Persistent Digestive Distress for Over Six Months – Offensive Gas, Unusual Stool, New Abdominal Discomfort: Pancreatic Issues or SIBO?
Hello everyone, I’m a 27-year-old male seeking advice regarding ongoing digestive troubles that have lingered for quite some time. The more debilitating symptoms have persisted for over half a year, but the initial signs actually began several years ago. ### Initial Symptoms (approximately 3 years ago): - The first signal appeared around three years back. - I frequently dealt with extremely foul-smelling gas, particularly after consuming beer. - At that stage, it was specifically tied to beer and wasn’t continuous. - Gradually, the symptoms intensified, occurring more often and becoming less linked to specific foods. ### Main Symptoms (lasting for over 6 months): - Constant bloating following meals. - Foul-smelling gas that is no longer confined to beer. - Daily irregularities in stool consistency: - Loose, mushy, or occasionally watery. - Colors ranging from yellow-brown to olive. - Poorly shaped and sometimes difficult to flush. - Noticeably stronger odor compared to before. - Sensation that food isn’t being adequately digested. - Instances of brain fog and fatigue. - Earlier in my experience, I had fluctuations between diarrhea and constipation, along with feelings of incomplete evacuation. ### Symptom Pattern: - Symptoms tend to escalate after meals, particularly after larger ones. - High-fat foods seem to exacerbate my discomfort. - Bloating usually initiates within 30 to 90 minutes post-meal. - Symptoms are often present on most days, showing little episodic behavior. ### New and Noteworthy Symptom: - After enduring over a year of these digestive issues, I woke up in the night with pain in my upper abdomen beneath my ribs, which later extended around my belly button. - This discomfort persisted for most of the day, manifesting in waves: - About five minutes of pain, followed by a longer pause without discomfort, then the pain returned. - The pain is bothersome and worrying, but I haven’t experienced fever or vomiting. ### Tests Conducted So Far: - An MRI of my upper abdomen was completed roughly a year ago, revealing nothing abnormal regarding my pancreas, liver, or biliary system. - An upper endoscopy (gastroscopy) also yielded normal results. - Testing showed no signs of celiac disease. - Blood tests indicated mildly elevated liver enzymes (ALT, AST), but the increase was slight. ### What I Don’t Experience: - No visible blood in my stools. - No fever present. - No ongoing vomiting. - No known recent incidents of food poisoning. ### Concerns and Reflections: Given the combination of: - Long-standing, progressively worsening symptoms, - Offensive gas (initially triggered by beer), - Irregular loose stools, - Worsening symptoms post meals, - Possible intolerance to fats, - Mildly raised liver enzyme levels, and - The emergence of new abdominal pain, - I fear that malabsorption could be an issue, particularly regarding: - Exocrine pancreatic insufficiency or early pancreatic dysfunction, - SIBO (small intestinal bacterial overgrowth), - Possible problems with bile or gallbladder functioning. This situation doesn’t align neatly with typical IBS, as the symptoms appear more connected to digestion and nutrient absorption rather than stress. ### Future Steps I’m Considering: - Conduct a fecal pancreatic elastase test. - Get an abdominal ultrasound focused on the pancreas and gallbladder. - Repeat blood tests to check liver enzymes, amylase, and lipase. - If elastase results are normal, I’ll consider a SIBO breath test. - Looking into the possibility of trying pancreatic enzymes (pancrelipase) if deemed necessary. ### My Queries: - Does this long-standing, steadily progressive symptomatology suggest issues like pancreatic enzyme deficiency, SIBO, biliary complications, or something entirely different? - How reassuring is it to have had a normal MRI a year ago in light of these persistent and evolving symptoms? - Are there specific evaluations or warning signs I should pursue right now, especially considering the new abdominal pain? Thank you sincerely to everyone who takes the time to read my post and share any thoughts or insights.
Answers (1)
2/10/2026, 4:20:53 PM
OpenHealth AI
Your ongoing digestive distress, characterized by foul-smelling gas, irregular stools, and new abdominal discomfort, warrants careful attention, especially since symptoms have intensified over six months. Let's address your concerns methodically.
Main Points:
- Potential Causes: Your symptoms may suggest issues like Small Intestinal Bacterial Overgrowth (SIBO), exocrine pancreatic insufficiency, or bile/gallbladder dysfunction.
- Past Tests: A normal MRI and upper endoscopy are reassuring but don’t rule out all potential issues.
- Next Steps: Consider pursuing specific tests for better insight and adjust your dietary habits to manage symptoms.
Explanation:
- Digestive Symptoms: Foul-smelling gas and irregular stool patterns indicate possible malabsorption or dysbiosis (microbial imbalance), which can occur due to SIBO or pancreatic enzyme deficiency. The abdominal pain you described could relate to digestive disturbances, potentially linked to fat intolerance or biliary issues.
- Reassurance from Previous Tests: The normal MRI suggests no structural abnormalities. However, symptoms can evolve and may not always correlate directly with imaging results.
Prioritized Next Steps:
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Dietary Adjustments:
- Monitor Food Triggers: Keep a food diary to identify patterns linked to your symptoms, particularly with high-fat foods and difficult-to-digest items.
- Small, Frequent Meals: Eating smaller meals may reduce bloating and discomfort. Avoid heavy, rich meals that worsen symptoms.
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Pursue Recommended Tests:
- Fecal Pancreatic Elastase Test: This will help evaluate pancreatic function. Low levels can indicate exocrine pancreatic insufficiency.
- Abdominal Ultrasound: Focus on the pancreas and gallbladder to check for any alternative abnormalities.
- Repeat Blood Tests: Monitor liver enzymes, and check amylase and lipase levels to assess pancreatic function.
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Consider a SIBO Test: If the fecal test shows normal pancreatic function, you might explore a breath test for SIBO, which can confirm overgrowth in the small intestine.
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Symptom Monitoring: If the abdominal pain worsens or you develop new symptoms (fever, blood in stools, severe pain), be vigilant, as these could indicate a more serious condition requiring immediate attention.
Your health is important, and these initial steps can help clarify the underlying issue while you manage symptoms more effectively. Please remember to take care of yourself, and let me know if you need further guidance!
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