Lots of talk about lots of stool here! Didn't know it was quite so exciting.
A few thoughts Robin Hood:
- if you eat a lot and a lot of fiber (salads, grains, etc), you're gonna shit a lot. Doesn't mean it's not getting absorbed.
- If you're lean, and assuming muscular, you will have a high metabolic rate and go through a lot of calories.
- The small bowel (duodenum, jejunum, ileum) absorbs our nutrients. The colon, as mentioned above is mostly to deal with water in the colon and compact / store things en-route. Thus, small bowel inflammation and diarrhea will be associated with malnutrition, but large bowel inflammation usually produces watery stools, but not much malnutrition.
- Crohn's disease and ulcerative colitis are inflammatory bowel diseases and can onset in early adulthood. Irritable bowel disease can affect lots of people, but doesn't have a specific anatomical, inflammatory problem in the bowel like the others above.
- a "bleeding ulcer" is usually in the distal part of the stomach or 1st part of the duodenum at the stomach outlet. But ulcerations can occur throughout the GI tract and can bleed. If you were older, bleeding in the bowel could indicate a bowel cancer. And yes, bleeding ulcers often DO occur in the absence of significant stress. It is now known to be strongly related to an infection called "H. pylori" (helicobacter), thus treated not only with acid-lowering drugs like losec, pepcid, etc. but also antibiotics and bismuth subsalicylate ("triple therapy"). Do keep in mind that small amounts of blood in the gut really speeds up transit time in the gut and can give diarrhea. If there is much bleeding it is often quite black and smelly (melena). That can be ruled out with a test for blood in the stools. Also, may be worth considering taking losec or similar and maybe having a gastroscopy to rule out another ulcer. Make sure you see your doc about it if you think that's the problem. He / she can also check you're albumin, iron, electrolytes, etc. in your blood to see that protein, minerals, etc are being absorbed into the blood from the GI tract.
- Supplements like creatine, high-concentration electrolyte drinks, etc. can also cause osmotic diarrhea. Their presence holds water with them and takes it out of the bowel instead of getting absorbed. If I use more than half-strength gatorade on long runs or rides I get the shits bad.
- "heartburn" is often used to describe acid reflux back up into the esophagus, giving a burning in the throat or acid in the mouth. That is different from typical gastric / duodenal ulcer pain. DU pain is usually a vague, achy feeling in upper abdomen and often feels like it is 'boring' through to your back. You often will not have acid reflux with this, as they are 2 different mechanisms. Food often makes GU pain worse, but relieves the pain of a DU.
