Long-standing gastrointestinal symptoms and need for diagnosis - #24328

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Medical Case Description: I have been suffering for more than ten years from chronic gastrointestinal symptoms, including: Recurrent diarrhea, sometimes severe Abdominal cramps and pain Presence of blood in the stool during some episodes A sensation of incomplete bowel evacuation after defecation These symptoms started many years ago and have appeared in intermittent flare-ups. Over the years: I used anti-amoebic treatments whenever symptoms appeared, which led to temporary improvement, but the symptoms would return after some time. At times, I used honey, and I noticed that the bleeding would stop. At other times, I assumed the problem was excess stomach acid or indigestion, so I used Gaviscon, which also seemed to stop the bleeding. Because of this, I lived with these symptoms for many years, assuming they were due to amoebiasis or acidity, without a definitive medical diagnosis. Recent Course of the Condition: About two weeks ago: I experienced diarrhea and abdominal cramps that lasted for several days. This was followed by blood in the stool. I took Flazol Plus, and my condition improved during treatment. However: Shortly after completing the medication, the symptoms returned again. Investigations: I underwent a stool examination and Helicobacter pylori (H. pylori) test. The results were negative. However, I am unsure about the accuracy of the tests because: There was no visible blood in the stool sample at the time of testing. My symptoms are intermittent rather than continuous. Reason for Consultation: I would like to: Identify the underlying cause of these long-standing symptoms. Determine whether this could be: Recurrent amoebiasis Schistosomiasis Colitis (ulcerative, inflammatory, irritable, or other types) Internal hemorrhoids Or another condition And to know which further investigations are most appropriate to reach a clear and definitive diagnosis.

How frequently do you experience these gastrointestinal symptoms?:

- Occasionally

Have you noticed any specific foods or activities that trigger your symptoms?:

- Not sure

Have you experienced any weight loss or changes in appetite?:

- No change

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Doctors' responses

Dr. Arsha K Isac

I am a general dentist with 3+ years of working in real-world setups, and lemme say—every single patient teaches me something diff. It’s not just teeth honestly, it’s people… and how they feel walking into the chair. I try really hard to not make it just a “procedure thing.” I explain stuff in plain words—no confusing dental jargon, just straight talk—coz I feel like when ppl *get* what's going on, they feel safer n that makes all the difference. Worked with all ages—like, little kids who need that gentle nudge about brushing, to older folks who come in with long histories and sometimes just need someone to really sit n listen. It’s weirdly rewarding to see someone walk out lighter, not just 'coz their toothache's gone but coz they felt seen during the whole thing. A lot of ppl come in scared or just unsure, and I honestly take that seriously. I keep the vibe calm. Try to read their mood, don’t rush. I always tell myself—every smile’s got a story, even the broken ones. My thing is: comfort first, then precision. I want the outcome to last, not just look good for a week. Not tryna claim perfection or magic solutions—just consistent, clear, hands-on care where patients feel heard. I think dentistry should *fit* the person, not push them into a box. That's kinda been my philosophy from day one. And yeah, maybe sometimes I overexplain or spend a bit too long checking alignment again but hey, if it means someone eats pain-free or finally smiles wide in pics again? Worth it. Every time.

90 days ago

Hello
Your symptoms need proper evaluation — after 10+ years with recurrent diarrhea, abdominal pain, and blood in stool, this should not be treated empirically anymore.
Most likely causes to consider:
Inflammatory bowel disease (IBD) — especially ulcerative colitis (very important to rule out)
Chronic infective colitis (amoebiasis is possible, but repeated relapses despite treatment make it less likely as the sole cause)
Schistosomiasis (if you live in or traveled to endemic areas)
Internal hemorrhoids (can cause bleeding, but do NOT explain diarrhea and cramps)
IBS alone is unlikely because IBS does not cause bleeding
🛑
Negative stool tests do not rule out these conditions, especially when symptoms are intermittent.
Investigations:
Colonoscopy with biopsies — this is the single most important test
Stool calprotectin (to detect intestinal inflammation)
Repeat stool tests (×3 samples) for parasites, including Entamoeba and schistosoma ova
Blood tests: CBC, ESR/CRP, iron studies
Do not rely on temporary symptom relief from antibiotics, honey, or antacids — they can mask disease without treating the cause.
Next step:
consult a gastroenterologist and request a colonoscopy.
That’s the only way to reach a clear diagnosis and prevent long-term complications.
You’re right to push for answers now — this has gone on long enough.
I trust this helps
Thank you

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Dr. Bharat Joshi

I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.

89 days ago

Hello dear
See as per clinical history it seems ibs chances
Iam suggesting some tests for confirmation of exact diagnosis and best treatment.
Please share the result with gastroenterologist or laproscopic surgeon for better clarity
Please donot take any medication without consulting the concerned physician
Esr
Cbc
Serum b12
Serum b6
Stomach USG
Serum RBS
Hemogram
Serum ferritin
Sigmoidoscopy or colonoscopy if recommended by gastroenterologist
Hopefully you recover soon
Regards

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Dr. Aarav Deshmukh

I am a general physician with 8 years of practice, mostly in urban clinics and semi-rural setups. I began working right after MBBS in a govt hospital in Kerala, and wow — first few months were chaotic, not gonna lie. Since then, I’ve seen 1000s of patients with all kinds of cases — fevers, uncontrolled diabetes, asthma, infections, you name it. I usually work with working-class patients, and that changed how I treat — people don’t always have time or money for fancy tests, so I focus on smart clinical diagnosis and practical treatment. Over time, I’ve developed an interest in preventive care — like helping young adults with early metabolic issues. I also counsel a lot on diet, sleep, and stress — more than half the problems start there anyway. I did a certification in evidence-based practice last year, and I keep learning stuff online. I’m not perfect (nobody is), but I care. I show up, I listen, I adjust when I’m wrong. Every patient needs something slightly different. That’s what keeps this work alive for me.

88 days ago

Given the chronicity and nature of your symptoms, it’s crucial to delve deeper into possible underlying causes like inflammatory bowel diseases (IBD) such as Crohn’s disease or ulcerative colitis. The persistent blood in stool and abdominal pain, alongside the intermittent symptom presentation, point towards these conditions. It’s also possible that other disorders like irritable bowel syndrome might be present, though the presence of blood leans more toward IBD. Internal hemorrhoids or recurrent infections like schistosomiasis could contribute to your symptoms but are less likely primary causes given your treatment history and wider symptom profile. You’ve already tried approaches that might suggest these conditions, such as anti-acid and anti-amoebic treatments but without a lasting resolution. Further investigation is necessary to clarify the cause. A colonoscopy would be a vital next step since it offers direct visualization of the colon and can identify inflammation, ulcers, or structural issues and allow for biopsy if necessary. In addition, considering the differential diagnosis list, blood tests for inflammatory markers like C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR), and fecal calprotectin can help detect inflammation typical of IBD. Imaging studies like a CT scan or MRI of the abdomen might be warranted if structural or abscess complications are suspected. Considering the bleeding, a rectal examination could clarify if hemorrhoids contribute to your symptoms. Make an appointment with a gastroenterologist for specialized tests and to discuss these investigations. The recurrence shortly after ending treatments indicates the need for a more focused diagnostic approach, rather than intermittent symptomatic treatment. Addressing underlying inflammation or structural issues could offer more enduring resolution than anti-amoebic medication or antacids.

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