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RAJESH  CHAUHAN
RAJESH CHAUHAN, Doctor
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My 80-year-old father has had chronic diarrhea for 3 months.

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My 80-year-old father has had chronic diarrhea for 3 months. He has been hospitalized continuously since May 24. The gastro doctors have run the full gamut of tests, but have found nothing. They say that his bloodwork is all normal as well. Today, they are doing a CT Scan, but do not know what they are looking for at this point in time. Pretty much, as soon as he eats, he gets diarrhea. He also gets diarrhea during the night -- last night it lasted for 5 hours. They've ruled out IBS, Inflammatory Bowel disease, Celiac Sprue, and a few other common causes of chronic diarrhea. Any suggestions for further testing that you may have would be most appreciated! ~Susan

Hello & Welcome to Just Answer,

Could you please help me understand your problem by giving me the following details:

1) Any other symptoms/ significant medical issues or significant history?

2) Any medicines that he might be taking?

Thanks. Shall be waiting for your reply.

Customer: replied 7 years ago.
Dad takes Diclofenac for his arthritic hip and takes Lasix (water pill) because he suffers from venous stasis. He wears support stockings and takes Lasix to keep the fluids from building up in the legs. When he was first admitted into the hospital, they took him off the Lasix and the stockings. That did not help the diarrhea. It did, however, cause him to develop a lemon-sized ulcer on the left leg. He is back on Lasix -- it does not seem to affect the diarrhea. They also have tried a gluten-free and dairy-free diet -- that also has not helped. He also takes a potassium pill. Other than Diclofenac and Lasix, he only takes Tylenol. Dad does have an enlarged thyroid (benign) that he has had for 50 years. They have concluded that it is not contributing to the diarrhea. He also has an enlarged prostate with a PSA reading of 5.5. However, upon physical examination, the urologist said that the enlarged prostate is really not that large and wouldn't be a factor in the diarrhea issue. They have also done an MRI of the lower spine, which revealed only arthritis. No herniated discs or anything that would be inpinging on any nerves that are connected to the gastrointestinal tract.

Thanks for the additional details. I think that by doing a CT now, the doctors are trying to look/ exclude the following possibilities which could manifest with diarrhea:

(a) Carcinoid tumor

(b) Pancreatic cancer (islet cell tumor)

(c) Gastrinoma, etc

That said, I think that the doctors may also like to exclude certain other conditions, like:

(a) Bacterial overgrowth

(b) Microscopic colitis due to NSAID use

(c) Osmotic diarrhea

(d) Malabsorption syndrome

(e) Parathyroid adenoma

(f) Bile induced diarrhea, etc.

I hope that this information is helpful to you. Please feel free to inquire if you have any remaining concerns or doubts, and it would be a privilege and a pleasure to try and help out as much as I can. Best wishes.

Customer: replied 7 years ago.
Should a carcinoid tumor have been found during the colonoscopy procedure? Also, they've mentioned the "malabsorption" theory but have not elaborated on the possible cause(s).

Thanks for the query. A carcinoid syndrome may not be detected during a colonoscopy and a CT may pick it up. Kindly have a look at this web resource which provides authentic information about this condition:

http://www.mayoclinic.com/health/carcinoid-syndrome/DS00690/DSECTION=tests-and-diagnosis

Regarding malabsorption syndrome, it is like a basket of various different causes, which have to be identified/ evaluated and ruled out one by one. Please have a look at this web resource which provides authentic information about this syndrome, as it might be helpful in your father’s case:

http://www.hopkinschildrens.org/tpl_rlinks_nav1up.aspx?id=5130

I hope that this information is helpful to you. Please feel free to inquire if you have any remaining concerns or doubts, and it would be a privilege and a pleasure to try and help out as much as I can. Best wishes.

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