Hi! I Go Through Bouts Of 2-3 Weeks Of Liquid,

Posted on Thu, 5 Nov 2020

Question: Hi! I go through bouts of 2-3 weeks of liquid, dark brown stool that smells like perm. Liquid as though I am prepping for a colonoscopy. Sometimes the liquid BM is yellowish. Nausea and throbbing guts last for a while after I go. I am on methotrexate (9.9 cc/wk, sub-cu) for psoriatic arthritis. Colonoscopy a year ago was clear, only minor inflammation.

Answered by Dr. Abhijit Deshmukh (1 hour later)

Brief Answer:
Please see the detailed answer below

Detailed Answer:
Hi,
Welcome to ask a doctor.
Thank you for the query.
I understand your concern.

Sometimes while on immunosuppressant drugs like methotrexate you can get odd bowel infection including rare parasites.

Worthwhile getting a stool routine, occult blood, and modified Ziehl XXXXXXX stain (ZN) on three different days and stool for Clostridium difficile toxin assay on one day. Also can consider taking an empirical course of medications like antihelminthic like albendazole/nitazoxanide after consulting your local physician.

sometimes these work wonders.
In addition, can try mild antispasmodic like dicyclomine or mebeverine SOS for pain and may help in loose stools too.

Dietary modification like reducing milk/milk products and increasing buttermilk/curd and taking a good quality probiotic will help in the long run too.

Avoid eating outside food and ensure clean water intake.
Hope this answers your query.
Wish you a speedy recovery.
Regards

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Above answer was peer-reviewed by : Dr. Arnab Banerjee