For more than a month I've been having digestive issues

Patient

Q: For more than a month I've been having digestive issues. Bloating/flatulence but I've started seeing a change in my stools. my stools come out normal at times but sometimes they float, break apart, and release bubbles until a thin layer of tiny foamy bubbles forms on the toilet. Sometimes there's only a small area of the toilet covered by bubbles but sometimes it's the whole toilet. I've noticed that whenever there's no bubbles, my stools come out normal. I've cut out lactose from my diet for the past few weeks. What could be causing this? I'm also taking digestive enzymes but the problem came from before I started taking them. Thanks.

Symptoms:  Foamy stools, bloating, flatulence
Doctor

A:   Hi.

Thanks for your query. Read the history of having digestion disturbance and varied forms of stools, foamy sometimes and otherwise as you have explained.
The foam is due to release of gas by the gas producing bacteria in the stool. This indicates that the normal flora of bacteria in your intestines is disturbed and hence you have the said problems.
I would advise in such a situation the following:
- First of all get teh investigations of stool, blood and urine, ultrasonography.
-Get a course of an antibiotic and metronidazole of 5 days and add on the following:
-Activated charcoal tablet,
-Probiotic and pre-biotic in combination to restore the normal bacterial flora.

I hope this should help you. Further tests and investigations may be necessary if required.

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