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Starting last August my bowel habits changed, explosive

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diarrhea, cramps in lower abdomen...
Starting last August my bowel habits changed, explosive diarrhea, cramps in lower abdomen, bowel incontinence, rectal pain. About 4 months ago, I began losing weight, not trying. I have lost 40 pounds, from size 16 to size 6. My PCP shared she was really concerned about this. We have tried different meds and nothing seemed to stop the weight loss or the change in bowel habits. I am 60 years old, had my first colonoscopy 8 years ago, 2 polyps were found and removed. Biopsy showed no malignancy. 2 months ago, I had my 2nd colonoscopy where 10-15 or more (Dr said he "could not count them all") polyps, 2 different types. I told him if I had more polyps, I wanted them removed. He removed 2, biopsy showed no malignancy. He did not remove them all saying that his "assumption is that the rest are also non-malignant". He says that stress is causing my weight loss and sent me to a Psychiatrist whom I know, who disagreed. Gastro Dr says my anxiety is imaginary, unfounded. What now?
Submitted: 8 years ago.Category: Medical
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6/14/2010
Doctor: The Physician, Doctor replied 8 years ago
The Physician
Category: Medical
Satisfied Customers: 1,159
Experience: Versatile Emergency Physician, 20 years experience as a Physician.
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Hello

Greetings from justanswer.com

Do you still have diarrhea and or abdominal pains?

If yes, what is the stool characteristics?

Any frank blood in the stools?

Do you have any associated nausea or vomiting.

What is your sleep pattern?

Do you have palpitations

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Customer reply replied 8 years ago
Diarrhea is sporatic and abdominal pains are constant to varying degrees. Rectal pain is also constant. Stool can go from slightly hard to liquid, not constant. Always brown to darker brown.

No blood in stool that I can tell. Sometimes bright red blood after passing hard stool.

Very seldom any nausea, no vomitting.

I take Tamazepam 30 mg to help me sleep. Have suffered with PTSD for most of my adult life.

History of 4 heart attacks. Do have palpitations at times and some angina treated with sublingulal nitro spray. Visit with Cardioligist regularly.
Doctor: The Physician, Doctor replied 8 years ago

Thanks for the update

I do not agree with the opinion that the weight loss can be dismissed as due to 'stress'

That is too simplistic.

There is an incontrovertible evidence that polyps especially adenomatoius polyps (non cancer) cause diarrhea as a symptom. Though adenomatous plyps are benign, it is always cautious to remove ALL of them.

Chronic diarrhea would cause weight loss due to the following

Reduced absorption of nutrients, due to reduced transit time

Electrolyte and mineral changes affecting effective metabolism

Reduced absorption of vitamins

I still believe there are elements of your condition that are feeding on your anxiety, but the solution is ALWAYS to take care of the known, and then the unknown factors might get exposed.

Let your Gastroenterologist establish a treatment objective for the polyps, and determine how far they can go cosidering your cardiac history. Or at least effectively control the diarrhea.

WE cannot do that from justanswer.com.

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Customer reply replied 8 years ago
The Gastroenterologist told me he did not remove the polyps because of their location, around the rectal area, and there is nothing of concern with these polyps and recommends another colonoscopy in TEN YEARS. Maybe I'm not getting something but it stands to reason to me that if 8 years ago, I had 2 polyps, now 8 years later "10-15 or more" have developed, something should be done now rather that waiting another 10 years to see how many I have then, or do they just dissapear?

I apologize my attitude, I have had this for some time and I am frustrated. I have thought about getting a second opinion and the only doctor that has come highly recommended is in the same group of doctors. I know doctors in the same group don't like to cross each other so I feel rather stuck!
Doctor: The Physician, Doctor replied 8 years ago

I admit that generally the trend is that doctors don't want to 'unduly' criticize decision of colleagues, but if there is a clear difference in opinion that rests on the life of a patient, I think that fraternity is exaggerated.

Please seek a second opinion.

You are now informed, and can have a respectful discuss with the doctor whom I believe would make a decision towards the BEST options for your TOTAL wellbeing.

The Physician
Category: Medical
Satisfied Customers: 1,159
Experience: Versatile Emergency Physician, 20 years experience as a Physician.
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Customer reply replied 8 years ago
Doctor, thank you so much for your time and helpful information.

Carol Burke
Doctor: Internist, Board Certified Physician replied 8 years ago
Internist
Internist, Board Certified Physician
Category: Medical
Satisfied Customers: 4,766
Experience: Int. Med., Gastroenterology. Fellow American College of Physicians. Trained, located in the U.S.
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I wold like to address this question if you want to repost it and ask for me.
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