# Diarrhea Color and Consistency



## rchippendale (Aug 16, 2011)

Hello,First, let me just say I am SO glad I found ibsgroup.org! I have been suffering from IBS-D ever since I had my gallbladder removed, literally. After the first bowel movement, I've had diarrhea ever since (literally). Since February 2007, I've been suffering with diarrhea almost daily. At least 350/365 days of the year, for the past 4.5 years. The pain is ALWAYS in my lower abdomen. I have since nicknamed it 'bubble guts'. It is sometimes not too terribly bad. Other times I get nauseous, become sweaty and shaky, light headed and it will literally bring me to my knees. I'm only 27, and sometimes it's a hit or miss if I make it to the bathroom. That's embarrassing for anyone, but especially when you're so young that you have a stigmata of "you're so young, you shouldn't have that kind of problem yet". It's frustrating, and many non-sufferers may never understand. Anywho, back to the topic at hand







One thing I haven't been able to find on here is a discussion about all the different 'types' of diarrhea, what each 'type' means, etc. I certainly hope I'm not the only case of IBS-D that will see 5-7 different 'types' of diarrhea in a given week (and by 'types' I mean all the combination of colors and consistency of a loose stool). I apologize now if this post is 'TMI' but given the condition being discussed, it's kinda hard not to get 'personal'. I have no idea if there is any difference between the 'types' but I've always wondered. So why not ask, right? I've done a couple searches in the forums for a topic like this but couldn't find anything specific on 'all' the different 'types' of diarrhea. So, I would like to start one here, and hope someone could provide some insight. The internet, in all honesty, hasn't been very helpful in answering my questions, but that could be due to my 'poor search techniques'! I've monitored what I eat and drink and compared it to what I 'empty' in the bathroom and I cannot find any link. Not between the food or beverage that was consumed or even the colors of the combination of foods eaten. I've gone out as far as 48 hours from the moment of ingestion. Some food, such as corn or lettuce, I pass as whole undigested food. I have found this to be pretty normal for folks with IBS-D (and by 'normal' I mean a common occurrence based on the cases, blogs, websites, etc. that I've read so far). When I do have a diarrhea flare-up, I will get one of the following 'surprises':1.) Neon-yellow (NEON), all liquid, toilet water is neon-yellow, always severe 'bubble guts' 2.) Split-pea soup green, all liquid, toilet water is green, moderate 'bubble guts'3.) Split-pea soup green, some 'loose' mass, toilet water is green, moderate 'bubble guts'3.) Iron-supplement green (I do not take iron supplements, just noting for color reference sake), 'loose mass', toilet water is green, moderate 'bubble guts'4.) Iron-supplement green (I do not take iron supplements, just noting for color reference sake), 'loose mass', toilet water is CLEAR and mass has pooled to the bottom, moderate-severe 'bubble guts'5.) Dark brown/mud, all liquid, toilet water is brown, moderate-severe 'bubble guts'6.) Dark brown/mud, some 'loose mass', toilet water is brown, moderate-severe 'bubble guts'7.) Dark brown/mud, some 'loose mass', toilet water is CLEAR, moderate-severe 'bubble guts'8.) Light brown/clay, all liquid, toilet water is brown, moderate-severe 'bubble guts'9.) Light brown/clay, some 'loose mass', toilet water is brown, moderate-severe 'bubble guts'10.) Light brown/clay, some 'loose mass', toilet water is CLEAR, moderate-severe 'bubble guts'I honestly cannot find a link between what I eat/drink and these outcomes. I've even done a 48 hour water cleanse before, and I still end up with one of these outcomes. Are any of these a sign of something I should be concerned with? Do any of these types mean anything? ANY help would be appreciated. I haven't been tested for all the different GI diseases, but mainly because I don't exhibit key signs/symptoms (i.e. no weight-loss, blood work revealed normal vitamin and mineral levels (was Vitamin D deficient at one point, but not anymore). I'm fairly confident that I do have IBS-D, and not a more serious condition. However, I'm not a doctor either. I look forward to your feedback. Thanks everyone!


