Sorry in advance... VERY long post!
I'm 46M and I've had a sensitive gut for more than 20 years. I've seen more 37 GI doctors, across 5 states, had my first colonoscopy at 25 years old, and by January 2025 I had undergone my 10th colonoscopy, along with approximately 4–5 upper endoscopies and a ridiculous amount of other testing including 2 camera pill to swallow.
But I'm posting because what has happened from September 2024 through today (August 31, 2026) feels different from the GI problems I've dealt with most of my life.
Since around September 2025, my baseline has generally become 2–7 bowel movements a day, predominantly Bristol 6–7, severe urgency, very dark brown stool, and more recently this strange oatmeal-like/mushy consistency.
I'm currently being evaluated at Mayo Clinic, and honestly, Mayo seems to be running out of ideas too.
What really has me scratching my head are several things that have temporarily made the diarrhea dramatically better or completely disappear: becoming more hypothyroid, colesevelam, and now Percocet/Robaxin after ankle surgery.
Quick background – I've been dealing with GI issues for 20+ years
I've had what I'd call a sensitive stomach since my early 20s.
I had my first colonoscopy at age 25.
In my 20s, though, my actual bowel habits were considerably more normal than they are today. My stools were generally around Bristol 3–4 and eventually became more like 4–5 as I got older.
I've essentially never been a constipated person.
More importantly, I used to have bowel control.
Even if I needed to go, I could generally hold it until I got somewhere convenient. That's honestly one of the things I miss the most.
I also don't have two symptoms that seem extremely common in IBS discussions: chronic abdominal pain and chronic bloating.
My problems are much more about loose stool, frequency and especially URGENCY.
In 2012, I had a total thyroidectomy with a neck dissection/lymph node removal.
After surgery I became profoundly hypothyroid before my thyroid replacement was adjusted. went from 240 surgery weight to 315 in a matter of 6 months. my TSH was 12.9 and I was sleeping roughly 19 hours a day. Once my replacement dose was changed to generic to name brand and was increased, I eventually got pushed pretty hard in the opposite direction and developed palpitations, elevated blood pressure and a lot of diarrhea.
That was probably my first indication that my bowel function was very sensitive to thyroid status.
Around 2015 is when the IBS and diarrhea really hit home for me.
I went through an absolutely insane period where, at its worst, I was going to the bathroom upwards of 20–25 times a day. I think a lot of it had to do with anxiety for some reason, but not a lot of things in my life at that time was changing. No new relationships, job was the same, finances were fine... I couldn't pin point my issues (anxiety).
Sometimes I'd have such an overwhelming urge to go that I'd sit down and basically nothing would come out because there was nothing left. It felt like my rectum/bowel was still trying to evacuate something that wasn't there.
I was prescribed Lomotil as a rescue medication but rarely used it.
A lot of those episodes happened while driving. I'd randomly have to pull over and literally run into the woods to use the bathroom.
This was really the period when IBS/diarrhea became a significant part of my life.
The extreme 20–25-times-a-day period didn't continue indefinitely, though. By 2016 things were settling down considerably and my bowel habits became much more manageable.
By 2017–2018, things were actually pretty good.
The following years were generally manageable too. I still considered myself someone with a sensitive stomach/IBS, but I wasn't continuously dealing with the kind of severe diarrhea and urgency I had experienced in 2015–2016.
I traveled, went about normal life, and don't remember the kind of constant bathroom emergencies or severe urgency that now dominate my life.
So while 2015–2016 is when IBS really hit home for me, there was a substantial period afterward where things were much better.
Doctors essentially settled on IBS/IBS-D because nothing else adequately explained it.
By January 2025, I was on colonoscopy #10, plus approximately 4–5 upper endoscopies and extensive other testing.
For the most part, everything has been remarkably reassuring.
That's the 20+ year background.
What I'm really trying to figure out starts around September 2024.
2012 – Thyroidectomy and the first major change
In 2012, I had a total thyroidectomy with neck dissection/lymph node removal.
After surgery, I became profoundly hypothyroid. I went from about 240 lbs at surgery to 315 lbs within roughly six months, my TSH reached 12.9, and I was sleeping close to 19 hours a day.
