Issues

[JoshNY]

Hello.  I'm 26 and seem to be in good health.  I exercise regularly, am not overweight, and there is no family history of illness.  I did have an appendicitis when I was 9 and my appendix was removed.

Anyway, starting in the end of December, I started experiencing random GI symptoms.  I would be constipated and then have diarrhea.  Sometimes my stools would come out and look 'twisted.' Other times I would go to the bathroom and mostly just gas would come out, along with a very very small piece of two of stool.  Sometimes the stools are narrower and sometimes they seem normal sized.  Also, I have a lot of bloating and gas, and very loud noises are heard in my abdomen.

I was seen by a gastroenterologist.  I had bloodwork, stool tests and a colonoscopy.  All were normal.  After the colonoscopy, the doctor did say the illeum seemed inflamed and swollen, but the samples he took came back normal.

Anyway, I'm just curious about what's going.  My symptoms seem to subside for a couple of weeks and then flare up, with no rhyme or reason.  I also tried going without lactose for a while, which didn't do anything.  Might this be something serious?

[JoshNY]

Generally, yes, they are normal color.  Maybe 2 or three times they have been pale or yellowish, but I feel like this happens anyway from time to time, so I am not sure if I should attribute it to everything else that's going on or if this is just a normal occurrence.

The main things are lots of gas coming out and maybe 1 or 2 or 3 very small pieces of stool; stool floating; and weirdly shaped stool that seems twisted or in other funny shapes.  I would have thought weirdly shaped stool would be attributed to a problem with the colon, but the colon seems to be ok, at least going by the colonoscopy and biopsies that were taken.

Thanks so much for your help.

[mikcin]

Maybe you should contact your GI and schedule another appointment,  It sounds like there is something else there.  I have had various problems with my instestines/CBD/gallbladder removal.  So many times they want to attribute it to IBS, but I think you need to have more tests to find out what is happening.  Make sure to make a list of questions.  It took 5 years and a lot of pain to finally get to the bottom of it all.  Not to mention 3 different GI's.  I ended up with impacted stones in my CBD, then had to have a repeat ERCP to remove sludge.  Are your stools normal color?

[JoshNY]

Also, sometimes I'll have a movement, the stool will be all twisted or in ball shapes, and then I'll go again in 10 minutes and it will come out perfectly normal.

[JoshNY]

Also, sometimes my stools float.

[Kevin Pho, MD]

Irritable bowel syndrome can cause alternating constipation and diarrhea.

The colonoscopy would exclude a majority of lower GI disease.  You can also send off the stool for malabsorption analysis, as well as blood tests to exclude celiac disease.

Further evaluation of the ileum can be done with a small bowel series or capsule endoscopy.  

I would also consider an upper endoscopy to evaluate the stomach and esophagus.

These options can be discussed with your GI physician.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com