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## whitescarf (Jul 11, 2011)

First of all, TELL ME ABOUT IT. I'm only 18 and I've suffered for about two years. I have pretty bad anxiety too and I get scared if my stomach starts to feel bad if there isn't a toilet around or I can't get to one, similar to most people on here. It's even harder being my age because it's extremely rare to have a problem like this at my age and it's very difficult socially. I don't have many friends now because of it. I don't know if you experience a similar thing because of your bad BM's? Do the occur several times a day or just once?You seem to have quite a severe case, I've never seen it before. I don't know what it means, but I definitely think you should get it checked out if you can. Mine changes colour, but it only gets lighter depending on how bad the flare-up is. I'm sorry I can't be of more help but I'm not an expert on stool. I'm better with food. By the way, never be embarrassed to get too personal on this forum, everyone on here is here because they _want_ to talk about the details since they're too embarrassed to talk about them with family or a friend.







We're all in the same boat here.I hope your get the answers you want.


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## Feline_Divine (Apr 14, 2011)

I have had these problems for about 10 years now. I also get the lower abdomen pain sometimes just for hours, but also for days afterwards. The pain is sometimes so unbearable that I can't function and it literally brings me to tears. That is what initially sent me to see the second gastro doc. I am on Lomotil now, but I still have bad flare-ups. Had one this past Monday in fact. It seems that you and I are similar with the kinds of diarrhea we are experiencing. I have had every kind you described. The only time I am able to match it up with what I have eaten is when the food isn't completely broken down and I can see it the bowl.I have been tested for many things, gluten, other alleregies, even had a endoscopy/colonoscopy which revealed absolutely nothing. I was tested for giardia and took a round of antibiotics. I peed into a jug for several days for a test and sent in stool samples. I was sure they find something wrong, but nothing. It is very frustrating.I am going to see new doc in Boston next month. He comes highly recommended so I hope he can help me get some insight.


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## EnviroChick (Jul 18, 2011)

Just thought I would say you're not alone! I have all those types of D, and all I get is D, all day everyday. Only way around it for me is 4 Imodium a day with 4 antispasmodics. I sometimes get backed up, but it is better than going no stop. I almost always have the neon yellow/orange diarrhea. I think that one is the worst, explosive and it just looks so nasty!I have had IBS-D for 5 years (I'm 23) and have yet to find out what is causing my unpredictable and horrible symptoms. I also get pain in my lower tummy, mainly below my belly button and to the right to my hip. I get the nausea, sweats and shakeyness too! We sound a lot a like!No doctor knows what is going on with me, I've been tested for most things, but my GI won't do an endospcopy or full colonscopy to see why I am in so much pain. I am currently on the fence about seeing a naturopathic doctor, as they have a more whole body approach to diagnosis and they work in conjuction with other medical doctors. I would suggest seeing a GI, and if you're GI won't help, get a new one!Good luck!


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## BayRat (Mar 28, 2011)

HiYa rchippendale, welcome to the forums! There's no such thing as TMI here, it's the nature of this forum that we get into 'unsavory' topics concerning GI functioning.







Has no doctor/GI looked into Bile Salt/Acid Malabsorption? Quite common after gallbladder removal. The green-to-yellow colored poops (that can burn and irritate anal tissues) and indigestion are typical indications of this condition, developing diarrhea issues, too. And no, it's not consistent. One day the poo is normal brown, next it's green. There's many meds to help, bile salt/acid binders like Questran.(Oh yeah, the condition can come about immediately after gallbladder removal, or years later)


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## rchippendale (Aug 16, 2011)

BayRat said:


> HiYa rchippendale, welcome to the forums! There's no such thing as TMI here, it's the nature of this forum that we get into 'unsavory' topics concerning GI functioning.
> 
> 
> 
> ...


