Can gut issues cause chronic fatigue and daily diarrhea?
Patient's Query
Hello doctor,
I’ve suffered from chronic fatigue for the past 10 years, and most of my issues seem to stem from my gut. I’ve experienced diarrhea nearly every morning during this time.
Kindly help
Hello,
Welcome to icliniq.com.
I understand your concern.
I have reviewed your case history and the attached colonoscopy images. Chronic fatigue with loose stools, along with a normal colonoscopy, stool tests, and blood work, is relatively reassuring. However, there are a few important questions I would like to ask. Have you ever noticed blood in your stools or black-colored stools? Is there any family history of similar problems, such as tuberculosis, inflammatory bowel disease, or cancer? Have you experienced nighttime symptoms like loose stools that wake you from deep sleep or any unexplained weight loss?
Also, have you observed that stressful situations or anxiety worsen your fatigue and episodes of diarrhea, with or without abdominal pain? Are you sleeping well, or do you have difficulty sleeping? Are there any stressors related to your job, finances, or family? (Just a yes or no would help.) It is unlikely that there is inflammation in your gut if your colonoscopy was normal. If your symptoms worsened after the colonoscopy, that may be an indication of a sensitive gut.
Chronic fatigue is less likely to be caused by gut issues alone, especially since the volume of loose stools you are having does not suggest a significant electrolyte imbalance that would explain the fatigue. If all relevant investigations are normal, chronic fatigue can sometimes be a symptom of depression, which can be clarified based on the responses to the above questions. Lastly, symptoms like brain fog, speech difficulties, and chronic fatigue should be evaluated by a neurologist at least once.
Wishing you well.
I hope I have solved your query.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
The images I attached were not the standard ones from around three years ago; I took them myself using my borescope. I know it was not a good idea, but trying to see a gastroenterologist on the NHS (National Health Service) has become nearly impossible. I had seen one before, though that was about nine years ago. Private consultation is now my only option.
There has never been any blood in my stools. The only family history I am aware of is my father, who had bowel cancer and had part of his bowel removed. I never experience symptoms at night. My loose stools are always in the mornings, and I have not experienced any weight loss. Stress makes the fatigue worse, but it does not affect my diarrhea or abdominal pain. I struggle to fall asleep at night, but I consider that normal due to sleeping during the day. There are no particular stressors.
Do the images I attached look normal? Before having the colonoscopy about three years ago, I took Movicol (Macrogol) to empty my bowels. Afterward, I could barely walk and had no strength whatsoever. I have always suspected it was because it flushed out essential nutrients, but could that also suggest an issue with the vagus nerve? I do tend to feel weaker after passing stools. I know others who have taken Movicol and did not have the same reaction.
I look forward to your response.
Kindly help.
Hello,
Welcome back to icliniq.com.
I read your query and can understand your concern.
These images appear normal; this is the typical vascular pattern of the large bowel mucosa. The only significant history in your case is that your father had colon cancer, so you may need a repeat colonoscopy in about three to five years. Movicol sachets are among the most commonly used preparations to cleanse the bowel and induce diarrhea. No essential nutrients are lost through this preparation method.
You can consider a simple stool test to check for infection or a stool occult blood test, which is a screening tool for colon cancer, before proceeding with a repeat colonoscopy. As for brain fog, speech difficulties, and weakness after passing stools, these symptoms should be evaluated by a neurologist.
I hope I have answered your question.
Let me know if I can assist you further.
Regards.
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