Seeking Answers for Digestive Distress: Recommended Tests and Advice
I am a 34-year-old Caucasian female, standing at 165 centimeters tall and weighing 78 kilograms. On a daily basis, I take several medications: Prestance (5/5), Aerius, a hormonal contraceptive vaginal ring, and magnesium bisglycinate (365 mg). Occasionally, I also use Lexaurin (bromazepam) at a dosage of 0.75 mg every two or three weeks, primarily for anxiety and sleep disturbances, though I have not taken it in the last three weeks. Previously, I underwent multiple tests. Initial blood tests indicated a slight increase in amylase levels, which led to an abdominal ultrasound, yet nothing abnormal was detected. Both flexible sigmoidoscopy and a subsequent abdominal ultrasound were performed, revealing only hemorrhoids and an anal fissure. Throughout my life, I’ve grappled with digestive issues. Since childhood, I dealt with constipation, which ultimately resulted in hemorrhoids and my first anal fissure. To address this, I became conscious of my diet and utilized osmotic laxatives, which significantly improved my situation for many years, allowing me to have regular bowel movements without bleeding. However, approximately one year ago, I began experiencing unexpected episodes of diarrhea that can last between a couple of days to a week at a time. Mornings are particularly challenging, as I often experience loose stools, which eventually stabilize later in the day. During these episodes, I feel continually fatigued; after waking up, all I want is to return to bed, and merely completing my workday feels incredibly taxing. I also suffer from persistent nausea without vomiting, and this typically follows a pattern of ten days of normal or firmer stools followed by three days of diarrhea. Thankfully, I managed to avoid any diarrhea for over two months and even found myself needing to use Miralax occasionally. However, this past Wednesday, I awoke to an upset stomach once again. My meals consist of homemade food, which I ensure is not overly greasy or heavy, avoiding fast food and excessive sweets altogether. My overall daily functioning is severely impacted by the fatigue and frequent headaches I experience. Although I don’t encounter much abdominal pain, I do feel cramping in the lower central abdomen along with considerable gas and rumbling. I have scheduled an appointment with my general practitioner for Monday, though I find her approach somewhat passive; she tends to follow my requests rather than take the lead. What diagnostic tests should I consider requesting? While I am open to the possibility of upper endoscopy, a full colonoscopy seems daunting due to my anal fissure. I would greatly appreciate any insights regarding what might be happening. I understand it’s difficult to provide specific answers, but any guidance would be immensely appreciated!
Answers (1)
2/7/2026, 7:40:32 PM
OpenHealth AI
It sounds like you are experiencing significant digestive distress, with a history of constipation that led to hemorrhoids and anal fissures, combined with recent episodes of diarrhea and fatigue. Understanding your symptoms and the potential underlying causes is essential moving forward.
Main Points:
- You have a complex history of digestive issues that includes constipation and, more recently, episodes of diarrhea, along with fatigue and nausea.
- Your past tests have not revealed severe abnormalities, but your current symptoms warrant further investigation.
- Given the variability of your symptoms, a targeted approach to diagnostics could aid in identifying the underlying cause.
Explanation: Digestive issues like yours can stem from several potential causes, including dietary intolerances, irritable bowel syndrome (IBS), gastrointestinal infections, or inflammatory conditions. The pattern of your symptoms—alternating between constipation and diarrhea along with fatigue—suggests something more than simple dietary issues.
Your previous tests have ruled out major concerns, but since you’re still facing significant challenges, further evaluation is warranted. Some conditions can be subtle, and additional testing might provide clarity. Keeping a symptom diary could be helpful to track food intake, stool consistency, and any triggers related to stress or medication usage, as these can also influence digestive health.
Prioritized Next Steps:
-
Discuss Diagnostic Tests: At your upcoming appointment, consider asking for:
- Comprehensive stool tests: These can check for infections, inflammation, and malabsorption issues.
- Food intolerance testing: This may help identify if any specific foods are contributing to your symptoms (e.g., lactose or gluten).
- Upper endoscopy (EGD): Given your ongoing nausea, this may help visualize the upper digestive tract for potential issues.
