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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 63757
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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I am 59 yrs old. last couple of years, I've had DAILY

Customer Question

Hello,
My name is***** am 59 yrs old. For the last couple of years, I've had DAILY Diarrhea. I do have some other health issues. Chronic Pancreatitis.... Just recently I've had a few accidents. Very troubling. I have been taking Metamucil and probiotics religiously. Still runs right thru me. My Dr. doesn't seem concerned. He prescribes laxatives when I need to take Oxycodone for Pancrease. I don't take them, as I always have runs. Any thoughts?
Thank you
Colleen
Submitted: 1 year ago.
Category: Medical
Expert:  Internist replied 1 year ago.

Hi there,

I am online and will be happy to answer your questions.

I am sorry to hear about your problem.

thank you for your patience.

Why should you take laxatives, if you already have diarrhea. ( constipation a side effect of oxycodone would be okay for you)

first we need to find out cause of diarrhea. most likely in your case is chronic pancreatitis and it can cause malabsorption diarrhea. ( foul smelling stools usually due to fat malabsorption )

you may need pancreatic enzyme replacement if that turns out to be the cause.

I recommend following.

stool testing

for ova and parasite

for leukocytes

for sudan stain ( checks for fat malabsorption )

serum TSH measurement.

I hope this helps.

Please let me know if you have any questions.

I am here to help you and I wish you best health,

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Expert:  Dr. Thomas, MD replied 1 year ago.

Hello

I think you are saying that oxycodone contipates you and then you treat this side effect with laxatives.

I have a much different answer for you here.

At age 50 with these symptoms you need a colonoscopy, period.

This is to screen for polyps, cancer, diverticulosis/diverticulitis, other inflammatory disease, etc.

This should be a first consideration.

it is standard of care medicine.

Talk to your doctor about this immediately.

This does not sound like parasites. Stool samples would rapidly eliminate this consideration.

You don't have the other symptoms of thyroid disease.

Pancreatitis can contribute to your symptoms.

I am a double board certified US doctor.

I am here daily.

Let me know if you have further questions.

Please click a positive rating.

Customer: replied 1 year ago.

I never took laxatives. I think my Dr. wanted me to because most people get constipated from opiates. Not me. Just runs. And now some incontinence.

Expert:  Internist replied 1 year ago.

colonoscopy is indicated in all patients above age 50 every 10 years.

the tests I ruled out are commonly used to rule out chronic causes of diarrhea.

if you have change in calibre of stools, weight loss, anemia, you should definitely undergo colonoscopy regardless of previous colonoscopy.

parasites are also common causes of chronic diarrhea.

in setting of chronic pancreatitis , it is necessary to rule out malabsorption diarrhea/

Please let me know about any questions you have.

Expert:  Dr. Thomas, MD replied 1 year ago.

HI

In the US, colonoscopy starts at age 50.

Age 50 is the first year.

It does not start above age 50.

I have included all of the possible causes in my initial answer, but colonoscopy with this story is due now.

Let me know if you have further questions.

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