Fat Malabsorption-* Updated question for belleenstien*

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WantRelief
Regular Member


Date Joined Feb 2006
Total Posts : 261
   Posted 3/5/2008 8:28 AM (GMT -7)   
I was reading in another post about fat malabosorption... is this a common occurance after resection?  I've noticed that I have floaty poo and sometimes it looks like little puddles of oil floating on top of the water.   Can someone explain this to me in more detail?  If my body is not abosorbing fat from the food I eat, does this mean weight loss may result or is that wishful thinking?


31year old female
CD of Terminal Illeum and Rectum Diagnosed 12/04
Unable/Unwilling to use immunosuppressents due to Melanoma history in 2000.
Illeocolonic Resection 1/08  (18 inches of terminal illeum, illeocecal valve, right colon and appendix)
Current Meds: Pentasa, Fosomax, Iron, Vitamin b12 injections, Vicodin, Flagyl

Post Edited (WantRelief) : 3/5/2008 7:00:38 PM (GMT-7)


MikeB
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Date Joined Mar 2006
Total Posts : 1169
   Posted 3/5/2008 8:48 AM (GMT -7)   
Basically yes to all of the above. If your poop continues to exhibit this evidence of malabsorption, I would mention to your GI.

Sarita
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Date Joined Mar 2005
Total Posts : 2486
   Posted 3/5/2008 8:50 AM (GMT -7)   
You very well may be malabsorbing fats if you've had a resection. Fat absorption is a complicated process but when you remove part of the intestine, you decrease the surface area in there that allows for full digestion. I think the main problem with malabsorption is that you will tend to lose the fat-soluble vitamins that you ingest as part of your diet (vitamins A, D, E, K) and so you should talk with your physician about how best to avoid deficiencies in these. Weight loss may or may not result based on what you're eating and how much intestine is gone...so I think your main concern at this point would be getting the nutrients you need and then the weight loss you can worry about later :)
Co-moderator - IBS Forum


dunny2
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Date Joined Jan 2007
Total Posts : 3200
   Posted 3/5/2008 9:40 AM (GMT -7)   
Vitamin B 12 as well. That seems to be the most common and sometimes serious...
Vicky

Too many years with CD
Two bowel resections, several obstructions.


Laughter is the brush that sweeps the cobwebs from our hearts


belleenstein
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Date Joined Feb 2007
Total Posts : 1010
   Posted 3/5/2008 12:20 PM (GMT -7)   
I don't think that the problem with fat-malabsorption, as far as diarrhea is concerned, for people with TI resections has anything to do with vitamin deficiencies. Theoretically the treatment itself could cause vitamin k deficiencies because it binds the fat as it binds the bile salts, making some fat soluable vitamins even less available.

The terminal ileum is where bile acids, excreted by the gall bladder/liver to aid in digestion, are reabsorbed back into the body. When the system works right it is very efficient. The reabsorbed bile acids actually recirculate back to the liver where they are reused. When enough of the terminal ileum is damaged or removed, the bile acids aren't re-absorbed through the bowel wall. Left to exit into the colon these bile acids pull in excessive water and salt to the colon and cause a kind of diarrhea that is called steatorrhea. It is typically identified by its large volume, greasy, oily appearance and smell. And is often preceded by loud explosive rumblings in the large bowel. Cholestyramine binds to the bile acids and neutralizes the laxative effect.

It is true that people with extensive terminal ileum resections also have problems absorbing many micro-nutrients but I don't think that is the cause of this particular problem with diarrhea.
Belleenstein:

30+ years living with Crohn's.


MikeB
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Date Joined Mar 2006
Total Posts : 1169
   Posted 3/5/2008 12:24 PM (GMT -7)   
Ballen, I think the point re B12 is that the same area which, when removed, inflamed or scarred, is responsible for fat absorption is also where B-12 and other nutients are taken up. So if you have fat malabsorption due to that you may also need to watch for B12 deficiency.

belleenstein
Veteran Member


Date Joined Feb 2007
Total Posts : 1010
   Posted 3/5/2008 12:36 PM (GMT -7)   
Point taken Mike, but taking b-12 or other vitamins will not reduce the diarrhea caused by fat-malabsorption.
Belleenstein:

30+ years living with Crohn's.


WantRelief
Regular Member


Date Joined Feb 2006
Total Posts : 261
   Posted 3/5/2008 4:50 PM (GMT -7)   
Belleenstein, you mentioned smell in your previous post. I know poop stinks but what kind of smell are you talking about?
31year old female
CD of Terminal Illeum and Rectum Diagnosed 12/04
Unable/Unwilling to use immunosuppressents due to Melanoma history in 2000.
Illeocolonic Resection 1/08  (18 inches of terminal illeum, illeocecal valve, right colon and appendix)
Current Meds: Pentasa, Fosomax, Iron, Vitamin b12 injections, Vicodin, Flagyl


belleenstein
Veteran Member


Date Joined Feb 2007
Total Posts : 1010
   Posted 3/5/2008 8:53 PM (GMT -7)   
Everyone experiences these things differently, but I think I would have to say foul in a way that is different from normal. Normal stool, even for us crohnies sort of smells like well, poop! I just find when I've had a high-fat meal or haven't taken my cholestyramine the stool smells more cloying. Rancid? I keep wanting to say sickly sweet, but that's not right. Sorry I'm at a loss for words. maybe someone else can do a better job.
Belleenstein:

30+ years living with Crohn's.


WantRelief
Regular Member


Date Joined Feb 2006
Total Posts : 261
   Posted 3/6/2008 1:53 PM (GMT -7)   
I got ya...I've been thinking my bm's had a "sweet" sort of odor to them.  I know exactly what you are talking about...Thanks!

31year old female
CD of Terminal Illeum and Rectum Diagnosed 12/04
Unable/Unwilling to use immunosuppressents due to Melanoma history in 2000.
Illeocolonic Resection 1/08  (18 inches of terminal illeum, illeocecal valve, right colon and appendix)
Current Meds: Pentasa, Fosomax, Iron, Vitamin b12 injections, Vicodin, Flagyl

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