- Colonoscopy: Though you’re apprehensive, it can be important for ruling out conditions like inflammatory bowel disease, especially if other tests are inconclusive. Discuss your concerns with your doctor; there are strategies to minimize discomfort.
-
Lifestyle Modifications:
- Continue monitoring your diet. Consider keeping a detailed food diary to identify any potential triggers.
- Increase water intake and dietary fiber gradually to manage constipation and diarrhea. Foods rich in soluble fiber (like oats, bananas, and apples) can be beneficial.
- Try to manage stress through relaxation techniques, as stress can exacerbate digestive symptoms. Techniques such as yoga or mindfulness meditation can be useful.
-
Track Your Symptoms: Note the frequency, consistency, and any associated symptoms such as fatigue or nausea. This information can guide your discussions with your doctor.
-
Seek Help for Fatigue: Since your fatigue is impacting your daily life, discuss this with your doctor as well. It may be a symptom of an underlying condition or related to nutrient absorption.
Finally, it’s important to advocate for your health. If you feel your concerns are not being fully addressed, don’t hesitate to seek a second opinion from another healthcare provider. Your health and comfort are paramount, and effective communication with your doctor is key.
Related Questions
Lymph Nodes Observed in Abdominal CT Scan
A 26-year-old female, standing at 5'1" and weighing 70 kg, who does not smoke and drinks alcohol occasionally, has been experiencing gastrointestinal problems characterized by alternating periods of constipation and softer stools since January 24th. Additionally, she was diagnosed with a bladder infection on February 3rd, which was treated with a single dose of antibiotics totalling 3000 mg. She sought emergency medical attention due to significant discomfort in her lower left back, initially feeling colicky before becoming a constant dull ache, leading to an overnight stay for an abdominal CT scan the following morning. The findings from this scan have caused her some concern, particularly regarding identified lymph nodes. **Medical Findings:** Diagnosis: Lumbosacral radiculopathy and fecal impaction. **Treatment Approach:** The patient has been prescribed spasmolytic analgesics and will undergo further radiological evaluation. **CT Scan Results:** The low-dose native abdominal CT revealed normal appearances of the kidneys and urinary tract on both sides, with no signs of urinary retention or kidney stones in the renal pelvis or ureters. However, a few small, nonspecific mesenteric lymph nodes were detected in the mesenteric root and perizocecal areas, along with small inguinal lymph nodes on both sides. There is also no indication of appendicitis, and the colon contains a moderate volume of stool. The remainder of the low-dose CT findings are within normal limits. **Ultrasound Findings:** The abdominal ultrasound indicates grade I ectasia of the left renal pelvis, while no abnormalities were noted in the left renal pelvis, and the bladder was observed to be empty following urination. **Next Steps:** A referral for further urological evaluation is recommended alongside maintaining adequate hydration, with analgesics suggested if pain management is necessary.
Could This Be IBS or Something Else?
Greetings! I’m a 27-year-old male, standing at 172 cm and of European descent, currently using Iqos. My medical troubles began roughly four months ago, around October 5, 2025. Initially, I experienced intense back pain lasting for two days, which I recognized as kidney stone pain. To alleviate this discomfort, I took NSAIDs, predominantly Metamizole-Natrium. Afterward, I visited urgent care, where I was given Diclofenac and Monural, an antibiotic for urinary tract infections. I took one of each at night. **A couple of days later, I started experiencing several troubling symptoms:** - Frequent diarrhea (4-5 times a day, often watery) - Significant gas and belching - Persistent nausea that greeted me each morning, sometimes relieved by eating - A general sense of malaise - A loss of 5 kg (I dropped from 63 kg) because I lacked appetite, especially under stress. These symptoms developed quickly and intensified through October, fluctuating over time. Blood tests showed no abnormalities, with normal CRP levels. Then in November, I underwent a colonoscopy and gastroscopy. - I had three very small erosions, about 1-2 mm, in the terminal ileum, but no signs of inflammation. Histology revealed no pathological issues, all was well. - There was one small erosion in the sigmoid colon, with minor inflammation around it. Histological findings indicated small infiltration in the lamina propria but no chronic signs, leading to a diagnosis suggesting a high likelihood of