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Dr. David
Dr. David, Board Certified Physician
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Experience:  Experienced Physician trained in New York City. I'm ready to help.
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I have diarrhea. It comes every 4 -5 days. On these days

Customer Question

I have diarrhea. It comes every 4 -5 days. On these days I have a normal bowel movement in the morning and then three hours later, with little warning an explosive diarrhea motion, with some cramps. After this there is no bowel movement for four or five days until the next episode. This has persisted for three months. I have had a colonoscopy which detected nothing abnormal.
I am hypertensive and take Amloc 5mg, Natrilix SR (indapamide)1.5mg, Rampil 10mg, Cardura XL(Doxazosin) 4mg. I am also dibetic and take Glucomed (glicaxide) 80mg *2, Metformin 1000mg *2, Simvastatin 20mg for elevated cholestral,Welbutrin (brupropion hydrochloride)150mg for depression.

Despite (or because of) the medication my blood tests are always in the good field. I feel fit, am 67 years old and still lecture at a university, and go to gym.

My diet is healthy wih low carbs and daily vegies. I do drink a bit too much Red wine, about 600ml every evening, and have done so for years.

I take a vitamen supplement, Omega 3 and Probiotics (IBS approved).

What can relieve this. There are no gastroenterologist specialists in my town and I have an appointment with one in six weeks at a centre 300km away. Do you have any suggestions?
Submitted: 5 years ago.
Category: Medical
Expert:  Dr. Cameron replied 5 years ago.

Welcome to JA. Thank you for your question. In order to help you find an answer, could you please answer the following?

Any other medical problems or medications?
Do you smoke? Alcohol? Drugs?
How long as this been going on?
Any other symptoms?

Have you had any stool studies?

Does a particular type of food trigger this?

Customer: replied 5 years ago.
Most information is in my original. I do not smoke and only take the prescribed drugs already listed. No particular food triggers this
Customer: replied 5 years ago.
ing abnormal.Most information is in my original. I do not smoke and only take the prescribed drugs already listed. No particular food triggers this. One stool study found nothing abnormal.
Expert:  Dr. Cameron replied 5 years ago.

Have you tried taking imodium to see if this helps?
Customer: replied 5 years ago.
I dont want to as I cannot take this indefinitely and it will cause constipation. I prefer any germs? to be excreted.
Expert:  Dr. Cameron replied 5 years ago.
Thanks for the additional information.
Well, with a normal colonoscopy and bowel studies, the most likely cause for this would be Irritable bowel syndrome- of the diarrheal variety.

Diet Triggers for IBS Diarrhea
Some foods can worsen IBS-related diarrhea. These include:
Too much fiber, especially insoluble fiber found in the skin of fruits and vegetables
Food and drinks with chocolate, alcohol, caffeine, fructose, or the sugar substitute sorbitol
Carbonated drinks
Large meals
Fried and fatty foods
Food and drinks with dairy
Foods with wheat -- Some people may be allergic or have a negative reaction to gluten
Prevention Strategies:
Eat a moderate amount of soluble fiber. It adds bulk to the colon and can help prevent spasms. Good sources are whole wheat breads, oats, barley, brown rice, pasta, the flesh of fruit (as opposed to the skin), and dried fruits.
Don't consume foods with extreme temperatures, such as ice-cold water and steaming hot soup, in the same meal.
Stay away from broccoli, onions, and cabbage. They can cause gas, which can make diarrhea sufferers feel worse.
Eat smaller portions.
Drink six to eight glasses of plain water a day, but drink the water an hour before or after meals, not with meals.

That being said, another common cause of diarrhea and cramping is lactose intolerance. I would consider cutting out dairy, with the exception of yogurt and cheese (as it has digestive enzymes)

If this doesn't help, then make the appointment to see the GI doctor.

I hope that this helps!

Warm regards.

Please click the GREEN ACCEPT BUTTON if this was helpful so that I will receive credit and compensation for my time. Positive feedback is always appreciated as well. Thank you and good luck!

Customer: replied 5 years ago.

My diet is pretty much what you are recommending. Can red wine be such a big factor in my diet?


I want to know why it builds up over 4 - 5 days and then lets rip?


Will IBS probiotics help at all?


Is this a normal IBS pattern?

Expert:  Dr. Cameron replied 5 years ago.
Red wine can help.
This sounds very typical of IBS. It builds up and then all comes out.
probiotics are helpful.
But you may also want to keep on top of constipation by taking small dose of an osmotic laxative like milk of magnesium.

Take care
Customer: replied 5 years ago.

I would have thought that a laxative would make it worse.

Am I then constipated until it all comes out? \

Why then do I have a normal bowel movement about three hours before the explosion?

Customer: replied 5 years ago.
Relist: Incomplete answer.
It would be nice to have other opinions.
Expert:  Dr. David replied 5 years ago.
Hello, this is Dr. David. I have read your question and am ready to help.

I don't think you should feel that you should have the diarrhea come out so that germs will come out. I don't think your body is having the diarrhea every 4-5 days because of excessive "germs".

The 600ml of red wine a night as you know is a bit excessive and can irritate the bladder and the bowels as well and along with certain foods you eat could be causing the explosive diarrhea and cramps. I would slowly cut down on your red wine consumption down to 300-400ml a day and see if that helps decrease the number of diarrhea episodes a day.

Customer: replied 5 years ago.

Would you concur that a light laxative would help? If so, Why?


I fail to grasp why the bowel builds up, makes a normal movement and then three hours later a big explosion?

Expert:  Dr. David replied 5 years ago.
you can try the laxatives, but I don't think they will help. I think they will increase the frequency of your bowel movements and cause you to have more loose stools and more frequent diarrhea.

I think what you need is to cut down on your alcohol, make your diet consistant, wash your hands before you eat always, and continue to have lots of fiber in your diet.

Often times constipating foods can help slow down your bowels a bit and keep you from having such bad explosive diarrhea. foods which can constipate would be bananas, cheese, startches, meats.

if your explosive diarrhea symptoms continue, I would try to see if certain foods cause these episodes such as dairy or gluten (pizza dough). some people develop colon allergies to lactose in dairy and gluten protein and these can cause diarrhea as well.
Dr. David, Board Certified Physician
Category: Medical
Satisfied Customers: 45586
Experience: Experienced Physician trained in New York City. I'm ready to help.
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Expert:  Dr. Cameron replied 5 years ago.
I would have to disagree. If you are having diarrhoea every 5 days it suggests that stool is building up prior to expulsion. Encouraging daily good bms may prevent this. As well as dietary changes. Sorry about the delay. I was driving