Dr. Golam Mortuza (General Practice) needs a second opinion on this medical case.
C/O : Foamy and oily stool for more than 1 Yr.
1. Stool is foul smelling. Complete evacuation occurs after at least 3 defecations. Food particles remain in present though patient can't say the type of the food present.
2. Increased acidity with sour feeling inside the mouth.
3. Increased thirst.
4. Appetite and food intake are normal.
5. Weight loss present (patient couldn't say how much weight he lost.)
6. Patient can't understand in which type of food he faces such problems.
7. Joint pain, fever, constipation, pain abdomen are absent. No blood in stool seen.
8. Already taken treatment for IBS-D with no result.
What is your provisional diagnosis and ddx? Discuss the cost effective approach and treatment. Prognosis?