Ongoing Gastrointestinal Concerns After Endoscopy - Gastroenterology and Hepatology

Q: Ongoing Gastrointestinal Concerns After Endoscopy

Hello： If you have undergone both colonoscopy and gastroscopy, you can generally feel reassured. <br>It is likely just a temporary dysfunction of the gastrointestinal tract following acute inflammation, and the recovery time varies from person to person. <br>It is important to be

I have undergone gastroscopy and colonoscopy, but I still feel very anxious?

Hello doctor, I have been experiencing severe gastroenteritis in January, July, and September since 2015, with symptoms including frequent diarrhea, no vomiting, and high fever.
Since the gastroenteritis episode in September, my gastrointestinal health has seemed off; I easily develop diarrhea and frequently need to use the restroom.
Once I start having diarrhea, it can last for more than two weeks, recurring intermittently.
In November, I consulted a physician who performed an X-ray and mentioned that there was no fecal impaction.
A few days later, I underwent a painless colonoscopy and gastroscopy, and the results showed no abnormalities, although some diverticula were found on the right side.

In early December, after attending a friend's wedding banquet, I experienced another episode of gastroenteritis accompanied by fever, followed by about a week of diarrhea.
Since then, I have intentionally increased my vegetable intake, eating only vegetables and brown rice for lunch, while having a normal dinner but still trying to eat more vegetables.
I also took probiotics, hoping for improvement, but new symptoms emerged.
My gastrointestinal issues persisted, with less frequent diarrhea, but I have been experiencing persistent dull pain in the left abdomen, left flank discomfort, occasional sharp pain, and sometimes a feeling of heaviness.
The pain is primarily in the lower left abdomen, but I also occasionally feel discomfort in the upper left and right abdomen.
I consulted another physician who suggested a CT scan, but I was concerned about the radiation exposure and did not proceed with it.
Later, I visited another hospital where the doctor performed an X-ray and indicated that I had significant fecal retention, which was causing abdominal pain due to sluggish bowel motility.
I was prescribed Through (a laxative), Gaslan (a gas relief medication), magnesium oxide, and Dicetel (an antispasmodic).
After taking these medications, my symptoms improved significantly.
During a follow-up visit, the doctor mentioned that if the medication alleviates the pain, it is unlikely to be cancer and advised me not to worry.

In January, I noticed that when I ate vegetarian meals for lunch, my stools were soft, but when I increased my meat intake, my stools became narrower.
I have hardly experienced diarrhea in January, and I am unsure what is happening with my body.
I am genuinely very worried...
I am uncertain about my symptoms and how I should proceed from here.

Xiao Gua, 20~29 year old female. Ask Date: 2016/01/28

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: If you have undergone both colonoscopy and gastroscopy, you can generally feel reassured.
It is likely just a temporary dysfunction of the gastrointestinal tract following acute inflammation, and the recovery time varies from person to person.
It is important to be patient and gradually adjust your diet.
Additionally, if you consume alcohol, caffeinated beverages, or fried foods, it is best to avoid them as much as possible.
The narrow stools are probably just due to insufficient fiber intake, so there is no need to worry too much.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun

Reply Date: 2016/01/28

More Info

It sounds like you have been experiencing a complex array of gastrointestinal symptoms for several years, which can understandably be quite distressing. Based on your description, you have had recurrent episodes of gastroenteritis, ongoing diarrhea, abdominal pain, and changes in bowel habits, despite undergoing endoscopic evaluations that did not reveal any significant abnormalities. Let's break down your situation and explore potential next steps.

Understanding Your Symptoms
1. Recurrent Gastroenteritis: Your history of severe gastroenteritis episodes suggests that you may have had infections or inflammatory responses that could have altered your gut flora or led to lingering sensitivity in your gastrointestinal tract. It's not uncommon for individuals to experience prolonged gastrointestinal symptoms after such infections, which can sometimes lead to conditions like post-infectious irritable bowel syndrome (IBS).

2. Chronic Diarrhea: The fact that you experience diarrhea that lasts for weeks at a time is concerning. This could be due to several factors, including dietary intolerances, stress, or even a functional gastrointestinal disorder. The fact that you have made dietary changes and incorporated probiotics is a positive step, but it may take time to see significant improvements.

3. Abdominal Pain: The left-sided abdominal pain you describe could be related to a variety of issues, including constipation, diverticular disease (given your mention of diverticula), or even muscular strain. The fact that your symptoms improved with medications that promote bowel movements suggests that constipation may have been a contributing factor.

