Positive fecal fat

Fat malabsorption shouldn't happen with well-controlled UC.

Have you had blood tests to check for celiac disease?

If celiac is negative, the next things to focus on are the gallbladder and pancreas.

Have you had an ultrasound of your gallbladder and/or an MRI of the gallbladder and pancreas (called an MRCP)?

I would push for MRCP.

q

My Lipase is 409 (upper range value 393) which was 31 when I was diagnosed with UC last year.
My GGT is 64 (upper range value 55). This is the 1st time I see GGT when they tested liver. Previously I only had albumin, bilirubin, globulin, AST, ALT tested. I guess it depends on the lab what they add to hepatic panel?

Should I be concerned about Lipase and GGT being elevated or this is something to do with IBD and considered to be expected since the value is not 2x or 3x?

The doctor told me the results, he didn't have an explanation. We will continue with the plan to test the small intestine when insurance approves. According to our best friend google elevated GGT may also be caused by alcohol abuse or use of drugs that are toxic to the liver.
I don't drink. I am on Entyvio only. I started to take Health Concerns supplement (liver and gallbladder formula) 1.5 weeks before I did the blood test. This formula is helping with bloating, gas, and I have formed stool. Prior to that I tried 'Enzymedica Digest Basic + Probiotics' for a week which kind of helped with bloating and gas but not stool. Do you think these supplements could've altered the blood work results?

Looking down
The pain is in the front below my rib cage 1/3 right from my left side and curves down to the left ending ¼ from my side a bit up from belly button level. The pain refers to my left shoulder blade. A lot of times the pain is pretty strong under my shoulder blade. The pain definitely worsens after food ~30 mins after I start eating. It hurts right now, radiates to my left shoulder blade and it has been 3 hours after I ate. It hurts all day long with different severity. Not sure if all of this makes sense. Too bad can not draw here or attach a picture.

I am sure it is not muscular. I get a lot of other pains on the left and they are spasms (which are not so bad atm as the supplement I am taking is helping) but the pain that radiated to my shoulder blade is not spasmatic. It worsens with food and disappears if I skip lunch but comes back after dinner. I really have to take a long brake from food for that pain to calm down (like skip lunch). I was thinking may be this is stomach since I did have erosions during my endoscopy in Dec 2020. I took PPI though for a longer time and the stomach pain settled down so I thought it healed. I am concerned about my pancreas. I am not sure how pancreas pain feels like. Since the MRI was normal my GI is not in the rush to do anymore image tests including MRCP.
GI didn't even want to do amylase and lipase blood work for which I asked a while ago and kept asking at each visit. When I went to get my Entyvio infusion I asked the nurse to check as it was time for a regular blood work they do every 6 months while on biologic.
Seems like MRI and/or MRCP will show tumors, cysts and blockages. I don't think they show an inflammation unless it is a very bad one and walls get swollen. If it was bad the pain would be excruciating and I would end up in the hospital. If this is just a small inflammation I am not sure how to check. The trick is to catch it early whatever it is.
The plan is to have a capsule endoscopy to check the small bowel. I am worried. I read some older posts in this forum about the capsule getting stuck.

I would push for an MRCP...still.
q

I’m on entyvio and have only had my levels checked once. My drs thinking is to test only if there are problems or symptoms.

For the erosive gastritis, what have the biopsies there shown? That would be important to know.

Do you take NSAIDs like aspirin or ibuprofen? Do you drink a lot of alcohol? Those can cause erosive gastritis.

Other causes are h. pylori infection (the bacteria that causes stomach ulcers can also cause gastritis), or Crohn's disease (I have Crohn's in my stomach that causes mild gastritis), and something called Zollinger-Ellison syndrome.

Those last two (Crohn's and Zollinger-Ellison) could lead to fat malabsorption. The MRCP is a good thing - it should help diagnose Z-E in the unlikely event that that is what you have.

One last question: How far did they go in for the upper endoscopy? Did they enter and view the entire duodenum? If so, was that clear?

I dont think MRCP will diagnose esophageal issues...it's a biliary MRI..but your GI could also request it be imaged at the same time. Did you have biopsies of your esophagus and stomach?... looking forward to the results.

q

GloriaD said...

I am still waiting for biopsies. I don't take NSAIDs. If needed I take tylenol. I don't drink alcohol. I drink only water and herbal tea. I specifically asked my GI if I have Crohn's in my stomach. He said from what he saw I don't have it. But again it is one person/GI opinion.

beave, how did they determine you have Crohn's in your stomach?

I asked my GI after procedure about esophagus and duodenum since only antral erosions were listed. GI said both were fine. This was EGD not ERCP. Don't they always include duodenum as the last point with EGD?

I started PPI today. I was on famotidine 20mg X 2 a day for a month prior + very bland diet (rice, potatoes, oat meal, cream of wheat, boiled or grilled chicken, fish, overcooked greens, cooked carrots, bread, gluten free brown rice pasta, water and camomile tea). My diet has been boring since last year. The picture of antrum looks horrific on the picture, completely erosive.

Let us know what the biopsy report says when you get it.

With upper endoscopies, they usually go into the duodenal bulb (the very first part), but they may or may not go past that.

For me, the doc did a push enteroscopy through the stomach and all the way through the duodenum, into the beginning of the jejunum. Visible inflammation was seen in the duodenum and was confirmed on biopsies. The stomach looked ok but biopsies showed inflammation there too, consistent with Crohn's.