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Loose stool and bad flatulence

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Hi, I hope you can offer me some insight into my problem. Sorry for some graphic descriptions.

It is to do with digestion and stool. I cant even remember for how long this has been a problem but I think for at least a year if not more but my stool is...hmm how to say sticky and not solid. It is never solid and it is not diarrhea but closer to that than solid.

Other symptoms maybe related: often bad gas, runny nose often (clear not green) and one nostrel is always blocked a lot but it changes from side to side, i feel tired a lot and often wake up de hydrated.

Some basic background on me..

I am a 27 year old male and I am pretty lean.

I exercise 5 times a week on average: cardio, calisthenics, yoga and walking.

My diet is on average

oatmeal, wholemeal bread, fruit, green tea, peppermint tea, rooboos tea, eggs, vegetables, salads, chicken, red meat once a week, fish, rice, brown pasta, dark chocolate, nuts and coconut oil, hemp protein powder and a small amount of cheese and a cup of coffee once or twice a week. I drink quite a lot of water along with teas in the day time. I take a multi vitamin, cod liver oil everyday and vitamin d and e a few times a week.

I have drank lactose free milk for a few months but it has not helped. I used to have a lot of dairy in the UK, full fat milk, yoghurt and cheese and have stopped that with exception to small amount of cheese but it has not made any difference.

I avoid processed sugar and foods and drink a glass of red wine two times a week on average.

I have moved from UK to Germany and am not able to see a doctor here until I sort out medical insurance etc so any help you can offer would be greatly appreciated.

Many thanks.




Category: Family Physician-GP

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Expert:  Dr. Deepu Sebin Sebastian replied 4 Days ago

Hello,

Thank you for asking your query at DoctorSpring.

I will need some more graphic description from you ! This will help me in forming a learned opinion about your symptoms. Hope it is Ok with you. You can reply as a followup question.

1. Again to confirm, do you every get bulky stools ?
2. Does the stool float in the closet while you try to flush it down ?
3. Is there any recent weight loss ?
4. Do you have any of the following symptoms - Feeling of incomplete evacuation of bowel, cramping abdominal pain (relieved by passing stools) or change in frequency of stool ?
5. Do you always have this sticky stool ? or is it occasional ?

Thank you


Patient replied :

Hi, thank you so much for the reply and I will happily answer your questions.

1. I can only remember once in recent times, so not really no.
2. No.
3. I exercise 5 times a week and have put on some muscle lately and lost some body fat.
4. Feeling of incomplete evacuation of bowel - yes often
Cramping abdominal pain (relieved by passing stools) or change in frequency of stool ? - No I can't think that I have had this.
5. It is always sticky and often sticks to the toilet. (sorry thats a bit horrible to write to someone but you are a doctor so I'll assume you don't mind.)

Another thing I have noticed over the past year or so as well is that my hair is thinning and has become very dry and brittle often. Also with the tiredness and feeling weak sometimes. Don't know if this is related but I was wondering about either a bacterial infection or a thyroid problem.

Many thanks.


Expert:  Dr. Deepu Sebin Sebastian replied 3 Days ago

Hello,

Thank you for providing the additional information.

There are two possibilities here - 1. A mild form of Irritable Bowel Syndrome (IBS) 2. A fat malabsorption syndrome. Both can cause of some level of defective absorption of fat. You will need to be consult a Gastroenterologist in person for further evaluation. (some blood tests, stool study, and OGDscopy) The hair fall could be due to a Vitamin Deficiency (as there is some amount of fat malabsoprtion). There is a possibility of a bacterial over growth in the small intestine (SIBO). For this you may require to take an antibiotic like Rifaximin in consult with your Doctor.

You can wait till your insurance issues are settled. There is no hurry. Meanwhile take a nutritious , high fiber diet. Please see this link for fiber level in various food items - http://www.mayoclinic.com/health/high-fiber-foods/NU00582. Try to reach 40g of fiber per day.

Hope this helps
Please feel free to ask followup questions
Thank you


Patient replied :

Thank you so much for your answer and time. Could I please ask one more question regarding the possibilities you stated in your last message.

I also wake up very dehydrated and sometimes feel this way in the day time (despite drinking a good amount of water and liquids in the day and water before I sleep.) Also I eat fruit and salad daily.

Could this symptom and the tiredness and hair thinning be related to anything you mentioned previously. I have a pretty good diet and don't drink much alcohol or processed sugar. I take a multi-vitmin and a cod liver oil capsule with vit a and d and with a good diet could this not help if I have a digestive or even thyroid problem?

I will make an appointment with a GP as soon as I can but just a little more information would help me feel better in the mean time.

Many many thanks.


Expert:  Dr. Deepu Sebin Sebastian replied 2 Days ago

Hello,

It is unlikely that the Vitamin Deficiency will cause severe hair fall and tiredness. But its a possibilty. Your symptoms do not denote any major malabsorption and hence a significant Vitamin Deficiency is unlikely. I would not recommend Vitamin A/D - cod liver oil supplements without evaluation. The reason being Vitamins like A and D can accumulate in your body unlike the B complex vitamins. (Step 1) In my opinion you should stop all supplements including the protein powder. You can continue the B complex vitamins (the ones needed for hair growth).

Step 2 - High fiber diet

Step 3 - Consult your GP. In view of your tiredness get a routine Physical examination done with Complete Blood Count, Thyroid and Liver function tests and Fasting blood sugar levels . Gastroenterology referral if needed.

Also keep in mind there is a possibilty of androgenic alopecia / baldness (especially if you have a family history. )

Hope this helps
Please DO feel free to ask followups
Thank you


Dr. Deepu Sebin Sebastian
Category: Select Speciality
Experience: 
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
Dr. Deepu Sebin Sebastian and 4 other Medical Specialists are ready to help you

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