I have been having constipation and floating stools from seven years. Can you help me ?

Question

Hello doctor,

I am a 25 year old who weighs 165 lbs, and my height is 5 foot 4 inches. Seven years earlier, I had a fever and constipation for three straight days. The fever resolved but since then, I have abnormal bowel movements. I also had a distended liver, but that is normal now.

My stools always seem greasy and have an oily film appearance, and they always float. The color appears normal though. I am never able to clear my bowel at one go. Stool culture reports acidic stool with no other problems. I feel too gassy.

Although I do not have any abdominal pain, I do have a discomfort on the lower left side. I tried homeopathic, ayurvedic and allopathic medications. But something seems wrong

My USG is normal, with the most recent one showing distended gall bladder without wall thickening, but there is a tiny calcification on the right hepatic lobe.

Also, I have been diagnosed with subclinical hypothyroidism (Hashimoto's disease), which after two months of treatment is under control. Apart from that I have got vitamin D and vitamin B12. In spite of these issues, I have not lost weight.

In fact, I have gained a lot of weight, about 44 lbs in the last seven years, and now stable at 165 lbs. I have taken probiotics and Rifaximin course thrice with no success.

I have also tried Nizonide, three-day course. Initially, I got well-formed stools, but when the doctor prescribed it for the second time , I found no improvement. I do not know what it is, but I feels it is slowly killing me.

Answer 1

Hello,

Welcome to our portal.

Your reports look fine, except for the vitamin deficiencies.

When the work up is not guiding us to a particular direction, then we should consider a functional disorder like irritable bowel syndrome.

In IBS, there is constipation with discomfort. In such a situation, we first carry out a bowel dis-impaction, then continue on maintenance laxatives with lifestyle modifications. In my opinion, you do not require any further investigations.

I suggest the following measures:

On the first day, take one packet of Peglec powder (a combination of polyethylene glycol and electrolytes), dissolved in two liters of water over four hours, and repeat if watery stool does not pass.
On the next day, start Laxopeg (polyethylene glycol), once in the morning and once at night.
Sit on the toilet two to three times a day for 15 minutes without straining, after intake of 500 ml water.
Consume a high fiber diet in the form of salads.
Avoid foods made with refined flour.
Ensure adequate water intake, about 4 to 5 liter a day.
Exercise regularly.
Alleviate mental stress, if any.

Get back to me after a week with your response report.

Revert after a week to a medical gastroenterologist.

Answer 2

Hello,

Welcome back to icliniq.com.

No, I suggest you go with this regimen. Apart from the medications, toilet training is very important for good bowel health.

Remember to follow the diet and exercise. Take care.

For more information consult a medical gastroenterologist online --> https://www.icliniq.com/ask-a-doctor-online/medical-gastroenterologist