My thyroid replacement was eventually switched from generic to brand name and increased. That ultimately pushed me pretty hard in the opposite direction, with palpitations, elevated blood pressure and a lot of diarrhea.
Looking back, that was probably my first indication that my bowel function was very sensitive to thyroid status.
2015–2016 – When IBS really hit home
Around 2015 is when the diarrhea and IBS problems really started for some reason.
I went through an absolutely insane period where, at its worst, I was going to the bathroom upwards of 20–25 times a day.
Anxiety seemed to be involved somehow, but I could never figure out why. Nothing significant in my life had changed—same job, finances were fine—so I couldn't pinpoint where the anxiety or GI explosion was coming from.
Sometimes the urge was so overwhelming that I'd run to the bathroom, sit down...and basically nothing would come out because there was nothing left. It felt like my rectum/bowel was still desperately trying to evacuate something that wasn't there.
I was prescribed Lomotil as a rescue medication, but rarely used it.
A lot of these episodes happened while driving. I'd suddenly have to pull over and literally run into the woods to use the bathroom.
This was really the period when IBS/diarrhea became a significant part of my life.
The extreme 20–25-times-a-day period didn't continue indefinitely, though. By 2016 things were settling down considerably, and my bowel habits became much more manageable.
2017–2023 – Things became much more manageable
After the major 2015–2016 period, things improved substantially. I still had IBS and intermittent loose stools/diarrhea, but I wasn't continuously dealing with anything resembling the severe urgency and predominantly Bristol 6–7 pattern I have now.
I had a number of relatively normal years where IBS was still part of my life, but it wasn't dominating my life.
The major change I'm trying to understand seems to begin again around 2024.
September 2024 – Diverticulitis with a microperforation
While in the Bahamas in September 2024, I suddenly developed severe abdominal cramping and significant abdominal distention/bloating. Again, 1 Imodium for the flight, landed and had some bad food. Imodium + bad food trying to leave my body, the Imodium was doing its job at keeping food in equals a disaster.
This was VERY unusual for me because chronic abdominal pain and bloating aren't normally my problem.
After returning home, I was diagnosed with diverticulitis with a microperforation.
Thankfully, I didn't require surgery.
After that episode, I would occasionally get a very specific kind of cramp. I'd suddenly get an intense abdominal cramp and, usually within about 60 seconds, I'd either pass a substantial amount of gas or have diarrhea. As soon as that happened, the pain disappeared. Those episodes used to happen every few months but fortunately have become much less frequent.
September 2025 – Something fundamentally changes
This is where my current problem really begins.
Around September 2025, my bowel pattern changed substantially.
Since then, I've generally been having 2–7 bowel movements per day, predominantly Bristol 6–7.
And the urgency is off the charts.
When I say urgency, I don't mean:
"I should probably find a bathroom."
I mean VERY short notice.
Years ago, even when my stool wasn't perfect, I generally had enough control to delay going until I got somewhere convenient...5-10 min and I'd be okay but not now.
Now my body sometimes gives me almost no negotiation time.
More recently, the stool itself has developed a strange appearance that's become remarkably consistent.
The best description I can give is oatmeal-like.
Very soft/mushy, poorly formed and with this weird texture rather than simply being straight liquid every time.
The stool has also generally been a very dark brown.
At this point, Bristol 6–7, dark brown, oatmeal-like stool and severe urgency have basically become my normal.
November 2025 – Extensive stool testing finds basically nothing
Because this was continuing, I had an extensive stool workup on November 15, 2025.
The GI PCR panel was negative for essentially everything tested, including multiple bacterial, viral and parasitic causes of diarrhea.
Among them were Campylobacter, C. difficile toxin A/B, Salmonella, Shigella/enteroinvasive E. coli, multiple diarrheagenic E. coli strains, Vibrio, Yersinia, Giardia, Cryptosporidium, Cyclospora, Entamoeba histolytica, norovirus, rotavirus, adenovirus, astrovirus and sapovirus.
Traditional cultures found no Salmonella, Shigella or Campylobacter.
E. coli Shiga toxin was negative.
Ova and parasite examination found no ova, cysts or parasites in the specimen.
There were no white blood cells seen in the stool.
A separate C. difficile cytotoxin B test was negative.
