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What is the reason for CHRONIC DIARRHEA, weight loss and MALABSORPTION?

Resolved question:
Hello,

I am 29YO male suffering from chronic diarrhea, malabsorption, rapid weightloss and nausea but no fever. I am suffering from these problems since quite a long period of time let's say 2010. It was not so severe at that time but now it is getting worse with accompanied weightloss.

I went to my GI and he told me that that i am suffering from iron deficiency anaemia by seeing all my reports. My reports were fine except the iron in my blood, low cholestrol and pus cells(4-6) in my stool examination as well as the ESR was high(30). I had undergone a whole abdomen ultrasound and everything was normal e.g. no Swollen lymph nodes etc.

He told me that it can be a giadiasis and prescribed me the following medicines:
-Tab ofloxacin 200 mg two times for 5 days.
- Tab metrogyl 400 mg two times for ten days.
- Tab zentel 400 mg 1 tab one day and other tab after 3 days.
- Tab Neksium 40 mg 1 tab daily for ten days.
- Tab VSL#3 1 Capsule daily.

I have completed the whole course of this medicine two days before. Watery stools were present but instead of 5-6 times during medicines i was goin 3 times. the most bothersome for me was blood in the stools which is still there once a day after stopping the medicines. Now the stools are still watery with food residues which are i think not absorbed by the intestine.

I am very worried and upset because of all this. I am not able to gain weight. What can be the reason???????

Submitted: 4 Days
Category: Gastroenterologist, Medical

Expert:  Dr. Ratnakar Kini replied 4 Days.

Hello.

Thanks for posting your query on DoctorSpring.com.

I am Dr.R.K and I am pleased to assist you.



I went through your post in detail and noted your symptoms of chronic diarrhea, malabsorption, weight loss and blood in stool.



It is very important that a conclusive diagnosis be reached for your condition. Once this is done, appropriate management will resolve your symptoms. In this regard you need more tests to be done. Inflammatory bowel disease is one of the possibilities and since you had blood in stools, a colonoscopy test has to be done. In this test a long slender tube is inserted through the anal opening and the inside of the large bowel is examined.



Another possibility is intestinal tuberculosis. The above mentioned colonoscopy test itself will help to diagnose intestinal tuberculosis.



Chronic diarrhea, malabsorption and iron deficiency can also occur in celiac disease. So this too has to be ruled out. An upper GI endoscopy with small biopsy and tissue Transglutaminase antibody blood test are to be done.



In summary, the following tests have to be done:



1. Colonoscopy.



2. Upper GI Endoscopy with biopsy.



3. Tissue Transglutaminase Antibody Test.



I hope that answers your question. You can get these tests done and get back to me with the results.





Let me know if I can assist you further.

Regards,

Dr.R.K.


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Patient replied :

Hello,
Yes i have a history of daily alcohol consumption and smoking but recently i have limited to a far extent.
As i mentined earlier that i had a normal whole abdomen ultrasound, cannot that rule out the posibility of intestinal tuberclosis??? As well as i am not experiencing any fever.


Expert:  Dr. Ratnakar Kini replied 3 Days.

Thanks for choosing Doctorspring.com



Hi,



There are many forms of abdominal TB. Diarrhea occurs in intestinal TB. Ultrasound scan usually does not detect any disease involving the intestine. CT scan is a better scan to detect intestinal involvement than ultrasound scan.



You need not always  have fever if you suffer from intestinal TB.



Moreover I discussed about the three "possibilities" based on the information you have given.



Regards


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Patient replied :

Thanks for the reply. I have already given my blood samples for Tissue Transglutaminase Antibody Test and will be reciving the reports tomorrow morning. As you told me CT scan is a better scan to detect intestinal involvement than ultrasound scan then should i go ahead for CT scan before going through endoscopy/colonoscopy?
If yes then which one to be done?

  1. CT Scan For Whole Abdomen (Plain)
  2. CT Scan For Whole Abdomen (Contrast)
  3. CT Scan Lower Abdomen (Plain)
  4. CT Scan Lower Abdomen (Contrast)

Regards


Expert:  Dr. Ratnakar Kini replied 2 Days.

Thanks for choosing Doctorspring.com



Hi,



Do not go for CT scan first.



Get a colonoscopy done first. With a colonoscopy you can not only look inside the colon but also take biopsy specimen if needed. This is not possible with CT scan.



 



So get colonoscopy done first.



Regards.



Dr.R.K


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Patient replied :

Hello,
i Have got my reports for Tissue Transglutaminase Antibody Test. Please have a look.i have attached the file
Regards


Expert:  Dr. Ratnakar Kini replied 1 Day.

Hello.

I have seen your report.

Good to know that you are negative for tTG which means you do not have celiac disease which, a common cause of malabsorption and chronic diarrhea.

The next step is to get a colonoscopy as suggested earlier. You can get back with the colonoscopy results.



Regards.


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