Struggling with Digestive Issues: Seeking Guidance
I am a 28-year-old nonbinary individual (they/them) weighing 132 lbs, and I find myself overwhelmed by ongoing digestive problems. For more than a year now, I have been dealing with stools that are not only foul-smelling but also exhibit a yellowish, greasy quality. These episodes are often extremely painful and are sometimes accompanied by severe nausea and vomiting; the consistency resembles sludge or wet concrete. At other times, I experience prolonged bouts of constipation that can last several weeks. This back-and-forth cycle has become my frustrating norm. Constipation has been a recurring issue throughout my life, and two years ago, I underwent gallbladder removal surgery. Since that operation, I have lost 50 lbs primarily due to persistent nausea and diarrhea. Over the last seven months, I have also been suffering from daily pain in my upper left abdomen, right beneath my breast. This pain is so intense that it prevents me from comfortably lying on my left side. In addition to these struggles, I am managing postural orthostatic tachycardia syndrome (POTS) and chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). To alleviate symptoms of POTS and nausea, I often have to lie at an angle, making eating difficult. Any pressure on my stomach while reclined leads to vomiting. I am feeling defeated and urgently need advice on how to discuss these issues with my general practitioner without being dismissed. I have documented my symptoms with photographs as evidence. Additionally, I’m interested in trying the FODMAP diet, but I feel lost on how to start. Any insights or recommendations would be greatly appreciated!
Answers (1)
8/15/2025, 8:20:52 AM
OpenHealth AI
It sounds like you are dealing with a complex set of digestive issues that have significantly impacted your quality of life. The combination of foul-smelling, greasy stools and alternating constipation is concerning, especially following your gallbladder removal, and it’s understandable that you feel overwhelmed. Let's break this down to help you communicate effectively with your healthcare provider and introduce the FODMAP diet.
Key Points:
- Communicating with Your Doctor
- Starting the FODMAP Diet
- Managing Your Symptoms
Explanation:
1. Communicating with Your Doctor:
Given your history and symptoms, it’s crucial to approach your healthcare provider with clarity and confidence. Here’s how you can prepare:
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Document Your Symptoms: You mentioned taking photos; continue to keep a detailed symptom diary, noting the frequency of bowel movements, stool characteristics (color, consistency), pain episodes, and when these occur in relation to meals or position changes.
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Clearly State Your Concerns: When you meet with your doctor, summarize your symptoms concisely. For example:
- "I have been experiencing foul-smelling, yellowish stools and regular constipation, accompanied by daily abdominal pain."
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Express Your Goals: State that your aim is to find relief from your symptoms, understand any underlying conditions, and explore dietary changes such as the FODMAP diet.
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Advocate for Yourself: If you feel dismissed, politely assert your experience: "I know my body, and these symptoms significantly affect my daily life."
2. Starting the FODMAP Diet:
The Low-FODMAP diet can be effective for managing digestive issues. Here’s a simplified approach to get started:
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Phase 1: Elimination (4-6 weeks)
- Avoid high-FODMAP foods entirely (e.g., certain fruits like apples and pears, dairy, wheat, legumes, and some sweeteners like honey).
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Phase 2: Reintroduction
- Gradually reintroduce FODMAPs one at a time every 3 days and monitor your symptoms to identify any triggers.
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Resources: Use recommended resources like Monash University's app for guidance on which foods to include/exclude.
3. Managing Your Symptoms:
While you prepare to see your doctor and start the diet, consider these additional steps:
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Stay Hydrated: Ensure you drink plenty of fluids, especially if you experience diarrhea. Electrolytes may also help, given your POTS.
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Eat Smaller Meals: By eating smaller, more frequent meals, you may reduce strain on your stomach and minimize nausea.
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Positioning: Since pressure on your stomach can cause nausea, continue using supports to ensure you’re comfortable during meals; consider sitting upright for a while after eating.
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Gentle Movement: Light walks may help digestion if you can manage them without excessive discomfort.
Please prioritize reaching out to a healthcare provider, as your symptoms warrant professional evaluation. Don’t hesitate to ask for referrals to a specialist if needed. You're showing resilience by seeking solutions, and it's important to continue advocating for your health. Let me know if you have more questions!
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