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How do I manage white stools, SIBO, and weight loss?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I have had a gastroenterology issue for over a month. I have mild to moderate upper and lower abdominal pain on the left side. The pain also extended to my left leg. Also, I pass stool twice a day (diarrhea-like stool) with large white balls in it, and I am facing weight loss.

I took Trimebutine and Mebeverine for over four weeks (I have IBS), also I am also taking probiotics and digestive enzymes. What is concerning me the most is the large white balls in the stool that are not mucus (they are quite firm) and the weight loss. Due to COVID-19, I want to avoid physically seeing a doctor, so please suggest a possible cause and treatment.

Kindly advise.

Hello,

Welcome to iCliniq.com.

It appears that you might be suffering from IBS (irritable bowel syndrome) and may have developed SIBO (small intestinal bacterial overgrowth), which often occurs together with IBS. In SIBO, fat malabsorption can occur, which may lead to white stools. Greasy stools are usually identified by a foul odor and the tendency to float on the water in the commode. Also, please mention how much weight you have lost and over what period.

I will start you on treatment for SIBO, but at the same time, it is important to perform certain investigations to rule out other possible causes whenever feasible. The most likely cause in your case appears to be SIBO.

Before deciding on the next steps, the following investigations are advisable:

  • CBC (complete blood count).
  • C-reactive protein.
  • TSH (thyroid-stimulating hormone).
  • Stool routine examination and culture.
  • Stool for fat content.
  • Stool for reducing substances.
  • Colonoscopy or sigmoidoscopy if needed in the future.

The following conditions need to be ruled out:

  • Pseudomembranous colitis.

I would suggest the following measures:

  • Tablet Rifaximin 550 milligrams thrice daily for 14 days.
  • Tablet Mebeverine thrice daily.

Preventive measures include oral rehydration solution and regular exercise.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.

Patient's Query

Thank you, doctor,

Sometimes, I do get greasy stools, especially when I have diarrhea. Sometimes I have bloating as well (at least once a week). I have lost three kilograms in one and a half months.

Kindly advise.

Hi,

Welcome back to icliniq.com.

So you are most probably having SIBO. Your weight loss is not significant, but looking into the history of Clostridium difficile and your recent antibiotic use, I will definitely want to rule out pseudomembranous colitis (caused by Clostridium) if your symptoms do not subside.

The good thing about Rifaximine (already suggested in treatment) is that it can work both in SIBO and pseudomembranous colitis. Please start it and do tell me about the response. The Possible cause can be SIBO.

The following conditions need to be ruled out:

  • Pseudomembranous colitis.

I would suggest the following measures:

  • Tablet Rifaximine 550 mg thrice a day for 14 days.

  • Take Tablet Mebeverine thrice a day.

You can follow up after 14 days.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.

Medically reviewed byDr. Vinodhini J.

Published At April 23, 2020
Reviewed AtOctober 9, 2025

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