Dr. Babu Lal Meena
Medical Gastroenterology
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Patient's Query
Hi doctor,
I have been having overflow diarrhea and constipation for about four weeks now. I am under investigation for IBS and will have a colonoscopy in a few weeks. I have been under so much stress lately. My blood tests on my kidneys and liver are fine, and I also do not have celiac disease. But I have gallstones and cysts in my ovaries. I have not lost any weight, or there has been any blood in my stool. I am just wondering what this could be. Please help.
Hi,
Welcome to icliniq.com.
I understand your concern.
Intermittent diarrhea and constipation are features of IBS. Mild pain and small intestinal bacterial overgrowth are some common features of IBS. Most of the organic causes are already ruled out based on your information. Treatment of IBS depends on the symptoms. Here I would suggest a few of the medicines, and the rest can be planned in further visits as per the response.
1. Tablet Rifaximin (antibiotic) 400 mg, one tablet twice a day for two weeks.
2. Tablet Loperamide (anti-diarrheal) 4 mg twice a day.
3. Psyllium husk (dieatary fibre), two scoops once a day.
I suggest you follow up after one week.
I hope this helps.
Investigations to be done
Probable diagnosis
Regarding follow up
Patient's Query
Hi doctor,
Thank you for your reply. As a follow-up, I have also experienced some nausea and vomiting. The general physician thinks that this could be a long-term cause of constipation. Also, she wants me to get tested for ovarian cancer, as some of the symptoms can be the same. When I have a bowel movement, I am in pain while pushing out. I also had a scan on the ovaries, which showed a calcification, so I think it is related to both causes. My stools vary in shape. Sometimes, large bowel movements fill up the toilet, or sometimes it is smaller, soft, and mushy. I have enclosed pictures of cysts in the ovaries. Thank you.
Hi,
Welcome back to icliniq.com.
I understand your concern.
Carcinoma of the ovary and an ovarian cyst are different entities. A gynecologist would be the better choice to comment on your ovaries. A tumor marker and CT scan (computerized tomography) would be better investigations, though the ultrasound can also pick them up. Pain during defecation could be due to anal fissures or hemorrhoids, or maybe due to hard stool. I suggest you take Polyethylene glycol 17 g per day with water, stool softeners, a high fiber diet, a sitz bath with Potassium permanganate crystals daily, drink adequate water, and do pelvic floor exercises. This way, we can alleviate the pain. Please follow up after one week.
Investigations to be done
Preventive measures
Regarding follow up
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Medical Gastroenterology
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