Q. I get flare up of diarrhea once in a month with lethargy, loss of appetite and dry mouth. Why?

Answered by
Dr. Ajeet Kumar Lohana
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on May 26, 2020 and last reviewed on: Jun 06, 2020

Hello doctor,

Every once a month at least I get a flare up of diarrhea where I go at least six times a day and nothing seems to settle my stomach. The stool itself has a weird texture, almost sand-like. Most of it float down but some do float up and there is mucus in it. Other symptoms I am experiencing are lethargy, feeling of being full yet hungry, loss of appetite, and dry mouth. Any idea of what this could be?



Welcome to

Do you have lost some weight since the start of symptoms? Do you have noticed any triggers (diets, stress, change in lifestyle, or drinking alcohol ) before such episodes? Alcohol has a large amount of fermentable carbohydrates which can cause diarrhea, gas, and bloating, often episodes of binge drinking.

The common possibilities are that you have one of the above trigger which causes your gastrointestinal (GI) upsets. They can go unrecognized with episodes of symptoms as in your case.

The other possibility is endometriosis. Endometrium is the lining of the uterine cavity of the female internal genital tract. In menstruation, the lining sheds causing bleeding and pain. Endometriosis is a condition where endometrial tissue is implanted into gut, and it behaves similarly as one has menstruation on monthly cycles. It causes pain (at times very severe), diarrhea, and even bleeding from the gut. It is important that you notice yourself the temporal (time) relation between the onset of symptoms and onset of menstruation.

I want that you should provide me more information, as I can be able to investigate you properly in a specific direction, providing you target management plan which can fit you best.

I hope this helps.

The Probable causes:

Cyclical abdominal symptoms. Endometriosis.

Differential diagnosis:

Celiac disease. Food allergies. Eosinophilic gastroenteritis.

Probable diagnosis:

Endometriosis. Environmental triggers.

Regarding follow up:

Follow up to provide more information to diagnose and investigate properly.

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