Hello,
XXXXXXX,
From your history I understand that you have had the diarrhea
problem even before you went on your travels. I am glad that your
stool exam is negative for ova and parasites. It is possible to recover
from some sort of intestinal infection from natural immunity and
subsequently have the diarrhea problem from Irritable Bowel
syndrome. I understand that your colonoscopy was negative for
any kind of colitis or inflammation. I am not sure if the doctor
found any pockets or diverticulosis at the time of exam. This
condition is common with gallbladder problems. I know you
have had your gallbladder out. There are two possibilities.
One is symtomatic diverticular disease without inflammation,
and the other is called "Bile salt induced diarrhea XXXXXXX after the
gallbladder surgery. What happens is, bile is released into
the intestine directly instead of being stored in the gallbladder
and released slowly during digestion. The bile salts act like
irritants on the lining of the colon and induce diarrhea.
If you have the diverticulosis problem, you definitely need
to increse the fiber intake. You can take things like
Metamucil or effersyllium or similar products daily.
There is a drug called Rifaximin (Xifaxan) which is effective
in controlling the symptoms associated with IBS with or
without diverticulosis. You can discuss this with your doctor.
This is given for two weeks and can be cycled once a month.
If the diarrhea is bile salt related, there is ursodeoxycholic acid
(URSO) which binds the bile salts and controls the symptoms.
Hope this gives you something to discuss with your own doctor.
Wish you well.

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