Hi BayRat!I'm honestly not sure if they have or not. I can tell you I don't know what Bile Salt/Acid Malabsorption is, so I'm guessing they probably haven't (at least not specifically). I agree that the yellow/orange kind is the WORST. That's where I get into the sweats, shaky, nausea, SEVERE lower abdominal pain (always below the belly button and feels like someone is stabbing my in the gut with a huge butcher knife! I actually stop breathing because it's too painful), and it literally feels like I'm pooping out acid!I am reading the information from the link you sent to me and it does state that the test used to diagnose the disorder isn't licensed in the USA, where I reside. I'm wondering how difficult it would be to have a test performed that would show definitive results?Update: I just found this as well. If I do have this disorder, I'm not sure if I'll be able to use the treatment. I have Hypothyroidism. Based on the below, it sounds like this will make my hypothyroidism worse (and that could eventually kill me)."IndicationSince bile acids are biosynthesized from cholesterol, the disruption of bile acid reabsorption will decrease cholesterol levels, in particular, low-density lipoprotein (commonly known as "bad cholesterol"). Therefore, they may be used for the treatment of hypercholesterolemia and dyslipidemia.In chronic liver diseases such as cirrhosis, bile acids may deposit in the skin, causing pruritus (itching). Hence, bile acid sequestrants may be used for the prevention of pruritus in patients with chronic liver disease.In addition, diarrhea may be caused by excess bile salts entering the colon rather than being absorbed at the end of the small intestine (the ileum). The condition of bile acid malabsorption occurs after surgery to the ileum, in Crohn's disease, with a number of other gastro-intestinal causes, or is commonly a primary, idiopathic condition. The SeHCAT test can be used for diagnosis. Bile salt diarrhea is a side-effect of gallbladder removal. Bile acid sequestrants may reduce diarrhea in these patients.Bile acid sequestrants may also be used to treat hyperthyroidism as an adjunct therapy. By inhibiting the enterohepatic circulation, more L-thyroxine will be lost through defecation, thus lowering body thyroxine levels."


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## BayRat (Mar 28, 2011)

rchippendale said:


> ...and it literally feels like I'm pooping out acid!


You are (if it is indeed bile acid/salt malabsorption). I don't suffer with this nasty condition, but I understand it can be quite painful.







Take care to clean yourself well, use non-alcohol wet baby wipes if you can.Oh heck, it's getting complicated. Generally, unless contraindicated, docs just try you on the med and see how it goes. Many IBS-D sufferers, with or without gallbladders, are simply tried on such a med just to see if it helps. Diagnostics can be run to verify, but generally if it works and the risk:benefit is tolerable, well, they don't ask Why too much.If you think this Bile Maladsorption suggestion has merit, potentially treating it will absolutely require consulting with your Doctor/GI because of your Thyroid complications. There may be other ways & meds that'll integrate and account for both conditions. It's just a place to start, something to rule in/out. Your symptoms could always be something else, totally unrelated to the cholecystectomy.Wikipedia is handy for a jumpoff research platform, but I'd not rely solely on it's contents. The downside of Wikipedia is it's open access to editing. They try to do a good job with verifying the information, but it's always in flux. For solid medical info stick with the trusted reliable names like:Medline PlusMayo Clinic


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## EnviroChick (Jul 18, 2011)

I have hypothyroidism as well, but have the diarrhea, which is odd since hypo causes constipation. Once my hypo was treated, my D got much worse, but I would take that than gaining 10 pounds in a week!If you aren't on medication to treat it, I would talk to a doctor about doing so, then you can take the bile salt medications and just adjust your dosage of the thyroid meds accordingly. Being hypothyroid cannot kill you unless you go years and years of being untreated. I went 2 years of not knowing what was wrong, finally after sleeping for over 14 hours a day for a month and gaining 35 poudns in about a month, my doctor tested my blood and my levels were near comatose. Even then, it wouldnt have killed me, I would have just kept sleeping for longer and longer. Hyperthyroid is the nasty one that can casuse major heart issues and is more serious, my friend has to be monitored a lot more than I do.Biggest thing is that you need to have to take medication for your thyroid, otherwise it can just get worse.


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## Almost Dreamless (Sep 16, 2011)

