Diarrhea, gluten, help?

Question
I am 60 years old and 5 years out following gastric bypass. Although I have intermittent bowel issues, I now have diarrhea 2-3 x week in the mornings. Have had Cdiff, other infections ruled out. Wondering if it might be a gluten intolerance or other late effect from the surgery. Any ideas? Next step?  Probably headed to a colonoscopy although my last was 2 years ago and normal.

Answer
Hi Linda,

at 5 years post op it is not likely to be not late effects of the surgery causing diarrhea. There are some causes, however - such as small intestinal bacterial overgrowth, or late internal hernias can occur. If you have introduced more sugar or fat into your diet, you might also be having mild dumping, especially if the timing of the diarrhea is related to when you eat. Have you had a follow up with your bariatric surgery practice in the last year? If you have not, it might be good to do now in conjunction with seeing your GI doc.

It is good that they have ruled out C.Diff, but you probably need to have other causes investigated. Things like gluten enteropathy are usually ruled out via an upper GI scope and biopsy of the small intestine. There are also blood tests to look for anti-gliadin and endomysial antibodies. You can also try an elimination diet and see how your symptoms do.

I hope this is helpful.

In Health,

Dr. Jacques

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