Seeking Expertise from Gastroenterology Specialists
Good evening. I am in search of assistance from expert gastroenterologists. At 44 years of age, I have been experiencing an unusual issue: my stools float daily, which seems indicative of steatorrhea. They leave a barely visible oily residue on the surface of the water, which I can only discern using a flashlight. This situation has raised my concerns, prompting me to investigate potential issues with my pancreas. To that end, I have undergone three MRIs, five ultrasounds, various blood examinations, and two pancreatic elastase tests, all of which returned normal results, with elastase levels exceeding 800. I also had a colonoscopy a year ago that showed no abnormalities, as well as a gastroscopy. However, I have encountered conflicting information suggesting that MRIs or MRCP might not detect mild chronic pancreatitis effectively. As a next step, I am scheduled for an endoscopic ultrasound. Interestingly, two physicians I consulted regarding my symptoms recommended Creon, indicating a suspicion of mild chronic pancreatitis. It's important to mention that I do not experience abdominal pain; instead, I have discomfort in my lower back. How is it possible for three MRIs, including one with MRCP, to overlook mild chronic pancreatitis? Moreover, when I expressed my concerns about the oily stools, they speculated about chronic pancreatitis. Prior to this, I consulted six gastroenterologists, none of whom showed concern regarding my floating stools. I have read that floating stools are a primary sign of pancreatic issues and that while they can stem from other conditions, such instances are rare. Some sources suggest that IBS or anxiety might play a role, yet I have found no studies indicating that stress or IBS can cause this symptom. My stools consistently float and exhibit a thin oily layer, though I rarely see actual oil droplets. They often appear light brown or even darker, and while they are not high in volume, the oily film on the water is noticeable.
Answers (1)
8/9/2025, 8:50:42 AM
OpenHealth AI
It sounds like you're dealing with a frustrating and concerning situation regarding your bowel habits and health, especially with the persistence of floating stools and your ongoing quest for clarity from medical professionals. Based on what you've described, it's important to understand the potential significance of your symptoms while also recognizing the thorough investigations you've already undertaken.
Main Points:
- Floating stools can sometimes be associated with malabsorption issues, including potential problems with the pancreas.
- Despite normal test results, there may be cases of mild chronic pancreatitis that are not easily detectable by imaging.
- Next steps include your upcoming endoscopic ultrasound and considering dietary factors.
Explanation:
Floating stools typically indicate that they contain excess fat, which can sometimes occur in conditions like pancreatic insufficiency, where the pancreas doesn't produce enough enzymes to digest food properly. Your high pancreatic elastase level is reassuring, as it suggests adequate enzyme production, but it's understandable that you still seek answers given your symptoms and discomfort.
It is indeed possible for mild chronic pancreatitis to be missed on standard imaging tests like MRIs, especially if the condition is not severe. Chronic pancreatitis can sometimes produce subtle changes that are not well-visualized on these scans. The discomfort in your lower back that you're experiencing could be related to multiple factors, including muscle strain or referred pain, rather than directly linked to any gastrointestinal disorder.
Next Steps:
- Endoscopic Ultrasound: Since you have this scheduled, it can provide detailed images of the pancreas and surrounding structures, which may reveal issues the other imaging techniques have missed.
- Dietary Review: Consider keeping a food diary to track any correlations between your diet and your stool characteristics. Reducing fat intake temporarily while monitoring for changes in stool consistency may be helpful.
- Hydration and Nutrition Optimization: Ensure you’re well-hydrated and possibly consider consulting with a nutritionist who specializes in gastrointestinal health. They can help guide you on dietary choices that could improve your symptoms.
- Symptom Monitoring: Keep a detailed record of your symptoms, stool characteristics, and any changes you notice during this time. Sharing this with your healthcare provider can be helpful.
While it can be disheartening to feel that your concerns are not being addressed thoroughly, you are taking the right approach by seeking further evaluation and considering all possible avenues for understanding your symptoms. Please feel assured that you're actively pursuing the right path, and I encourage you to continue communicating your concerns with your healthcare team.