My fecal pancreatic elastase was >800 µg/g, with >200 considered normal.
So that entire infectious/parasitic/pancreatic workup basically gave us nothing to explain what was happening.
2026 – I end up at Mayo Clinic
I started working with Mayo Clinic in 2026 and I'm still undergoing evaluation.
So far, bloodwork and other testing have generally been normal/reassuring.
Nobody has given me a convincing explanation.
And at this point, Mayo seems to be running out of ideas too.
That's not meant as a criticism of Mayo. There's only so much you can do when test after test keeps coming back normal.
But it's a big reason I'm now throwing this entire ridiculous history onto Reddit.
Then I accidentally discovered something interesting with my thyroid
My TSH had been hovering around approximately 2.3, which is generally considered perfectly reasonable.
But knowing how much diarrhea I experienced when my thyroid replacement pushed me too far in the other direction years ago, I started wondering:
What if a TSH of 2.3 is technically normal, but my gut behaves differently at that level? When looking at my records which I do blood work every 3-4 months measuring TSH since Sept 2012. I have over 50 blood work ups in the past 14 years and 2.3 on paper, didn't have any recorded diarrhea issues (I'm pretty meticulous about writing every little thing down).
I essentially performed an experiment on myself and allowed myself to drift more hypothyroid. I stopped working out/walking and I started to eat a lot of fast food. I gained only 3 lbs and noticed an overnight immediate change.
- The bowel urgency basically disappeared.
- My stools became firmer.
- Frequency decreased.
- Suddenly I felt like I had bowel control again.
When I checked my thyroid labs, my TSH was approximately 5.9.
April 3rd 2026 – Colesevelam almost feels like a miracle
Then something else happened.
In early April, I was preparing for a motorcycle trip to Arizona.
My diarrhea and urgency were awful, and obviously having 30 seconds to find a bathroom doesn't work particularly well when you're riding motorcycles all day.
I contacted my colorectal surgeon and was prescribed colesevelam, a bile-acid sequestrant that's primarily a cholesterol medication but is also used for bile-acid diarrhea.
Because of timing/interactions with my other medications, I couldn't take the full regimen. I could essentially only take about half the intended dose, around the middle of the day.
I don't normally eat lunch either, so I wasn't even taking it with a regular meal.
And yet...
Within about a day, something changed dramatically.
- My diarrhea improved.
- My stool became more like Bristol 4–5.
- Frequency dropped.
- Most importantly:
- The urgency dramatically decreased.
By around day three, I was genuinely emotional about it.
After dealing with this for so long, it felt like somebody had handed me my life back.
I remember thinking:
Holy crap! We found it. It's bile-acid diarrhea.
Except apparently it wasn't going to be that simple.
Arizona – For 2 weeks I'm almost normal again
I continued taking colesevelam throughout the trip.
There were several other differences from my normal life.
During the motorcycle portion of the trip, breakfast and dinner were generally chef-prepared meals. Some were foods I would never normally make for myself. Overall, the food was healthier and heartier than my usual diet.
I also wasn't drinking my normal iced latte.
During approximately a week of riding, I think I had maybe one or two episodes where I needed a bathroom and had loose stool.
But even those were completely different.
It was:
"Okay, I need to find a bathroom."
Not:
"I have 30 seconds before we have a serious problem."
That distinction is ENORMOUS for me.
April 15–17 – I come home and within 48 hours it's back
I returned to Orlando around April 15.
On April 16, I resumed normal life: usual breakfast, normal iced latte, normal routine.
By April 17, the diarrhea and urgency were back.
Multiple bowel movements. Bristol 6. Severe urgency.
It was almost like I wasn't taking colesevelam at all.
The transition happened incredibly fast.
I tested the obvious coffee/milk theory
My morning iced latte routine is extremely consistent and has been for years.
Same basic recipe, same Fairlife whole milk, same ingredients.
So I stopped the coffee/milk combination for several days.
No meaningful improvement.
The diarrhea continued.
But simply removing my latte did not reproduce what happened in Arizona.
Here's another thing I can't explain – even water, white rice and chicken can result in diarrhea
This is why I've struggled to identify a reliably “safe” food.
I can eat something obviously unhealthy and get diarrhea.
But I can also eat plain white rice and get diarrhea.
