@kmc123 There are many pathologies of the GI tract that can manifest causing diarrhea. When a physician is not taking an approach to making a diagnosis that will then lead to treatment for resolution, this is the time to switch providers and find a specialist.

One of the first tests that should be done is a fecal elastase test. This measures the production and secretion of digestive enzymes. If there is impairment as indicated by a value below 200 micrograms elastase/gram stool, that indicates a pancrealipase such as Creon or Zenpep is required.

In patients that have pancreatic cancer and/or HD. Whipple resection, it can be the cause of Exocrine Pancreas Insufficiency (EPI). Maintaining a sufficient level of enzymes with meals will resolve the diarrhea. With respect to Imodium, I never had the desired effect when taking that OTC product. What did provide relief before I was prescribed a pancrealipase was an Rx anti-diarrheal medication. The one’s I found efective were Loperimide, Lomax, Lomotil and the inexpensive generic diphenoxylate atropine.

Other GI pathologies that can be present complicating a diagnosis are Small Intestine Bacterial Overgrowth (SIBO), Lactose Intolerance, Gluten sensitivity, Crohn’s disease, ulcerative colitis, diverticulitis, INS/IBD and a few other conditions. If this has been going on for a long time, you need to advocate for yourself and escalate this up to being seen at a comprehensive cancer center in the GI department. These large centers have a higher level of expertise and diagnostic tools to evaluate.

I learned how to strongly advocate for myself when I initially worked as a medical technologist in a hospital clinical diagnostic laboratory. From my contact with patients, the term I heard over and over is to know when to cut your losses and move on. I learned this lesson well and why I survived stage IV pancreatic cancer and achieved clinical cure. I learned for anything serious or ongoing, you need to find an a specialist at/a major center.