Related Questions
Can Eating More Fiber Alleviate Menstrual Cycle-Related Constipation?
Every month, during the week and a half leading up to my menstrual period, I experience constipation. I'm curious if boosting my fiber consumption might ease this issue. I already ensure that I drink plenty of water throughout the day. I am a woman in my mid-20s.
Seeking Relief from Mild Fecal Impaction: Should I Go to the ER?
At 20 years old, I find myself dealing with a frustrating issue: fecal impaction. It's not something I've faced before, or at least I can’t recall, but I’ve had chronic stomach difficulties throughout my childhood, including constipation from ages four to twelve. Recently, I've been experiencing more digestive challenges after a few years of feeling normal. Currently, I’m under the care of a gastroenterologist, and we’re working on diagnosing the underlying problems. For about five days now, I haven't been able to relieve myself. While I’ve had considerable gas, that’s been the only symptom. Today has been particularly difficult; I’ve spent the last 11 hours in the bathroom grappling with severe discomfort and impaction. Each attempt to relieve the situation is excruciating, to the point where my body is resisting the effort—it’s so painful that I find myself in tears. I imagine this is what birth must feel like. I suspect this intense fear and pain are remnants of my past struggles, as for many years I’ve feared using the bathroom due to the agony it causes. Despite trying various remedies like Miralax mixed with coffee, a bullet suppository, and even a manual approach with gloves, nothing is yielding results. I’m genuinely tempted to head to the emergency room and ask them to put me under so they can help me without the pain. My mother suggests they would likely opt for a liquid suppository treatment like they did during my childhood, which was quite traumatic. I’m torn—it feels like the ER might be my last resort, but I'm concerned they won’t take me seriously since my situation doesn’t seem dire. How foolish would it be to bring up wanting sedation? I desperately want to avoid this pain; it’s becoming increasingly difficult, and I’m fighting back tears from the frustration. Can they truly provide sedation for this type of issue even when it isn’t severe? I worry that my parents might react negatively to my quest for relief and think I’m being dramatic. I’m utterly drained and don’t know where to turn. When there’s no painful push against my body, I can’t even sense the severity of the issue, yet, I am experiencing leakage, leaving me unsure. Would it be unreasonable to pose this question to the doctors in the ER? I apologize if this message is jumbled; I’m also dealing with a migraine, making it hard to focus. For context, my daily medications include phentermine, iron supplements, and vitamin D. I stand at 5’4” and currently weigh 204 pounds as part of my ongoing weight loss journey.
Eight Years of Persistent ‘Hunger’—Is It a Functional Gut Disorder?
Greetings everyone, I’m a 28-year-old woman standing at 5 feet 4 inches, and for nearly eight years, I have struggled with a constant, hollow sensation in my upper abdomen that resembles hunger. Here are some key points about my experience: - This sensation arises between meals or soon after I have eaten. - It gets momentarily better after eating but eventually returns. - Though it feels like hunger, I know it's not genuine hunger. - Mornings are especially tough as the sensation intensifies. I maintain a regular meal schedule and consume enough calories without any restrictions. Currently, I find it difficult to trust my hunger cues, so I'm tracking my calorie intake. I do not take any medications and have previously used proton pump inhibitors without any noticeable improvement. Additionally, I neither smoke nor consume alcohol. Visits to my general practitioner have yielded no definitive diagnosis, with much of the feedback being centered on dietary adjustments. I am currently facing a waiting period of approximately eight months for a gastroscopy. Strangely, I also notice that I feel particularly weak during my workouts, despite my calorie intake being sufficient. Has anyone else faced a similar long-term issue? Did you find it to be functional dyspepsia, gastritis, visceral hypersensitivity, or something entirely different? Were you able to obtain assistance through a gastroenterologist, a dietitian, or therapy? Thanks for your insights!
