[30M] Experiencing gastrointestinal symptoms including bloating and excessive gas

Patient Description

A 30-year-old male has been experiencing gastrointestinal symptoms for approximately 4 to 5 months. The patient reports daily excessive gas that is consistent throughout the day and has a stronger odor than usual. He also experiences bloating, described as a feeling of fullness in the lower abdominal region, which improves after large bowel movements. Additionally, the patient has floating stools that are normally colored and consistent but tend to float, and occasionally greasy stools, particularly after periods without bowel movements. The patient has a history of occasional constipation, which has been a lifelong issue. There has been no unintentional weight loss, skin rashes, or changes related to the gastrointestinal symptoms. The patient is currently taking Lexapro (20 mg) and has been on this medication for a few years. No known drug allergies or adverse reactions to medications have been reported.

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Arora's Assessment

What might be happening

Based on the information provided, possible diagnoses include:

  • Exocrine Pancreatic Insufficiency (EPI): This condition occurs when the pancreas doesn't produce enough enzymes to digest food properly. Symptoms can include greasy or floating stools, gas, bloating, and occasional constipation.

    • Treatment typically involves pancreatic enzyme replacement therapy (PERT), which helps the body absorb fats and other nutrients.
  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine and can cause bloating, gas, and changes in bowel habits.

    • Treatment often includes lifestyle modifications such as changes in diet and stress management. Medications may also be prescribed to manage symptoms.
  • Malabsorption syndromes: These are conditions in which the body cannot absorb nutrients from food. Symptoms can include gas, bloating, and floating or greasy stools.

    • Treatment typically involves addressing the underlying cause and supplementing the nutrients that the body is unable to absorb.

Please note that these are just possibilities and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

What you can do

  1. Keep a food diary: This can help you identify any foods that may be contributing to your symptoms.
  2. Stay hydrated: Drink plenty of fluids to help prevent constipation.
  3. Eat a balanced diet: Include a variety of fruits, vegetables, lean proteins, and whole grains in your diet.
  4. Exercise regularly: Physical activity can help stimulate intestinal function and reduce symptoms of constipation and bloating.
  5. Consult a healthcare provider: They can provide a definitive diagnosis and appropriate treatment.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe or worsening abdominal pain
  • Blood in your stool
  • Unintentional weight loss
  • Persistent or severe diarrhea
  • Symptoms that interfere with your daily activities or quality of life

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for accurate information.

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1 yr ago

Top picked over-the-counter products for Irritable Bowel Syndrome: American College of Gastroenterology Guidelines

People Also Ask


What causes floating stools and should I be concerned?

Floating stools can be caused by excess gas or malabsorption of nutrients, such as fats. While occasional floating stools are usually not a concern, persistent changes should be evaluated by a healthcare provider to rule out conditions like malabsorption syndromes or pancreatic issues.


How can I manage excessive gas and bloating?

Managing excessive gas and bloating can involve dietary changes, such as reducing intake of gas-producing foods (like beans and carbonated drinks), eating smaller meals, and avoiding swallowing air by eating slowly. Regular exercise and staying hydrated can also help. If symptoms persist, consulting a healthcare provider is recommended.


What is Exocrine Pancreatic Insufficiency (EPI) and how is it treated?

Exocrine Pancreatic Insufficiency (EPI) is a condition where the pancreas does not produce enough digestive enzymes, leading to symptoms like greasy stools, gas, and bloating. Treatment typically involves pancreatic enzyme replacement therapy (PERT) to aid digestion and nutrient absorption.


Can Lexapro affect my digestive system?

Lexapro, an antidepressant, can sometimes cause gastrointestinal side effects such as nausea, diarrhea, or constipation. However, it is not commonly associated with symptoms like floating stools or excessive gas. If you suspect Lexapro is affecting your digestive system, discuss this with your healthcare provider.


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