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What causes stomach aches, grainy and foul smelled stools?

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4 1/2 year old has complained off and on for over a year about stomach aches. Has a hearty appetite and is in the 90th percentile for weight and height. He has frequent bowel movements but often has accidents claiming he doesn't feel them coming. Over the last year or two, there have been a handful of times where the stools were very grainy, almost like sand and hard to clean off. Most recently, he has been having bouts of diarrhea and today, he vomited, had little to no appetite, was very sleepy, had a constant belly ache and had a bowel movement of a very pasty white stool. Also, I cannot even begin to describe how foul his stools have always been. I can wash my hands multiple times after a cleaning and still not get the smell out.

Category: Family Physician-GP

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Category: Sexually Transmitted Diseases(STD)Specialist
Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

Thanks for writng to us with your health concern.

I have gone through your query with diligence. One good thing is that he has not passed any blood in the stool, so had no bouts of dysentry and hence we can rule out some of the bacterial causes for his problem.

Vague abdominal pain, cramps and foul smelling bouts of diarrhea points more towards malabsorption. He might have lactose intolerance, where a patient will develop such symptoms, on having any dairy products such as milk or cheese. He can also be allergic to certain food items. Commonly in infants and young children, rota virus is the leading cause of viral diarrhea. I will suggest you to get some tests done, since the poor kid has been suffering for a long time :-

1) CBC with ESR

2) Stool Culture : For ova, cysts and parasites

3) Renal Function tests ( RFT ) , LFT

4) Serum electrolytes

5) Rotavirus antigen test

6) CT Abdomen ( it can pick up some inflammatory condition, if present)

Once you get these tests done, the picture will be much clearer. Kindly consult a gastroenterologist to get an appointment for his condition and the tests. Once you're done, kindly upload the reports and we will assist you further.

Patient replied :

Hello again! Sorry for the delaye response, we had a doctors appointment today. It is definitely not the rotavirus because the diarhhea was short lived (only a couple days). The first set of blood work results came back normal indicating there is no virus. I'm waiting on the results of the rest of the blood work as well as the stool sample.

Expert:  Dr. Deepu Sebin Sebastian replied 3 Days.


Good to hear the first set of blood tests are normal. I still strongly suspect malabsorption. This can be known from the stool test by the presence of fat globules. Reducing substances in stool, if positive can indicate lactose intolerance. The good thing is, this can be managed well by initial restriction of lactose containing foods and other appropriate measures.

So when the test results are available, please do upload the reports.

Looking forward to hearing from you at your convenience.

Thank you.

Dr. Deepu Sebin Sebastian
Category: Sexually Transmitted Diseases(STD)Specialist
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.
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