Understanding My Lack of Appetite
I’m a 14-year-old girl about to turn 15, standing at 155 cm (5' 1'') and weighing around 53-54 kg. My exact weight remains unclear since I am battling anorexia and have been advised against using the scale. I am currently on a regimen of antidepressants (150mg of semonic daily) and antipsychotics (15mg of olanzapine). Along with my eating disorder, I've struggled with self-harm and have been diagnosed with a conduct disorder (though I'm unsure if that is the correct term in English as I'm receiving treatment in Spain). In September, coinciding with the start of the school year, I experienced a relapse regarding my eating disorder. This phase lasted a few weeks until I transitioned to homeschooling. Initially, recovery felt manageable; I experienced satiety quickly, and I was relieved to allow myself to eat once more. However, I’ve noticed a significant decrease in my appetite. I rarely feel hungry, and even when I do, it doesn't seem to bother me. I’ve lost the desire for typical meals, though I still find myself yearning for snacks, particularly sweets or salty options, which are much more appealing and easier to consume. Foods like rice are particularly challenging; I have to push myself to continue eating them because they don't excite me at all. I’m uncertain if this change is due to some underlying issue or merely stress, although I don't currently feel stressed. Perhaps my lack of physical activity contributes to my diminished appetite, as I haven't been particularly active and might not need as much food as others. It’s also worth noting that I haven’t grown taller for about a year or two, remaining at 5' 1''. This situation wouldn’t be as concerning if I weren’t dealing with anorexia, allowing me to simply eat less. Yet, given my background, I require supervision at mealtimes, which complicates my relationship with food. Whenever I lack the desire to eat, those around me jump to the conclusion that I am relapsing, which I am not. I enjoy food tremendously, especially sweets, and I snack throughout the day. It’s just the full meals that elude my cravings completely.
Rapid Heart Rate During Illness
A 27-year-old male, standing at 6 feet 3 inches tall and weighing 275 pounds, presents as non-smoking with a medical regimen including buspirone, sertraline, and Nexium. He does not consume alcohol or use illicit drugs. His medical background highlights anxiety and a previously noted Wolff-Parkinson-White (WPW) pattern observed on an ECG in 2023, without any prior ablation or recorded arrhythmias. On February 5th, I visited the emergency room after experiencing a sudden and alarming increase in my resting heart rate to approximately 130 beats per minute while at home. This spike was particularly distressing given my history of chronic anxiety. Reflecting on the earlier part of the day, I recall experiencing mild body aches, a cough, and a sensation akin to a low-grade fever, which now appear to have been early signs indicating I was becoming ill. Once at the emergency room, the medical team administered 10 mg of propranolol, resulting in a gradual decrease in my heart rate from 130 to the mid to upper 90s over a span of about one hour and 45 minutes. The ECG revealed only sinus tachycardia, and notably, the doctor informed me that the WPW pattern from 2023 was no longer evident. All laboratory tests returned normal results with standard electrolyte levels, kidney function (eGFR at 108), and a complete blood count showing only a typical stress response characterized by elevated neutrophils and reduced lymphocytes, alongside normal urine tests. There were no indications of dehydration, infection, thyroid irregularities, or arrhythmia. After returning home, it became clear that I was battling a viral infection. I experienced chills, extensive body aches, and fever peaking at 101.8°F, as well as a cough with medium brown mucus (not excessively dark or bright red). I have not experienced shortness of breath or wheezing at rest. Notably, my heart rate has paralleled my fever. When my fever ranges between 101°F and 102°F, my resting heart rate typically aligns between 105 and 125 beats per minute. Conversely, as my fever declines into the 99°F range, my heart rate drops to the 80s and 90s. Under normal circumstances, my resting heart rate hovers around 60 beats per minute. Currently, I am measuring a temperature of approximately 100.6°F to 100.8°F, with a heart rate around 110 to 115 beats per minute. About an hour ago, I took Tylenol, and am staying hydrated and resting. The only discomfort I feel is due to persistent coughing. I have a few inquiries: - Is this heart rate fluctuation typical during a viral infection accompanied by fever? - Should I expect to see an elevated heart rate persist even during sleep when my fever is elevated? - Is there any cause for concern regarding my previous WPW even though the recent ECG indicates that pattern is no longer present? Thank you for your assistance.