I can eat plain chicken and get diarrhea.
Even drinking water can trigger bowel activity/diarrhea for me.
Sometimes it feels less like what I'm eating and more like the simple act of putting something into my GI tract causes everything to start moving.
And I've noticed the opposite too.
If I substantially reduce my food and fluid intake and become dehydrated: The diarrhea can and will almost always stop.
I know dehydration isn't healthy. I'm absolutely not presenting that as a treatment.
Unfortunately, there have been important times when I've actually resorted to it.
If I'm going somewhere with friends or family — for example, spending the day at the parks — I'll sometimes intentionally avoid eating and drinking because it's the only way I feel confident I can leave the house.
So I'll be out trying to enjoy myself while hungry, thirsty and eventually dealing with a dehydration headache, simply because I'm afraid that eating or drinking will start the diarrhea.
That's the level to which the urgency has affected my life.
August 11, 2026 – Steel Cut Oats
Multiple doctors have told me for years to add soluble fiber.
I've bought Metamucil multiple times and then basically let it sit in the house.
My thinking was always:
“I already have diarrhea. Why would I add fiber and make myself poop even more?”
I've since learned that's an oversimplification and that soluble fiber can absorb water and potentially help form loose stool.
So on August 11, I started eating steel-cut oats every single morning.
And I've actually stuck with it.
Today is August 31, and I've eaten steel-cut oats every morning for 20 straight days.
I've also continued drinking my iced latte every morning.
Here's why those dates become interesting:
From August 11 through August 20, I was eating the oats every morning and I still had my usual diarrhea.
Then August 21 arrived.
August 21–31 – Ankle surgery, Percocet...and suddenly my poop is NORMAL
On August 21, I had ankle surgery.
I've basically been stuck at home on one foot ever since and was prescribed Percocet (oxycodone/acetaminophen) for pain and Robaxin (methocarbamol) as a muscle relaxant.
And my diarrhea basically disappeared.
I went from my usual:
- 2–7 bowel movements/day
- Bristol 6–7
- Severe urgency
- Very dark brown
- Oatmeal-like/mushy
to:
- ONE bowel movement a day.
- Well formed.
- No diarrhea.
- And even the color went back to what I consider normal-looking brown.
I honestly haven't consistently seen my poop look this normal since my 20s/early 30s.
And this has continued.
Because I'm stuck at home recovering, my diet has actually been unusually boring and consistent.
Every morning I'm still eating the same steel-cut oats I've been eating since August 11.
I'm still drinking my iced latte every morning.
I'll usually have a small snack during the day while I'm home and having nurses rotate through for my post-op check-ins.
Dinner has generally been something simple like chicken with sweet potatoes or chicken with rice.
Remember, I've eaten chicken and rice before and gotten diarrhea.
I've even had water trigger diarrhea.
So I can't simply say:
"Well, I completely changed my diet after surgery and that's why everything got better."
I didn't.
The oats were already there for 10 days before the diarrhea stopped.
The latte is still there.
Chicken and rice are still there.
Here's the part that REALLY caught my attention.
I can brush my teeth, and NO I'm not swallowing the toothpaste and within min. I have to rush to the bathroom with urgent oatmeal diarrhea, almost level 7.
I stopped taking the post-op medications for one day.
The next day?
The diarrhea came back.
The stool went right back to being loose and very dark brown, basically like it was before surgery.
I started taking the medications again.
And it went right back to:
One well-formed, normal-looking brown bowel movement a day.
And that's where I am today, August 31.
I completely understand that oxycodone is an opioid and opioids are notorious for slowing intestinal motility and causing constipation.
I'm not suggesting Percocet as a long-term treatment for diarrhea.
But here's what I find so interesting:
I'm not constipated.
I'm still going every day.
It's almost like slowing my GI tract down has taken it from whatever the hell it normally does and put it back into normal gear.
So...what the hell am I missing?
This is the pattern I can't stop thinking about:
- More hypothyroid → diarrhea and urgency dramatically improve.
- Colesevelam → diarrhea and urgency initially dramatically improve.
- Percocet → diarrhea disappears, 2–7 bowel movements/day becomes ~1/day, stool becomes well formed, and the very dark brown color changes back to normal-looking brown.
