Can’t digest foods anymore, what’s going on?

Unresolved stomach issues, can’t digest anything, specifically fats it seems

Hi, I’m a male in my twenties.

Have seen 7 GPs, done all the blood tests (including for food allergies, celiac disease, enzymes, metabolism, etc etc), seen psychologists and done all the gastrointestinal examinations (Colonoscopy once with biopsies, gastroscopy three times with biopsies, MRI and CT of abdomen + pelvis, test for bacterial overgrowth), tried everything from diet (eliminated food after food, can't eat gluten, dairy, eggs, coconut baking, corn / tortilla chips, anything with a lot of fiber nuts, seeds, sesame , crisps & foods with a lot of fat). I have tried everything I can myself regarding lifestyle and my own reading about IBS / intestine.

Experiencing this and it seems to get worse every year:

If I eat nuts, coconut products, corn chips, I get severe pain in the middle of the abdomen (burning / stabbing + pressure), constant pressure in the entire abdomen, and gas. I have to go to the bathroom after this (the stool in this case is hard and slimy)

If I eat something with a lot of fibre, e.g. chickpeas, oats, seeds, beans, I get a feeling of fullness in the abdomen and pressure and have to go to the bathroom after this too and then the stool is more porridge-like or watery. It causes a feeling of something “stuck” in lower abdomen even after bowel movement. Eggs, mayonnaise and crisps cause diarrhea or more watery stools.

It seems that I can tolerate less and less, have really tried to just give in and eat but it doesn't work. No matter what I do, there is constant pressure and discomfort in my stomach. I can't sleep until I've managed to empty myself because of the pressure that comes after I eat, and it usually happens in the evening (it takes time for my stomach to go if I stick to a safe diet)

The constant discomfort / pressure in the stomach makes it very difficult to empty the bladder and it takes time.

About three years ago I started experiencing constant mild leakage of stool. One year ago I started to experience leakage of urine e.g. if I bend over, sneeze, cough, it leaks for several hours after I have gone to the toilet. It is possible that this is due to a weak pelvic floor due to straining to defecate, which is again due to IBS (be aware that this can happen, those of you who struggle with constipation / hard / slow stools!)

I’ve tried diet after diet, not sure what is going on. I’ve been trying HCl betaine supplements but it’s not doing anything. Digestive enzymes also didn’t do anything. I’ve been on PPIs (somac / nexium / omeprazole etc) for almost eight years and I’ve for the longest time suspected this has ruined my stomach but I did successfully do about two weeks without them but saw virtually no improvement. I couldn’t do longer because reflux is severe and it took a month of tapering down to get here.

Chicken, rice products, potatoes, vegetables in general seem to be best tolerated. My diet consists of rice porridge, whatever fruit is available and whatever dinner is available. I may have to cut rice and all sugars because whenever I eat those I feel very sleepy / like a zombie / feel “drugged” and much less sharp (yes had all glucose relevant blood tests and they are all normal, only have slightly elevated C-peptide which the doctor said truly doesn’t contribute to my symptoms).

Does anybody have any idea what could be going on here / what can I try / anybody share similar experiences?

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