organic cause. The fact that your stool sometimes appears mucous-like and bubbly could indicate increased mucus production in the intestines, which is not uncommon in IBS.

However, the severity of your symptoms, particularly the abdominal pain and the presence of mucus in your stool, raises the possibility of other conditions that should be ruled out. For instance, inflammatory bowel diseases (IBD) such as Crohn's disease or ulcerative colitis could present with similar symptoms, including diarrhea, abdominal pain, and changes in stool consistency. These conditions often require more extensive diagnostic testing, including colonoscopy and imaging studies, to confirm or rule out.

Another potential cause of your symptoms could be an infection, whether viral, bacterial, or parasitic. Gastroenteritis, commonly known as stomach flu, can lead to severe diarrhea and abdominal discomfort. If you have recently traveled or consumed food from questionable sources, this could be a contributing factor. Stool tests can help identify infections, but you mentioned that your tests came back normal, which may suggest that an infectious cause is less likely.

Dietary factors also play a significant role in gastrointestinal health. If you have made any recent changes to your diet or have been consuming foods that are high in fat or sugar, this could exacerbate your symptoms. Additionally, food intolerances, such as lactose intolerance or gluten sensitivity, could lead to similar gastrointestinal distress. Keeping a food diary to track your intake and symptoms may help identify any correlations.

Stress and anxiety can also significantly impact gastrointestinal function. The gut-brain connection is well-documented, and emotional stress can lead to or worsen symptoms of IBS. If you have been experiencing increased stress or anxiety, it may be beneficial to explore stress management techniques, such as mindfulness, yoga, or counseling.

Given the complexity of your symptoms and the lack of improvement with medication, it is crucial to follow up with a healthcare provider who can conduct a thorough evaluation. This may include further diagnostic testing, a review of your dietary habits, and possibly a referral to a gastroenterologist for specialized care. In some cases, a trial of dietary changes, such as a low-FODMAP diet, may be recommended to help manage symptoms.

In summary, while your symptoms may align with IBS, the severity and persistence warrant a more in-depth investigation to rule out other potential causes. It is essential to work closely with your healthcare provider to develop a tailored treatment plan that addresses both the physical and emotional aspects of your gastrointestinal health.

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