infection. - The areas were healing, with fibrin present. The rest of my colon appeared healthy. The doctor attributed the ulcers to NSAID-induced damage. I was later diagnosed with LA-A GERD. Due to my anxiety about health, I spent the month consumed by fears of complications such as colon cancer, PC, or Crohn's disease. I finally found some relief and felt symptom-free for the subsequent two weeks. However, in December the troubles resurfaced, though to a lesser degree, with occasional loose stools—2-3 times for a few days— and lingering gas. My anxiety about Crohn's returned, and I mistakenly took Algopyrin Complex, which triggered additional stress. **In December, my primary worries included:** - Loose stools resembling Bristol type 5-6, mainly occurring once each morning - Excessive gas often felt trapped in my rectum - My weight stabilized at 62 kg **I underwent various tests:** - Negative results for Giardia and E. coli - Negative FIT tests - Negative MRI (everything appeared normal) - Negative MRE (all normal) - Calprotectin level measured at 18.7 - I was found to have low levels of B9 and Vitamin D, with B12 at 320 and LDL at 5.9 **Moving into January:** - I only had one bowel movement each morning, sometimes loose, but mostly firm in the past three weeks (Bristol 4), compared to my usual Bristol 2. - After meals, I often felt gas building in my rectum, sometimes getting stuck before eventually releasing. This gas, thankfully, rarely had an odor. - Mornings have been troublesome, as I needed to pass gas 2-4 times, and in bed at night, I felt bloated with gas movements. **What I have observed:** - No signs of blood in my stools - No pain - No nocturnal symptoms affecting my sleep - No extraintestinal symptoms - My weight has stabilized without additional loss after recovering some weight Overall, I feel fine, yet the worry about my condition persists in my mind. Previously, I would have bowel movements twice weekly, with little to no gas. It baffles me that I often wake up feeling this uncomfortable. My primary concern is whether I should be worried about Crohn's disease (which occupies my thoughts constantly) or if my symptoms might stem solely from anxiety. Currently, I'm taking the following medications and supplements: - Itopride (doctor suggested it for motility issues) - L-Glutamine - Curcumin - A B-complex supplement - Ashwagandha - I briefly tried rifaximin for three days, but it did not yield significant changes. - I had also experimented with antacids previously, though they proved ineffective. Thank you for your assistance in advance!
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.
Did My Appendectomy Resolve My Digestive Issues?
I’m a 27-year-old non-binary person who had their appendix surgically removed due to appendicitis early last October. Since that procedure, I’m experiencing something I never thought possible: regular bowel movements. Remarkably, this newfound routine hasn’t faded away, contrary to what my doctors predicted. Historically, I have struggled with constipation throughout my life. As a child, I often felt compelled to mislead healthcare professionals about my bowel habits, claiming I had daily movements out of fear that something was amiss. In reality, I would only have a bowel movement every three to five days. I also live with autism, ADHD, dysthymia, and PTSD. Given my history of burnout, it would be logical to attribute my digestive struggles to stress. However, these issues persisted even during holidays and rarely intensified during particularly stressful times. Most of the medications I tried, including SSRIs and various birth control options, had no impact, except for Ritalin, which occasionally provided some relief when not taken consistently. Prior to the appendectomy, I underwent two surgeries: one for a fractured arm and the other a double procedure to remove my uterus and breasts. Unfortunately, neither operation had any effect on my bowel function. Since my surgery, my dietary, hydration, exercise, and substance use habits have remained unchanged. A bit of additional context: My thyroid hormone levels are normal, although I occasionally have low Vitamin D, for which I take supplements. I receive B12 injections to address low levels since dietary sources aren’t effective for me. Additionally, I deal with a persistent mystery of chronic fatigue that shows no signs of improvement post-surgery. This leads to my question: Could my appendix have been the source of my gastrointestinal issues? Alternatively, did the surgery trigger some other change that resolved my long-standing problem? I’m curious if anyone else has encountered similar experiences. What are the chances that I’ll revert back to my past issues with constipation? Any insights on this would be greatly appreciated, mostly out of interest.