[ashia]

The first reaction of my GI doctor was yes. He said if I had sticky stool, then I didn't have IBS. But now he can't find anything "wrong" with me, this despite the fact that I've been losing about 500g (1 pound) a week and am now down to 47 kilos (103 lbs.). I promise you I am not anorexic. I love to eat and I eat pretty healthfully and cook most of my own food. I've actually been feeling somewhat better with some recent diet changes, but I continue to lose weight. This started after a gastro infection in late March. I've already had myriad stool and blood tests and an endoscopy, although no colonoscopy yet. Did a course of Metronidazol, i.e., no parasites. I don't have fever or bloody D either, such as is associated with Crohns and the Crohns blood test was negative. Thoughts? Can sticky stool + weight loss only be related to a malabsorption syndrome? What further tests should I push for?

 

[Kathleen M.]

Well if the one and only symptom you have is your stool is a bit too soft and so isn't so easy to clean up that isn't enough symptoms for an IBS diagnosis, but plenty of people with IBS do complain of stools that take a lot of clean up. If that is what you mean by sticky.You might play with how much fiber you eat to see if you can get the texture easier to clean up.Have you counted your calories to make sure you are eating enough to maintain your weight?If you are and still losing weight make sure you have been checked for celiac disease as that can disrupt the small intestine's ability to absorb things.If by sticky you mean you strain for a long time before you can get any stool, even normal consistency, out then get your pelvic floor tested as you may not relax when you are supposed to.

 

[ashia]

Thanks Kathleen. To clarify - by "sticky", I mean D that is like sticky greasy gooey peanut butter, totally gross -- no straining to get it out. If anything, i have more of a problem with urgency. This sticky stool is together with a lot of abdominal discomfort. Celiac and Giardia tests were negative, including via biopsy. I have become lactose intolerant in the last few months, that much is clear, but I haven't been eating any dairy recently and symptoms continue. You're right - it is in fact hard to get enough calories into me with such a restricted diet (no dairy/gluten/coffee/alcohol/greasy foods/hard to digest foods), but I've been trying to make up for it with quantity, at least when I can and my stomach isn't too upset. The upside of this diet is that I have more energy and my poop is no longer an alternating variety of gray, green and yellow. I count that as a big improvement! Still, like so many others here on the forums, it would certainly make me feel better to have a clear diagnosis, and as a result some kind of potential pathway toward treatment.Do you have a perspective re: gluten intolerance (without Celiac's) causing the kind of sticky stool I am describing? I have been getting conflicting info on this. I definitely react to eating whole grain wheat (the result is extra extra sticky and gross), but I can't clearly say whether this is a result of the fiber or the gluten and my doctor is not a believer in the existence of gluten intolerance without Celiac's. (I know this is contentious territory.) Thoughts? Does what I'm describing rule in or rule out IBS?Oh, PS: No liver/gallbladder/pancreatic problems, already had blood tests, ultrasounds, stool tests, etc.

 

[Kathleen M.]

Usually what I think is going on with people who are wheat sensitive but do not have celiac is it is more the starch that causes issues (and they don't usually get any of the small intestinal damage). Most of them get better on a wheat free diet a lot faster than the people I know with celiac's disease who have to wait for the intestines to heal before they really feel better and often tolerate way more wheat in their diet than anyone I know with celiac.The "just a small cookie" and they are fine is something that would set a person with celiac off for several days. The people I know with celiac can't tolerate the food they eat being touched by anything that touched wheat and wasn't washed first. Which can make eating out a big issue as sometimes they aren't careful enough in the kitchen to keep the gluten free food totally isolated.I do know a lot of people feel better when they avoid obvious wheat in their diet. (without having to go through every ingredient of every single thing they eat and look for any of the hundreds of wheat, rye, or barley based food additives before they get substantial relief like most of the people with celiac end up having to do).I don't see anything in your description that rules out functional GI issues and there are some functional problems that are "not quite IBS" but usually other things people worry about have way more symptoms in addition to the IBS symptoms than IBS, not just one symptom but not the whole package of pain/discomfort with stool consistency/frequency issues that you see in people diagnosed with IBS. There is no particular consistency/frequency issues that is clearly not IBS. Although copious watery diarrhea is rarely just from IBS alone nor is constipation so bad you only have 1-4 BM's a month.

 

[ashia]

Kathleen, thanks again. That's helpful. I hadn't thought of starch per se, because I can eat boiled potatoes and rice no problem -- in fact, they seems to help. The plainer the food, and seemingly the less fiber, the better (even if my taste buds disagree). And the especially smelly/sticky/greasy poop seems to be linked to wheat. For instance, about a month ago, I had a bowl of plain quinoa and rice for dinner, but added some bouillon for flavoring, which I didn't realize had wheat in it. Paid for that big time. Other than accidents like this though, I really haven't been having even a "small cookie" or pizza slice or any of that. I have been trying to eat a reasonable amount of vegetables and a bit of fish though, even if it is sometimes hard to digest, simply because I can't see subsisting on a diet of boiled potatoes, rice and quinoa for the next 6 months or whatever it ends up being.Follow-up question - Do you think that wheat starch has different qualities than other types of starch, making it more difficult to digest even in some non-celiac people?

 

[Kathleen M.]

Every starch has some easily digestible starch and some starch resistant to digestion by humans (called resistant starch).Wheat has quite a bit of resistant starch, rice has much lower levels.

 

[ashia]

Every starch has some easily digestible starch and some starch resistant to digestion by humans (called resistant starch).Wheat has quite a bit of resistant starch, rice has much lower levels.

Interesting! Thank you!!