Diagnostic Considerations
Given that your endoscopic evaluations were normal, it may be worthwhile to consider the following:
- Food Intolerances: Consider keeping a food diary to track what you eat and any symptoms that follow. Common culprits include lactose, gluten, and certain fermentable carbohydrates (FODMAPs).

- Functional Gastrointestinal Disorders: Conditions like IBS can cause chronic abdominal pain and altered bowel habits without any identifiable structural abnormalities. A diagnosis of IBS is often made based on symptom patterns and the exclusion of other conditions.

- Diverticular Disease: Since you mentioned having diverticula, it's important to monitor for any signs of diverticulitis, which can cause pain and changes in bowel habits.

Next Steps
1. Follow-Up with a Gastroenterologist: Since your symptoms are persistent and complex, it may be beneficial to have a follow-up appointment with a gastroenterologist who can review your history in detail and possibly recommend further testing, such as a CT scan or additional blood tests to rule out other conditions.

2. Dietary Modifications: Continue with your dietary changes, focusing on a high-fiber diet, which can help regulate bowel movements. If you suspect food intolerances, consider working with a dietitian to identify and eliminate potential triggers.

3. Medication Management: It seems that the medications you were prescribed have helped alleviate some symptoms. Continue to take them as directed, and keep your doctor informed about your progress. If symptoms persist, your doctor may consider adjusting your treatment plan.

4. Stress Management: Stress can significantly impact gastrointestinal health. Consider incorporating stress-reducing techniques such as mindfulness, yoga, or regular exercise into your routine.

5. Monitoring Symptoms: Keep track of your symptoms, including the frequency and nature of your bowel movements, any associated pain, and how your diet affects your condition. This information can be invaluable for your healthcare provider in tailoring your treatment plan.

Conclusion
Your ongoing gastrointestinal concerns are multifaceted and may require a comprehensive approach to management. By working closely with your healthcare team, making dietary adjustments, and monitoring your symptoms, you can take proactive steps toward improving your gastrointestinal health. Remember, it’s essential to communicate openly with your healthcare provider about your concerns and any changes in your symptoms.

Similar Q&A

Understanding Post-Endoscopy Symptoms: When to Seek Further Gastrointestinal Care

I previously underwent an upper gastrointestinal endoscopy due to Helicobacter pylori, and the doctor indicated that there were no signs of gastric ulcers, but there was some gastritis. I was prescribed proton pump inhibitors, but after taking them for a month and then stopping, ...

Dr. Chen Qifeng reply Gastroenterology and Hepatology
Hello: Generally speaking, gastroscopy is a safe procedure with few complications. Symptoms such as nausea, vomiting, and abdominal bloating should not be related to the gastroscopy. As for whether these symptoms are associated with gallstones, further differential diagnosis shou...

Understanding Digestive Issues: Symptoms and Concerns After Endoscopy

The doctor performed an endoscopy yesterday and found mild inflammation and ulcers. My stomach feels strange now; could it be because the test for Helicobacter pylori made me feel like the endoscope was pulling in my stomach? Also, if it were colon cancer, would the symptoms come...

Dr. Chen Qifeng reply Gastroenterology and Hepatology
1. After the gastroscopy, there may be slight discomfort due to air insufflation, which is unrelated to the Helicobacter pylori test. 2. This is likely a symptom of gastroenteritis; a light diet low in oil, dairy, and irritants is recommended, and you may also consider consulting...

Understanding Post-Endoscopy Diarrhea: Causes and Concerns

Last week on March 5th, I underwent an upper gastrointestinal endoscopy and a colonoscopy. The day before, on March 4th, I drank a bowel preparation solution, which I believe was called Nifuratel. After the procedures, I returned home and have been experiencing diarrhea, which is...

Dr. Chen Qifeng reply Gastroenterology and Hepatology
Hello: 1. Some individuals may experience a slower recovery after bowel cleansing due to intestinal irritation. It is advisable to maintain a light diet, low in oil and dairy, which should help restore normal function. 2. If it is a specimen, a complete report may be provided aft...

Post-Colonoscopy Complications: When to Seek Further Medical Attention

I previously had issues with gastric ulcers. This time, I underwent an endoscopy and my first colonoscopy, which I completed yesterday on March 29. There were no significant problems found, but I experienced severe pain in the evening that made it difficult to sit or stand. My di...

Dr. Cai Anshun reply Gastroenterology and Hepatology
Hello: If it is confirmed that no large polyps have been removed, this situation is mostly due to irritation of the intestines, leading to excessive peristalsis and even intestinal spasms. It is recommended to start eating and replenish fluids. If discomfort persists, it is advis...