Dr. Anil Bellur Seetharam, MD

Mucus in the stools may be a result of colonic inflammation or hemorrhoids. There are other possibilities. If these abnormalities have been persistent, would make an appointment to see a gastroenterologist.

Stool may become more acidic in the context of lactose intolerance or an infection. Next steps depends upon your symptoms. Would review these results with your PCP and if you are having GI symptoms ask them about a referral to a gastroenterologist.

Transit through the intestine and the color, content and caliber of our stools are highly variable. Would speak to your PCP about obtaining basic laboratory workup to rule out infection and assess your blood sugars.

It is reassuring that you have had a high quality colonoscopy within the last year. Also reassuring that there is no blood in your stool. Certainly there has been some stress, and this can affect frequency or character of bowel movements. Would consider increasing dietary fiber bulk stools more and perhaps avoid excessive caffeine or gum chewing (if you do those things) and monitor. If changes persist would review these issues with your primary care. Another consideration would be to keep a food diary, tracking what you eat and any subsequent bowel movement characteristics to look for patterns.

Blood in your stools is a concerning symptom and warrants a discussion and further investigation with your physician. Would make an effort to stay very well hydrated with water and contact your primary care physician.

Association with between certain foods can occur; however, sometimes results are not as predictable as we would like. Would suggest a diary of reflux symptoms after association with various foods to idetify any particular triggers. Avoidance of "spicy foods," caffeine, tomato sauce etc. is often suggested and this certainly can be tried as well

There are several options for acid supression. Medicines such as proton pump inhibitors (omeprazole, pantoprazole, esopmeprazole) can be good options when taken 30 minutes to an hour before meals. Another class of medicines works on a different pathway to acid suppress and can be helpful as well: famotidine. It's not clear that there is a "best" option and sometimes takes trial and error. If symptoms of upset stomach persist despite a trial of antacid for a few days would seek advice from your physician.
Anil Seetharam MD

Water and bland foods, bread, rice, apple sauce, toast may all be applicable. Would avoid caffeine or dairy while your stomach is upset. Sometimes, ginger ale or sprite may be good. If you feel dizzy, lightheaded, have diarrhea, or fever, would consult with your physician as soon as possible.

Blood in the stools is always concerning. Would recommend you go to an emergency room for physical exam and laboratory evaluation

Colonoscopy is the best test available for colon cancer screening. It’s utility in the workup of abdominal pain depends on the specifics of your pain and associated findings. If you have symptoms that are in line with diverticulitis, then it’s likely more appropriate to consider imaging of the abdomen and antibiotics before pursuing colonoscopy. Other associated symptoms such as blood in the stool may warrant more urgent endoscopic evaluation. A key first step is to meet with a gastroenterologist to review the characteristics of your abdominal pain; together you can determine the best course of action.

Gas pains and bloating are common and these symptoms may occur at any time of the day or night. Sometimes, they occur as a result of ingestion of particularly gas forming foods. If gas pain is recurring at night, a good first step would be to review intake for dinner and any snack thereafter. Minimization of particularly “gassy” foods at these times may alleviate discomfort. In addition, one must review the time of their ingestion to the time of laying down for bed. If this difference is only 30 minutes to an hour, this may precipitate gas. Try to space out at least 3 hours from last ingestion to laying down. If symptoms persist despite a trial of above, would discuss in detail with your provider.

Antibiotics may be associated with diarrhea for a number of different reasons. Use may be associated with diarrhea as a side effect. In addition, certain antibiotics may alter bacterial populations in the colon; allowing certain pathogenic (diarrhea causing ones) to overpopulate. An example of this would be clostridium difficile infection which may occur during or after discontinuation of certain antibiotics. If diarrhea or abdominal pain persists one should seek attention with a provider who can test for this in the stool.

Stomach ulcers can be very troubling as a source of both pain and internal bleeding. When identified during an endoscopic evaluation, your physician may counsel you on various strategies to promote healing.

One of the cornerstones of gastric ulcer healing is acid suppressors and these generally should be taken twice a day (often about 30 minutes before breakfast and dinner) for about 2 months...though this should be reviewed with your physician. In addition, sometimes a bacteria called Helicobacter pylori can cause gastric ulcers--this may require antibiotics along with acid suppressant medicines. Common offending medicines such aspirin, ibuprofen, or aleve can cause ulcers and these may need to be stopped. Ideally, avoidance of inhaled tobacco and excessive alcohol will help as well. Lastly, if your GI doctor identifies gastric ulcers on endoscopy, he or she may want to repeat an upper endoscopic exam about 3 months from the last exam to make sure things are healing as they should.

Abdominal pain can be complicated. Would consider making a diary of your symptoms, specifically what you feel, when you feel it, and if there is any change in character or intensity with things like deep breaths, meal ingestions, movements of your body or bowel movements. Identifying patterns can help your provider localize where the discomfort may be coming from and help generate a management plan if the discomfort persists.
Anil Seetharam MD

In our experience, many feel an improvement in abdominal symptoms/bowel habits within 3-4 weeks. Many feel dramatically better after 3-4 months. Some of the anatomic/architectural changes in the small bowel may take a bit longer. It's key to review dietary ingestions for any "hidden" forms of gluten. Thoughtful review with a nutrionist can be very helpful.