How can I manage severe bloating and fecal incontinence?

Question

Hello doctor,

I have had constipation and diarrhea for a long time, and later on, I was diagnosed with endometriosis three years ago and I underwent a surgery to remove it. In the past two years, the bloating has become unbearable. In addition, I have fecal incontinence and I have had several accidents, probably three to four times in a month. Over the past several months, my bowel reaction to foods has become extreme, and I have become dependent more on protein shakes in the last four to six weeks.

I had recently undergone blood tests and endoscopic examination and the results are:

1. High urea nitrogen.

2. High BUN or creatine ratio.

3. High absolute eosinophils.

4. Endoscopy showed peptic ulcers and damage to the esophagus.

5. Colonoscopy showed no concerns other than hemorrhoids.

I am currently taking PPIs, tablets Singulair, and Zoloft.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have reviewed your case in detail along with the attached file of your laboratory investigations (the attachment was removed to protect the patient's identity). My suggestions are:

1. Regarding your lab reports, nothing much alarming. High urea levels can be because of dehydration or a high protein-containing diet. Your creatinine is good, so your kidneys are working well.

2. Your blood eosinophils are high, which can be due to allergies from food items, drugs, or seasonal allergies. You can recheck your complete blood profile after two weeks.

3. Your endoscopic finding is suggestive of distal esophagitis and gastritis. Along with proton pump inhibitors (PPI), you can take syrup Gaviscon (antacid syrup) 10 ml after every meal. In addition, you should be checked for Helicobacter pylori stomach infection either with helicobacter pylori stool antigen or urea breath test.

4. Regarding your surgery and endometriosis, I guess you should be on regular follow-up with your physician; this needs a detailed history and physical examination.

5. Regarding your diet, try to have a balanced diet, with home-cooked meals, meat, vegetables, and fruits. This will keep you healthy and prevent micronutrient deficiencies.

6. Avoid excessive use of protein shakes.

Kindly consult a specialist, talk with them and take medications with their consent.

I hope I was helpful to you.

Thank you.