Bacteria?

I feel the diarrhea I've been having for several months now,  is somewhat different from the crohn's related diarrhea of several years?    I don't have the pain of an obstruction and my tummy is soft on examination, no fever, but the diarrhea is relentless. It consists of all fluid with a little bit of sediment, it goes around the clock and even wakes me up at night.  I go a little, walk away and back I am in the washroom.   Will I ever have a bowel movement that is even a little denser in consistency without it being all fluid?  Outside of feeling drained and exhausted, I don't have any particular symptoms.  Could it be bacteria or would I be feeling very sick with it?   I should mention that I have been treated for bile Acid diarrhea in the past after surgery, but even the Questran isn't firming it up?

So sorry you are going through all that. I know how exhausting that must be. I agree with Gumby and would make sure to get stool cultures asap if you haven't already. I have been having reoccurring cdiff for a couple months now. It all started from a 10 day course of Flagyl. Took Vanco it went away, then came back worse so I'm on Vanco taper plus florastor now. Hopefully you will get some answers soon!

Yes, you will need either a plastic hat to put in the toilet or you can even do it with saran wrap. But when the stools are fluid, it is the best time to test for it. I would not wait another three weeks with severe D. I think you should call your GI on Monday morning and ask them to order stool cultures immediately. Or you can go to the emergency department, but only if your GI refused to do it. It's one thing to say you have D, but it's another to have "relentless D" that is all fluid. Either you have an infection or Crohn's flare, or they need to work harder to find medication that will help bile acid D.

It sounds like it could be c-diff but hopefully once they test your stool (I believe with the complaint of diarrhea they check for any possible bacterial strains that could cause it) otherwise they may chalk it up to being irritable bowel syndrome since sadly that can coexist with IBD as well.

Good luck, I hope it turns out to be something easy to fix.

Ask for protoza culture test too.

Crohn's is linked to excessive bile acid production and poor conversion into secondary bile acids that can be utilized and re-absorbed in the ileum.

The first thing I would do is cut simple sugars out of your diet. This creates excessive bile acid production which can lead to malabsorption and an environment conducive to growth of bad bacteria such as C. Diff.

"Refined sugars, on the other hand, mediate the overgrowth of opportunistic bacteria like C. difficile [54] and C. perfringens by increasing bile output [55]. "
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3448089/

One thing that can help with this is Taurine supplementation, as Taurine is the amino acid to which primary bile acids are exposed and converted into secondary. It's been shown to help improve disease activity index levels. When bile acids are conjugated into secondary bile acids they are more water soluble, they work better to digest food and can be re-absorbed in the ileum more effectively.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1411649/?page=1

Cholestyramine may be effective but you'll need a prescription.

Psyllium husks have also worked for me on reducing / preventing sugar-induced diarrhea and bile but it's no replacement for a proper diet limitation.

If you tolerate psyllium husks well you may want to try polydextrose or other RS supplements like ON's Fitness Fiber.
http://ajcn.nutrition.org/content/72/6/1503.full

I don't know much about cholestyramine admittedly.
Taurine didn't work for me but it's worth a try, psyllium husks and low to zero sugar diet worked pretty darn good.

I can cheat on it with psyllium husks though, just gotta be careful when / how much.

You may be able to rebuild you gut bacteria to protect against invasive bacteria and prevent diarrhea. It will require a multiple step approach. I believe that following the guidance of the SCD or AID-IBD diets might work, but here's an outline from my blog on some ideas on how diet can work to rebuild proper gut balance.

It's not as detailed or complete as SCD or AID-IBD though but lays down some of the principles for what feeds what bacteria:
https://beyondtheoddsfitness.wordpress.com/2015/07/07/eat-away-those-food-intolerances/

Admittedly I focus a lot on firmicutes and not on bifido bacteria which are also important, but the diet should benefit both.