Hi I’ve Had Persistent Diarrhea With A Malodorous Smell For

Brief Answer:
You may try to avoid milk and if the symptoms persist examinations are indicated

Detailed Answer:
Hello and welcome to "Ask a Doctor" service,

I carefully read your query and understand your concern.

Urge to pass stools and passing watery stools may be due to a wide range of conditions varying from irritable bowel syndrome to malabsorption and more serious conditions such as tumors.

Because you have had diarrhea for longer than 3 weeks, investigations may be needed to identify the cause.

You may need to first avoid milk (you can still use cheese and yogurt) as milk intolerance is a common cause of watery malodorous stools. Gluten intolerance is the cause in some patients and in this case, antigliadin antibodies measured in blood help rule it out.

Thyroid check may be indicated to rule out thyroid problems (TSH and FT4). Some stools tests such as stool microscopy, stool for ova and parasites, stool antigen for giardia, etc may rule out parasites as the cause of your symptoms.

Normally, patients over 55 years of age should have a colonoscopy (every 5-10 years) to visualize the inner layer of their bowel (to rule out tumors). If you have not had one in the last couple of years, this may be a good reason to have one.

Rarely, pancreatic enzyme deficiency may cause diarrhea. Having pancreatic enzymes orally may help relieve the symptoms in these patients.

To conclude:
- try to avoid milk for a few weeks and notice if there is an improvement as milk intolerance can be a cause of your symptoms
- if no improvement even though you avoid milk then tests will be needed as you are having diarrhea for longer than 3 weeks
- blood tests, stool tests, and colonoscopy (as explained in detail above) are the main examinations that are ordered to try and identify the cause.

I hope this answers your query.
I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj,
General and Family Physician

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