Dear rchippendale,YOU NEED TO BE TESTED FOR BILE ACID MALABSORPTION! I became a member of the forum just so I could write to you. It's a tragedy that the majority of medical professionals are either not taught, or do not recognize that bile salts diarrhea IS a symptom of having your gallbladder removed in some, unfortunately unlucky, people. I have been sick for almost 9 years, getting worse over the last two. My senior year in high school I realized that the doctors had given up on me, simply labeling me with the term "IBS," which, by the way, simply means that they have no idea what is wrong with you, only that you have similar symptoms to everyone else diagnosed with IBS. I began trying to take my fate into my own hands, researching other possible conditions, and eventually taking a nutrition class. Almost a year ago, I began putting together the information I was learning about fat digestion, along with my mom's experience after having her gallbladder removed almost twenty years ago, and eventually, after more specific research than I had ever been able to do before, came to the conclusion that I may also have Bile Acid Malabsorption. It took me another five months to discover that there was a test for the condition, the SeCHAT (which as you know is not available in the USA), and another few days to find that there is, supposedly, an alternative blood test that can be preformed in the US. While my latest doctor is being uncooperative in getting me the blood test because she doesn't listen and refuses to read the information I brought to her, and therefore believes that BAM is a "rare" condition, which, more recently, has been proven wrong, I think in your case, a doctor wouldn't hesitate to order the test given that you have had your gallbladder removed. Because I have not had my gallbladder removed, my doctor doesn't believe that I could possibly have BAM, however, if she would have let me explain, she would have realized that recent studies have shown that some people may be deficient in a hormone that is supposed to regulate the production and release of bile into the small intestine, therefore causing the same symptoms that someone would have if their gallbladder was removed. Doctors may tell you that gallbladder removal has no effect on your health, that is what doctors told my mom twenty years ago, but according to my research, they are wrong. Your symptoms appear to be very severe, and the least you can do is to find the real cause, even if you can't take the medication, there may be alternatives if you KNOW what the problem is. Please don't cling to the diagnosis of IBS; it's an almost meaningless term, and from my experience over the last nine years, a hopeless condition if you give up trying to find the real problem.The best information I've found so far on BAM was on PubMed if you want to do more research on BAM.The Best of Wishes


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## rchippendale (Aug 16, 2011)

Thanks, Almost Dreamless!It's been brutal. While sometimes it is brown, it is usually yellow/orange or green. I also always seem to have elevated liver enzymes. He thought I might have a fatty liver and I was supposed to go in for an ultra sound but it never got scheduled and has since fallen off the radar. Could BAM be linked to my elevated liver enzymes? I'm on PubMED now and holy #### there are a lot of articles on BAM! Thanks for the resource! Do you by any chance know what the name of the alternative blood test(s) is called?


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## overitnow (Nov 25, 2001)

I always hate it when others tell me to calm down; but please, calm down. My D was all over the map in terms of colour and texture and consistency. When i finally found a supplement to treat it, my stools became quite consistent to this day, some 12 years later. Try Linda's Calcium regimen. If that fails, try Questran. If that fails, try a regular dose of Immodium. If that fails, then look at the more powerful prescription meds. (I would have included the self-hypnosis program but I don't know if that works on bile salts D. Maye you could sent a question to cookies4marylin for that.) I am not sure I could do this, even today; but the less you look into that bowl the better. It really is all D. When you start to recover, I guarantee you you will know it.Mark


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## Almost Dreamless (Sep 16, 2011)

rchippendale said:


> Thanks, Almost Dreamless!It's been brutal. While sometimes it is brown, it is usually yellow/orange or green. I also always seem to have elevated liver enzymes. He thought I might have a fatty liver and I was supposed to go in for an ultra sound but it never got scheduled and has since fallen off the radar. Could BAM be linked to my elevated liver enzymes? I'm on PubMED now and holy #### there are a lot of articles on BAM! Thanks for the resource! Do you by any chance know what the name of the alternative blood test(s) is called?


I don't know about the liver enzymes, but that could be a very interesting connection to look into. Also, I'm sorry, but I don't know what the name of the alternative test is, only that I've read there is one. My regular doctor won't order it, and I'll probably have to see a specialist. You'll have to ask your doctor if they will order the test or if you need to see a gastroenterologist first to get the test.


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## gingerbrown12872 (Oct 15, 2010)

I'd second the suggestion of the calcium. I am also hypothyroid & am currently experiencing either an IBS flare (which I have sometimes after having had my gallbladder removed!) or an episode of c-diff (long story







), and I could feel that I was not absorbing my synthroid properly for the 3 weeks the d flared up. I started the calcium & felt better immediately. If you need to take the medication that is used to treat hyperthyroid patients, you can adjust your synthroid (or whatever hypo med you take) accordingly. You've got to get the D slowed/stopped in order to absorb your thyroid meds & the calcium can help.


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