Meanwhile:
- Eating can trigger diarrhea.
- White rice can trigger diarrhea.
- Chicken can trigger diarrhea.
- Water can trigger diarrhea.
- Reducing my dehydrating myself can essentially stop it.
And now I've had this accidental little experiment where I ate steel-cut oats + my normal iced latte for 10 days and continued having diarrhea, then continued eating/drinking those exact same things while taking my post-op medications and suddenly my bowel movements normalized.
I know the obvious answer to the Percocet part is:
“Opioids slow your gut. Of course the diarrhea stopped.”
Yes. I completely understand that.
But that's actually part of my question.
Why does slowing my gut repeatedly seem to take me from severe diarrhea/urgency 4x a day, mushy oatmeal, I have 15 seconds to make it to the bathroom all the way back to what looks and feels like normal bowel function, normal color, ZERO urgency and sometimes maybe skipping a day to poop?
Medications I've already tried
Rifaximin – 2026: Tried it for the diarrhea/IBS symptoms.
Colesevelam – 2026: Tried it with the dramatic initial response I described above, although the improvement didn't last after I returned home. 2 weeks taking only 3 pills at lunch time because I could not take the full 6 pills because of medicine dosing times and possible issues over overlap.
Lomotil – around 2015: This was prescribed when my more serious IBS/diarrhea problems first started. I took it very rarely back then and haven't taken it since.
Imodium
- 2015 - 2016 - Not effective at all, then I was given Lomotil which worked.
- 2000-2024 - I could take one pill and it would work for me, make me stop using the bathroom for 1-3 days and then I would have explosive diarrhea following. Would help with just fly days, from having an accident on the plane.
- October 2024 - was asked to not take it anymore due to my diverticulitis diagnosis.
- 2026 Arizona Trip - 6-8 pills every 24 hours every single day while in Arizona for 9 days straight before introducing Colesevelam and it didn't even slow my gut down at all. Still having 3-10 diarrhea episodes per day.
Actual Data
One advantage of dealing with this for so long is that I actually have years of bowel movement data.
I started formally tracking on February 6, 2016, shortly after the extreme diarrhea/urgency period I went through in 2015. My older Poo Keeper records contain 3,182 logged bowel movements through March 20, 2025.
There is an important caveat, though.
I was pretty diligent about logging everything when I first started, but somewhere around 2018 I became less consistent. So I don't consider the totals from those middle years an accurate count of every bowel movement I had. They're still useful for seeing what my stool looked like, but not necessarily for measuring frequency.
In 2025, I started using a different tracking app that I really liked, and I became much more consistent about recording everything again.
That's where the numbers get interesting.
2025 — 703 recorded bowel movements
Bristol 1: 7
Bristol 2: 11
Bristol 3: 13
Bristol 4: 41
Bristol 5: 223
Bristol 6: 344
Bristol 7: 64
2026 through August 31 — 492 recorded bowel movements
Bristol 1: 2
Bristol 2: 0
Bristol 3: 2
Bristol 4: 27
Bristol 5: 144
Bristol 6: 266
Bristol 7: 51
The part that really stands out to me is the change in what is “normal” for my body.
In the older records, Bristol 3–4 stools were common. In the recent records, they're almost nonexistent. In 2026, I've recorded only 29 Bristol 3–4 stools compared with 461 Bristol 5–7 stools.
So when I say my bowel pattern has changed over the years, I'm not relying entirely on memory. I actually have a ridiculous amount of data showing the shift.
Location Data - 2015 - 2026
Number of times I've had to pull over on the side of the road and crap right next to the car while on the highway with zero privacy: 103
Number of times I've had to pull over on the side of the road and run into the woods to post up next to a tree with some level of privacy: 87
Number of times I've crapped myself because I simply couldn't make it to a bathroom: 4
Number of times I've crapped myself in the car and the damage was too great and I ended up salvaging the car and getting a new one: 1
Number of times I've almost crapped myself but couldn't get my clothes off fast enough while sitting in first class bathroom and crap was everywhere in the bathroom: 1
Number of times I've had to jump out of the pickup line at a major airport because I knew I wasn't going to make it and post up next to a 100% public tree while cars are passing by seeing me completed naked crapping all over a tree/ground: 1